Crowley Jennifer, Ball Lauren, Wall Clare, Leveritt Michael
Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Aust J Prim Health. 2012;18(2):90-5. doi: 10.1071/PY11116.
The prevention and management of chronic disease is a key priority for primary care services. Nutrition-related care is an integral feature of several best practice guidelines for management of chronic disease in the general practice setting. This paper critically reviews the international literature to enhance the nutrition knowledge, skills and overall capacity of GPs to provide nutrition care using examples from nutrition in medical education, continuing medical education, GP-centred and practice-setting approaches. The medical nutrition education approach provides an opportunity for linear translation between desired nutrition competencies and curriculum learning objectives, while that of continuing medical education allows for tailored nutrition education to increase nutrition competencies once a learning need is identified. The GP-centred approach focuses on the determinants of nutrition care provision by GPs as strategies for enhancing nutrition care delivery, whereas the practice setting approach aims to increase the nutrition-related exposure to patients through avenues independent of the GP. In the Australian and New Zealand context, the potential appropriateness of these approaches requires judicious consideration, as it is unlikely that one approach will comprehensively address this topic. Ongoing multifaceted evaluation of each approach is needed to ensure enhancement of GPs' capacity to provide nutrition care by increasing nutrition knowledge and skills, and improving patient health outcomes.
慢性病的预防与管理是基层医疗服务的关键优先事项。在全科医疗环境中，营养相关护理是多项慢性病管理最佳实践指南的一个重要组成部分。本文批判性地回顾了国际文献，以利用医学教育、继续医学教育、以全科医生为中心以及实践环境方法中的营养实例，增强全科医生提供营养护理的知识、技能和整体能力。医学营养教育方法为期望的营养能力与课程学习目标之间的线性转化提供了机会，而继续医学教育方法则允许在确定学习需求后进行量身定制的营养教育，以提高营养能力。以全科医生为中心的方法将重点放在全科医生提供营养护理的决定因素上，以此作为加强营养护理提供的策略，而实践环境方法旨在通过独立于全科医生的途径增加患者与营养相关的接触。在澳大利亚和新西兰的背景下，这些方法的潜在适用性需要审慎考虑，因为单一方法不太可能全面解决这一主题。需要对每种方法进行持续的多方面评估，以确保通过增加营养知识和技能以及改善患者健康结果来提高全科医生提供营养护理的能力。
