Parker Elizabeth Kumiko, Ashley Mellisa Anne, Moretti Courtney, Harris Deanne Maree, Stefoska-Needham Anita
Department of Dietetics and Nutrition, Westmead Hospital, P.O. Box 533, Wentworthville, Westmead, NSW, 2145, Australia.
Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.
J Eat Disord. 2022 Mar 18;10(1):40. doi: 10.1186/s40337-022-00567-0.
Timely diagnosis and treatment of eating disorders (EDs) are essential for achieving the best possible outcomes, and dietitians have an important role in the multidisciplinary team. ED-specific training has been shown to enhance the knowledge, mental health literacy and confidence of health professionals in providing patient treatment. However, the ED-specific training needs of dietitians have yet to be determined. This study aimed to explore the perceived readiness of dietitians and student dietitians to treat patients with EDs; to identify the key training components that would enhance their confidence in delivering ED-specific treatment; and to examine any barriers associated with engagement in ED-specific professional development.
A semi-structured question guide was developed by researchers to elicit information from six virtual focus groups consisting of a purposive sample of practising dietitians and student dietitians enrolled in their final year of an Australian tertiary accredited dietetic program. Members of professional organisations were approached to participate via email; and a recruitment flyer was promoted on various social media platforms. Discussions were recorded, transcribed verbatim and analysed qualitatively using inductive thematic analysis.
Thirty-eight participants (26 dietitians, 12 student dietitians) were recruited, mean age of 32.5 years ± 11 SD. Three major themes emerged: (1) reluctance to practice in EDs, which was associated with limited ED-specific training at university, lack of clinical guidelines, mental health complexities of patients with an ED, ambiguity regarding the dietitian's role, systemic complexities with ED care, and beliefs of health professionals; (2) the need for additional ED-specific training and clinical supervision both during and after university, with the focus on identification, assessment, management and treatment, mental health literacy, and counselling skills, identified as an essential component to improving professional confidence and competence; (3) limited awareness and access/supply of ED-specific training opportunities were found, which included the financial cost of training/clinical supervision, and limited access to suitable clinical supervision.
Dietitians currently practising in the workplace and dietetic students perceive that enhanced ED-specific training during university and after graduation is essential to work with patients confidently and competently with EDs. This research has implications for Australian university dietetic programs and workforce development. This study aimed to explore the perceptions and readiness of dietitians and student dietitians to treat patients with eating disorders (EDs); to identify the key training components that would enhance their confidence and competence in delivering treatment; and to examine any barriers associated with engaging in ED-specific professional development. Twenty-six dietitians and twelve dietetic students participated in six virtual focus group discussions, which identified three main themes: (1) reluctance to practice which was associated with limited ED-specific training at university, lack of clinical guidelines, mental health complexities of patients with an ED, ambiguity regarding the dietitian's role, systemic complexities with ED care, and beliefs of health professionals; (2) the importance of engaging in ED-specific training, beyond an introductory level, during university and after graduation to confidently and competently work with patients with EDs; (3) barriers to accessing further ED-specific training and clinical supervision were found, including poor awareness of training opportunities, high financial cost of training/clinical supervision, and limited access to obtaining suitable clinical supervision. Results from this study provide insight into the ED-specific training needs of practising and student dietitians. This research has value for university programs and workforce development.
及时诊断和治疗饮食失调症（EDs）对于取得最佳治疗效果至关重要，营养师在多学科团队中发挥着重要作用。针对饮食失调症的特定培训已被证明能提高医疗专业人员在为患者提供治疗方面的知识、心理健康素养和信心。然而，营养师针对饮食失调症的特定培训需求尚未确定。本研究旨在探讨营养师和实习营养师对治疗饮食失调症患者的感知准备情况；确定能增强他们提供饮食失调症特定治疗信心的关键培训内容；并研究与参与饮食失调症特定专业发展相关的任何障碍。
研究人员制定了一份半结构化问题指南，以从六个虚拟焦点小组中获取信息，这些小组由澳大利亚高等认可的营养学项目最后一年的在职营养师和实习营养师的目的抽样组成。通过电子邮件邀请专业组织的成员参与；并在各种社交媒体平台上推广招聘传单。讨论内容被记录、逐字转录，并使用归纳主题分析法进行定性分析。
招募了38名参与者（26名营养师，12名实习营养师），平均年龄为32.5岁±11标准差。出现了三个主要主题：（1）不愿从事饮食失调症治疗工作，这与大学期间针对饮食失调症的特定培训有限、缺乏临床指南、饮食失调症患者的心理健康复杂性、营养师角色的模糊性、饮食失调症护理的系统复杂性以及医疗专业人员的观念有关；（2）大学期间及毕业后需要额外的饮食失调症特定培训和临床监督，重点是识别、评估、管理和治疗、心理健康素养以及咨询技能，被确定为提高专业信心和能力的重要组成部分；（3）发现针对饮食失调症的特定培训机会的认识和获取/供应有限，这包括培训/临床监督的财务成本，以及获得合适临床监督的机会有限。
目前在职的营养师和营养学学生认为，大学期间及毕业后加强针对饮食失调症的特定培训对于自信且胜任地为饮食失调症患者提供治疗至关重要。本研究对澳大利亚大学营养学项目和劳动力发展具有启示意义。本研究旨在探讨营养师和实习营养师对治疗饮食失调症患者的看法和准备情况；确定能增强他们提供治疗的信心和能力的关键培训内容；并研究与参与饮食失调症特定专业发展相关的任何障碍。26名营养师和12名营养学学生参加了六次虚拟焦点小组讨论，确定了三个主要主题：（1）不愿从事相关工作，这与大学期间针对饮食失调症的特定培训有限、缺乏临床指南、饮食失调症患者的心理健康复杂性、营养师角色的模糊性、饮食失调症护理的系统复杂性以及医疗专业人员的观念有关；（2）在大学期间及毕业后参与入门级以上的饮食失调症特定培训对于自信且胜任地为饮食失调症患者提供治疗的重要性；（3）发现获取进一步的饮食失调症特定培训和临床监督存在障碍，包括对培训机会的认识不足、培训/临床监督的高财务成本以及获得合适临床监督的机会有限。本研究结果为在职和实习营养师针对饮食失调症的特定培训需求提供了见解。本研究对大学项目和劳动力发展具有价值。
