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执业护士在初级保健中为成年患者提供营养咨询的经历。

Nurse practitioner experiences providing nutrition counseling to adult patients in primary care.

作者信息

Eaton Maggie, Duffy Lisa, Pozzar Rachel, Board Rhonda

机构信息

Bouvé College of Health Sciences, School of Nursing, Northeastern University, Boston, Massachusetts.

Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Department of Medical Oncology, Harvard Medical School, Boston, Massachusetts.

出版信息

J Am Assoc Nurse Pract. 2022 May 1;34(5):738-747. doi: 10.1097/JXX.0000000000000712.

Abstract

BACKGROUND

Poor nutrition is one of the leading risk factors for preventable chronic diseases in the United States. Nutrition counseling has been shown to improve clinical outcomes in the adult primary care setting. Nurse practitioners (NPs) can help fill the critical need for nutrition counseling, yet little is known about their role providing nutrition counseling.

PURPOSE

To describe the primary care NP's experience in providing nutrition counseling to adult patients in primary care practice.

METHODS

Qualitative descriptive study design. Data were collected through virtual semi-structured interviews with 18 board-certified primary care NPs. Interviews were audio-recorded, de-identified, transcribed verbatim, and analyzed. Data collection and analysis took place concurrently and continued until data saturation was achieved.

RESULTS

Five themes emerged from NPs' descriptions of their experiences in providing nutrition counseling to adult patients in primary care practice: (1) role of nutrition counseling in NP primary care practice; (2) developing NP self-efficacy in nutrition counseling; (3) nutrition counseling is more than the provision of information; (4) emotional aspect of nutrition; and (5) barriers to behavior change.

CONCLUSIONS

Findings suggest that although NPs understand the importance of nutrition counseling in primary care practice and provide it in some capacity, its continuance is limited by multiple barriers. Future research should evaluate ways to enhance NPs' preparedness to provide nutrition counseling, assess specific resources and tools to aid in nutrition counseling, and determine best practices for communication when delivering nutrition counseling.

IMPLICATIONS FOR PRACTICE

Future interventions have the potential to positively affect patients' dietary practices and improve clinical outcomes.

摘要

背景

营养不良是美国可预防的慢性疾病的主要风险因素之一。营养咨询已被证明可改善成人初级保健环境中的临床结果。执业护士(NPs)可以帮助满足对营养咨询的迫切需求,但对于他们在提供营养咨询方面的作用知之甚少。

目的

描述初级保健执业护士在为初级保健实践中的成年患者提供营养咨询方面的经验。

方法

定性描述性研究设计。通过对18名获得委员会认证的初级保健执业护士进行虚拟半结构化访谈收集数据。访谈进行了录音、去识别化处理、逐字转录并进行分析。数据收集和分析同时进行,持续到达到数据饱和。

结果

执业护士对其在初级保健实践中为成年患者提供营养咨询的经历描述中出现了五个主题:(1)营养咨询在执业护士初级保健实践中的作用;(2)培养执业护士在营养咨询方面的自我效能感;(3)营养咨询不仅仅是提供信息;(4)营养的情感方面;(5)行为改变的障碍。

结论

研究结果表明,尽管执业护士理解营养咨询在初级保健实践中的重要性并在一定程度上提供了营养咨询,但其持续性受到多种障碍的限制。未来的研究应评估提高执业护士提供营养咨询准备程度的方法,评估有助于营养咨询的特定资源和工具,并确定提供营养咨询时的最佳沟通方式。

对实践的启示

未来的干预措施有可能对患者的饮食习惯产生积极影响并改善临床结果。

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