Den Hamer-Jordaan Gerlinde, Groenendijk-van Woudenbergh Geertruida J, Kroeze Willemieke, Troost Ellemijn, Haveman-Nies Annemien
Department of Nursing, Christian University of Applied Sciences (CHE), PO box 80, Ede, 6710 BB, The Netherlands.
Wageningen University & Research (WUR), Consumption & Healthy Lifestyles Group, PO box 9101, Wageningen, 6700 HB, The Netherlands.
BMC Nurs. 2024 Oct 21;23(1):774. doi: 10.1186/s12912-024-02403-z.
Community nurses (CNs) play an important role in supporting healthy lifestyles, including healthy eating behaviour of patients. However, many CNs do not incorporate healthy eating support in their daily routines to the fullest extent possible. This study aimed to explore (1) the associations between nurse-related behavioural determinants and self-reported healthy eating support practices of Dutch CNs and (2) CNs' need for additional knowledge.
In this cross-sectional survey design, 244 Dutch CNs completed an online, self-administered questionnaire in October-November 2021. The 60 questionnaire items were related to CNs' characteristics, nurse-related determinants, healthy eating support practices (observing problems, having a conversation about patients' dietary behaviour, motivating patients to eat and drink healthier and supporting patients in goal setting) and the need for additional knowledge. The items on determinants and practices used a 5-point Likert scale. Adjusted prevalence ratios (PR) with 95% confidence intervals (95%CIs) were obtained for the associations between determinants and practices, using adjusted Poisson regression with robust variance estimations.
More CNs practiced observing problems (75%) and having a conversation (70%) than did motivating patients (45%) and supporting goal setting (28%) at least often. A more positive attitude (PR 1.8; 95%CI 1.5-2.2), greater self-efficacy (PR 1.3; 95%CI 1.1-1.5), greater motivation (PR 1.5; 95%CI 1.3-1.7) and better abilities (PR 1.4; 95%CI 1.2-1.6) were associated with a greater prevalence of supporting healthy eating at least often (vs. never to sometimes). Barriers were not associated with healthy eating support (PR 1.1; 95%CI 1.0-1.2). CNs especially desired more knowledge on diet in relation to cancer, gastrointestinal diseases, severe psychiatric diseases and dementia; methods for motivating patients to start and for supporting patients to sustain healthy eating; and dealing with patient autonomy.
This study suggests that nurse-related behavioural determinants such as attitude, self-efficacy, motivation and ability should be addressed to improve CNs' competences in healthy eating support. In addition, based on self-reported need for additional knowledge, it is recommended to pay attention to evidence-based behaviour change techniques, dealing with patient autonomy, and diet in relation to cancer, gastrointestinal diseases, severe psychiatric diseases and dementia.
The STROBE Statement was followed for reporting.
社区护士在支持健康生活方式方面发挥着重要作用，包括患者的健康饮食行为。然而，许多社区护士并未在日常工作中充分纳入对健康饮食的支持。本研究旨在探讨：（1）荷兰社区护士与护士相关行为决定因素和自我报告的健康饮食支持实践之间的关联；（2）社区护士对额外知识的需求。
在这项横断面调查设计中，244名荷兰社区护士于2021年10月至11月完成了一份在线自填问卷。问卷的60个项目与社区护士的特征、护士相关决定因素、健康饮食支持实践（观察问题、就患者的饮食行为进行交谈、激励患者更健康地饮食以及支持患者设定目标）以及对额外知识的需求有关。关于决定因素和实践的项目采用5点李克特量表。通过使用稳健方差估计的调整泊松回归，获得决定因素与实践之间关联的调整患病率比（PR）及95%置信区间（95%CI）。
与激励患者（45%）和支持设定目标（28%）相比，至少经常进行观察问题（75%）和交谈（70%）的社区护士更多。更积极的态度（PR 1.8；95%CI 1.5 - 2.2）、更强的自我效能感（PR 1.3；95%CI 1.1 - 1.5）、更大的动力（PR 1.5；95%CI 1.3 - 1.7）和更好的能力（PR 1.4；95%CI 1.2 - 1.6）与至少经常支持健康饮食的更高患病率相关（与从不或有时支持相比）。障碍与健康饮食支持无关（PR 1.1；95%CI 1.0 - 1.2）。社区护士尤其希望获得更多关于癌症、胃肠道疾病、严重精神疾病和痴呆症相关饮食的知识；激励患者开始并支持患者维持健康饮食的方法；以及处理患者自主性的方法。
本研究表明，应关注态度、自我效能感、动力和能力等与护士相关的行为决定因素，以提高社区护士在健康饮食支持方面的能力。此外，基于自我报告的对额外知识的需求，建议关注基于证据的行为改变技巧、处理患者自主性以及癌症、胃肠道疾病、严重精神疾病和痴呆症相关的饮食。
遵循STROBE声明进行报告。
