ABSTRACT
BACKGROUND: Little is known about how dietitians conduct their communication with individual patients in the process of nutrition education. To study this issue, both practitioners' and patients' perceptions of dietitians' skills were examined in the first phase of a two-phase study. The resulting narratives were used to develop a questionnaire to survey Australian dietitians involved in clinical practice. METHODS: A purposive sample of dietitians in one state (n = 46; 12%), working in hospital, community or private practice, and a quota of their adult patients (n = 34), were interviewed. In the second stage, Australian dietitians (n = 258; 16%) responded to a national survey in 2006, which asked about educational strategies, communication skills, and professional attributes. Descriptive statistics were used to compare response distributions, and nonparametric statistics were used to examine between-group relationships. Criterion for item acceptance was established as >or=70% agreement. Triangulation of results revealed strong agreement between data sources. RESULTS: Four main communication competencies were established: interpersonal communication skill, nonverbal communication, professional values, and counselling skill. There was no significant difference in practice by work category or experience. The communication competencies, together with 26 accompanying skills, are described. CONCLUSION: An understanding of this guide to communication practice might help enhance dietitian-patient relations.
Subject(s)
Communication , Dietetics , Professional-Patient Relations , Adult , Australia , Clinical Competence , Focus Groups , Humans , Patient Education as Topic/methods , Patient Satisfaction , Surveys and QuestionnairesABSTRACT
The phenomenon of adherence, also known as compliance, is the vital link that allows effective medications to have the desired clinical effect when self-administered. It is often assumed that the population is generally adherent, but more than 50% of people with chronic illness do not take their medication as prescribed. We highlight how the terminology and language of non-adherence act to conceptualize adherence as a patient problem in a manner that is inadvertently judgmental, narrowly focused and clinically unhelpful. In contrast, knowledge of the dynamic nature of adherence promotes the conceptualization of adherence as the common problem that it is, where the responsibility for improving it lies primarily with the health professional. The example of asthma is used to highlight how individually focused clinical strategies can fit within a population perspective that, in its entirety, can be conceptualized as a framework of adherence-promoting strategies.
Subject(s)
Patient Compliance , Patient Education as Topic , Self Administration/psychology , Adolescent , Asthma/drug therapy , Child , Chronic Disease , Drug Prescriptions , Humans , Patient Education as Topic/methods , Physician-Patient Relations , Terminology as TopicABSTRACT
Duration of breastfeeding was studied in 556 women delivering at 2 maternity hospitals in Perth, Australia. At discharge 83.8% of women were breastfeeding their infants, including 6% who were giving complementary feeds. At 3 and 6 months, 61.8% and 49.9%, respectively, were still breastfeeding. In a Cox survival analysis of factors associated with duration of breastfeeding a positive association was found with maternal education, age and intended duration of breastfeeding. Male infants were more likely to be weaned before female infants and women whose partners were unemployed, or did not have a preference for breastfeeding, breastfed for shorter duration. There is still a need for programmes which support and encourage breastfeeding, focusing particularly on younger, less well-educated women who intend to breastfeed for less than the recommended 4-6 months.
Subject(s)
Breast Feeding/statistics & numerical data , Adult , Attitude , Australia , Breast Feeding/psychology , Educational Status , Fathers/psychology , Female , Humans , Infant, Newborn , Longitudinal Studies , Male , Maternal Age , Odds Ratio , Sex Factors , Survival Analysis , TimeABSTRACT
OBJECTIVE: To identify factors that influence a woman's decision to breast-feed. METHODOLOGY: Five hundred and fifty-six women were recruited from the maternity wards of two Perth hospitals. Data were collected from a self-administered questionnaire completed by participants prior to discharge. Logistic regression analysis was used to determine factors influencing the initiation of breast-feeding. RESULTS: At discharge from hospital 83.8% of women were breast-feeding, including 6% who were giving complementary formula feeds. After controlling for potentially confounding demographic and biomedical factors, the father's reported preference for breast-feeding was found to be the most important factor influencing a woman's decision to breast-feed (OR 10.18). CONCLUSION: Fathers participate in and influence the choice of infant feeding method and should be included in breast-feeding discussions.
Subject(s)
Breast Feeding , Health Knowledge, Attitudes, Practice , Paternal Behavior , Adult , Attitude to Health , Australia , Breast Feeding/statistics & numerical data , Decision Making , Educational Status , Female , Humans , Logistic Models , Male , Multivariate Analysis , Occupations , Odds Ratio , Socioeconomic Factors , Surveys and QuestionnairesABSTRACT
Analysis of breast-feeding data from the 1989-90 National Health Survey suggests that since peaking in the mid-1980s, breast-feeding initiation and duration rates have declined in Australia. Data from a recent prospective study of infant feeding practices among 556 women indicates that in Perth, at least, breast-feeding rates have remained relatively stable for the past nine years.
