This article appears in the following Family Practice issue: Creating Supportive Environments for Nutrition Guidance: Towards a Synergy Between Primary Care and Public Health. Proceedings of the Fifth Heelsum International Workshop 10-12 December 2007. [View the issue table of contents]
Nutrition care for adult cardiac patients: Australian general practitioners' perceptions of their roles
a School of Exercise and Nutrition Sciences, Deakin University, 17 Champion Street, Black Rock, Victoria, Australia
b School of Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia
Correspondence to Sylvia EM Pomeroy, School of Exercise and Nutrition Sciences, Deakin University, 17 Champion Street, Black Rock, Victoria, Australia; Email: spomeroy{at}iprimus.com.au
Received 31 May 2008; Revised 25 October 2008; Accepted 31 October 2008.
 |
Abstract |
|---|
Background. Australia has implemented systematic managed care for patients with chronic disease. Little is known about how GPs perceive their nutrition care role in this system.
Objective. To examine GPs’ perceptions of their roles in the nutrition care of cardiac patients and to identify factors that influence their role.
Methods. Multi-methods research design. Semi-structured interviews were conducted with a sample (n = 30) GPs Victoria, Australia. The resulting narratives were used to develop a quantitative questionnaire to survey a random sample of GPs. Principal components analysis was conducted to reduce the role items to a small number of underlying dimensions. The association between roles and demographic variables were examined using stepwise multiple regressions.
Results. In all, 248 GPs (30% response) participated. Three main roles were established: Influencing, Coordinating and Nutrition Educator role. Together, the roles explained 54% of the total variance. Demographic variables were not associated with these roles. The majority (mean = 88%) endorsed the items which loaded on to the Influencing and Coordinating (mean = 49%) roles. Short consultation time, use of prescribed medications and perception of patient attendance at cardiac rehabilitation reduced the priority for nutrition education.
Conclusions. This study highlights the importance of developing more effective team care arrangements for patients with chronic disease and working with the medical education colleges to develop education resources for doctors that include an explanation of the non-pharmaceutical as well as the pharmaceutical treatment for each chronic disease condition.
Keywords. Dietetics, doctor–patient relationship, general practitioner, nutrition, primary care.
Pomeroy SEM and Worsley A. Nutrition care for adult cardiac patients: Australian GPs’ perceptions of their roles. Family Practice 2008; 25: i123–i129.