Mahony Georgia, Haracz Kirsti, Williams Lauren T
School of Health Sciences, University of Newcastle, Callaghan, NSW, Australia.
Aust Occup Ther J. 2012 Aug;59(4):294-301. doi: 10.1111/j.1440-1630.2012.01028.x.
Poor diet is a contributing factor to the high rates of obesity and related comorbidities in people with severe mental illness, and dietary change is a key treatment strategy. Providing healthy lifestyle interventions is a recognised role for occupational therapists. However, the existing literature fails to elucidate boundaries of this role. To begin to address this gap in the literature, this study explored the attitudes, actions and beliefs of mental health occupational therapists about providing diet-related interventions.
Semi-structured interviews were conducted with mental health occupational therapists working in one Area Health Service in New South Wales. Purposive sampling was used. Data were analysed using Constructivist Grounded Theory methods, where meaning is co-constructed by, and the theory ultimately grounded in the experiences of, the participant and researcher.
The participants felt confident providing clients with interventions to promote diet-related skill development and providing general healthy eating education to support this development. However, they were not comfortable providing clients with specific dietary advice. Participants identified a need for further training and support to enhance their effectiveness in providing healthy eating education and highlighted the need for more dietitians in mental health services.
The occupational therapists in this study identified clear boundaries of their role in providing diet-related interventions for people with severe mental illness. Suggestions for improvement in this area included further training for occupational therapists as well as increased access to dietitians for those services that lie outside the occupational therapy role.
不良饮食是导致重度精神疾病患者肥胖率及相关合并症高发的一个因素，而饮食改变是一项关键治疗策略。提供健康生活方式干预是职业治疗师公认的职责。然而，现有文献未能阐明这一职责的界限。为了填补这一文献空白，本研究探讨了心理健康职业治疗师在提供与饮食相关干预方面的态度、行为和信念。
对在新南威尔士州一个地区卫生服务机构工作的心理健康职业治疗师进行了半结构化访谈。采用目的抽样法。使用建构主义扎根理论方法对数据进行分析，即意义由参与者和研究者共同建构，理论最终基于参与者的经验。
参与者对于为客户提供促进与饮食相关技能发展的干预措施以及提供一般健康饮食教育以支持这一发展感到自信。然而，他们对于为客户提供具体饮食建议并不自在。参与者认为需要进一步培训和支持以提高他们在提供健康饮食教育方面的成效，并强调心理健康服务中需要更多营养师。
本研究中的职业治疗师明确了他们在为重度精神疾病患者提供与饮食相关干预方面的职责界限。该领域的改进建议包括对职业治疗师进行进一步培训，以及为那些超出职业治疗职责范围的服务增加获取营养师服务的机会。
