Beckingsale Louise, Fairbairn Kirsty, Morris Caroline
University of Otago Wellington, Department of Primary Health Care and General Practice, New Zealand.
University of Otago, Department of Human Nutrition, New Zealand.
J Prim Health Care. 2016 Dec;8(4):372-380. doi: 10.1071/HC16018.
INTRODUCTION Dietetic service delivery in primary health care is an emerging area of dietetic practice in New Zealand. AIM This paper aims to describe the dietetic services being delivered in this setting and dietitians' perceptions of the factors that have an effect on their ability to deliver an optimal service. METHODS Individual, qualitative, semi-structured, face-to-face interviews were conducted with 12 primary healthcare dietitians from a range of age, ethnicity and professional backgrounds. Interviews were audio-recorded, transcribed verbatim and analysed using inductive thematic analysis. RESULTS Participants were delivering a range of services including: providing nutrition care directly to patients, helping to upskill other primary health care professionals in nutrition, and delivering health promotion initiatives to their local community. Three key factors were identified that participants perceived as having an effect on their ability to deliver effective dietetic services in primary health care: being part of a multidisciplinary general practice team, having flexible service delivery contracts appropriate for the setting and that supported integration, and having an adequate level of dietetic experience. DISCUSSION Dietitians working in primary health care recognise the importance of being well integrated into a multidisciplinary general practice team. This enables them to deliver more collaborative and coordinated nutrition care alongside their colleagues, to benefit patient care. Establishing flexible dietetic service delivery contracts, which support integration and take into account funding and workforce capacity requirements, may help ensure that the unique skill set of a dietitian is utilised to best effect.
引言
在新西兰,初级卫生保健中的饮食服务是饮食实践的一个新兴领域。
目的
本文旨在描述在这种环境下提供的饮食服务,以及营养师对影响他们提供最佳服务能力的因素的看法。
方法
对12名来自不同年龄、种族和专业背景的初级卫生保健营养师进行了个人、定性、半结构化的面对面访谈。访谈进行了录音,逐字转录,并采用归纳主题分析法进行分析。
结果
参与者提供了一系列服务,包括:直接为患者提供营养护理,帮助提升其他初级卫生保健专业人员的营养技能,以及向当地社区开展健康促进活动。确定了三个关键因素,参与者认为这些因素会影响他们在初级卫生保健中提供有效饮食服务的能力:成为多学科全科医疗团队的一员,拥有适合该环境且支持整合的灵活服务提供合同,以及具备足够水平的饮食经验。
讨论
在初级卫生保健领域工作的营养师认识到充分融入多学科全科医疗团队的重要性。这使他们能够与同事一起提供更具协作性和协调性的营养护理,从而使患者护理受益。建立灵活的饮食服务提供合同,支持整合并考虑到资金和劳动力能力要求,可能有助于确保营养师的独特技能得到最佳利用。