Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.
Department of Endocrinology & Bariatric Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
J Hum Nutr Diet. 2021 Jun;34(3):494-503. doi: 10.1111/jhn.12855. Epub 2021 Jan 13.
Multi-component lifestyle interventions are the first line treatment for obesity. Dietitians are ideally placed healthcare professionals to deliver such interventions. However, only a small proportion of patients with obesity are referred by general practice to dietitians, and the reasons for this are not clear. The present study aimed to explore general practice healthcare professionals' (GPHCPs) experiences and perceptions of dietitians in the context of obesity management.
A convenience sample of GPHCPs practicing in the UK was recruited via a targeted social media strategy, using virtual snowball sampling. Data were collected using semi-structured interviews and analysed using framework analysis.
In total, 20 participants were interviewed (11 general practice nurses and nine general practitioners). Experiences of referring patients with obesity for dietetic intervention resulted in two main themes: (i) access barriers and (ii) the dietetic consult experience. Three themes emerged from participants' perceptions of a role for general practice dietitians: (i) utilising dietetic expertise; (ii) access to dietitian; and (iii) time. Participants experienced barriers to accessing dietitians for obesity management and felt that having a dietitian working within their general practice team would help address this. Having a dietitian embedded within their general practice team was perceived to have the potential to alleviate GPHCPs' clinical time pressures, offer opportunities for upskilling, and may improve patient engagement with obesity management.
GPHCPs perceived that embedding a dietitian within their general practice team would be valuable and beneficial for obesity management. Our findings provide support for the funding of general practice dietitian roles in the UK.
多组分生活方式干预是肥胖的一线治疗方法。营养师是提供此类干预措施的理想医疗保健专业人员。然而，只有一小部分肥胖患者被全科医生转介给营养师，其原因尚不清楚。本研究旨在探讨全科医疗保健专业人员（GPHCP）在肥胖管理背景下对营养师的经验和看法。
通过有针对性的社交媒体策略，使用虚拟滚雪球抽样，招募了在英国执业的方便样本的 GPHCP。使用半结构化访谈收集数据，并使用框架分析进行分析。
共采访了 20 名参与者（11 名全科护士和 9 名全科医生）。将肥胖患者转诊进行饮食干预的经验产生了两个主要主题：（i）准入障碍和（ii）饮食咨询体验。参与者对全科营养师角色的看法出现了三个主题：（i）利用饮食专业知识；（ii）获得营养师的途径；和（iii）时间。参与者在获得肥胖管理营养师方面遇到了障碍，并认为在他们的全科医生团队中增加一名营养师将有助于解决这个问题。在他们的全科医生团队中嵌入一名营养师被认为具有缓解全科医疗保健专业人员临床时间压力、提供技能提升机会的潜力，并可能提高患者对肥胖管理的参与度。
GPHCP 认为将营养师纳入他们的全科医生团队对于肥胖管理将是有价值和有益的。我们的研究结果为英国资助全科医生营养师角色提供了支持。
