Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, NSW, Australia.
Blackbird Initiative, Órama Institute, Flinders University, Adelaide, SA, Australia.
J Hum Nutr Diet. 2022 Jun;35(3):512-522. doi: 10.1111/jhn.12980. Epub 2022 Feb 10.
Dietetic involvement in eating disorder (ED) treatment is often initiated by other members of a patient's treating team. The present study aimed to examine the impact of patient characteristics on clinicians' decisions to involve a dietitian in a patient's ED treatment, as well as the influence of clinician characteristics on their decision-making.
ED clinicians were recruited to complete an online survey, which used case vignettes to assess their likelihood of referring patients to a dietitian or consulting with a dietitian for guidance. Questions were also included that measured clinician anxiety, beliefs about the therapy they deliver, beliefs about dietitians and views on evidence-based practice to determine whether these were related to their responses to case vignettes.
Fifty-seven clinicians completed the survey, with the largest group being clinical psychologists (n = 22, 39%). ED diagnosis, weight status, medical co-morbidities and progress in treatment were all shown to be influential on whether clinicians involved dietitians in ED treatment. Clinician characteristics and their beliefs about dietitians were generally not correlated with the likelihood of seeking dietetic input.
The present study indicates that clinicians' decisions to involve dietitians in ED treatment are systematic rather than random decisions influenced by individual clinician characteristics. Clinicians require further education on the potential for malnutrition regardless of patients' ED diagnosis or weight status, and the dietitian's role in addressing this.
饮食失调（ED）治疗中的饮食治疗通常由患者治疗团队的其他成员发起。本研究旨在探讨患者特征对临床医生决定将营养师纳入患者 ED 治疗中的影响，以及临床医生特征对其决策的影响。
招募 ED 临床医生完成在线调查，该调查使用案例描述来评估他们将患者转介给营养师或咨询营养师以获取指导的可能性。还包括询问临床医生的焦虑程度、他们所提供治疗的信念、对营养师的信念以及对循证实践的看法，以确定这些是否与他们对案例描述的反应有关。
57 名临床医生完成了调查，其中最大的群体是临床心理学家（n=22，39%）。ED 诊断、体重状况、合并症和治疗进展均被证明对临床医生是否将营养师纳入 ED 治疗中具有影响。临床医生的特征及其对营养师的看法与寻求饮食建议的可能性通常没有相关性。
本研究表明，临床医生决定是否让营养师参与 ED 治疗是系统的，而不是随机的决策，受到个别临床医生特征的影响。无论患者的 ED 诊断或体重状况如何，临床医生都需要进一步了解营养不良的可能性，以及营养师在解决这一问题中的作用。
