Doctors' attitudes and confidence towards providing nutrition care in practice: Comparison of New Zealand medical students, general practice registrars and general practitioners

Abstract

INTRODUCTION: Improvements in individuals' nutrition behaviour can improve risk factors and outcomes associated with lifestyle-related chronic diseases. AIM: This study describes and compares New Zealand medical students, general practice registrars and general practitioners' (GPs') attitudes towards incorporating nutrition care into practice, and self-perceived skills in providing nutrition care. METHODS: A total of 183 New Zealand medical students, 51 general practice registrars and 57 GPs completed a 60-item questionnaire investigating attitudes towards incorporating nutrition care into practice and self-perceived skills in providing nutrition care. Items were scored using a 5-point Likert scale. Factor analysis was conducted to group questionnaire items and a generalised linear model compared differences between medical students, general practice registrars and GPs. RESULTS: All groups indicated that incorporating nutrition care into practice is important. GPs displayed more positive attitudes than students towards incorporating nutrition in routine care (p<0.0001) and performing nutrition recommendations (p<0.0001). General practice registrars were more positive than students towards performing nutrition recommendations (p=0.004), specified practices (p=0.037), and eliciting behaviour change (p=0.024). All groups displayed moderate confidence towards providing nutrition care. GPs were more confident than students in areas relating to wellness and disease (p<0.0001); macronutrients (p=0.030); micronutrients (p=0.010); and women, infants and children (p<0.0001). DISCUSSION: New Zealand medical students, general practice registrars and GPs have positive attitudes and moderate confidence towards incorporating nutrition care into practice. It is possible that GPs' experience providing nutrition care contributes to greater confidence. Strategies to facilitate medical students developing confidence in providing nutrition care are warranted. KEYWORDS: General practitioner; health knowledge, attitudes, practice; medical education; nutrition therapy

Are doctors nutritionists? What is the role of doctors in providing nutrition advice?

“…; Crowley et al . ). However, they are not always able to translate this priority into practice and provide sufficiently detailed and sustained nutrition advice that results in meaningful changes (Kahan & Manson ).…”

“…A survey of New Zealand medical students, registrars and GPs suggested that confidence in providing nutrition advice was positively related to experience (Crowley et al . ). Thus a doctor's confidence in providing nutrition advice is likely to vary across their career and be dependent not only on their knowledge but also their specialty, and possibly their proximity to dietitians in their work environment.…”

“…Doctors acknowledge nutrition plays an important role in health and agree that providing nutrition advice is part of their role (Ball et al 2010;Kolasa & Rickett 2010;Mitchell et al 2011;Crowley et al 2015a). However, they are not always able to translate this priority into practice and provide sufficiently detailed and sustained nutrition advice that results in meaningful changes (Kahan & Manson 2017).…”

“…It is therefore understandable that doctors report having a lack of confidence and knowledge or indeed the complex skills required for effective, person-centred nutrition counselling (Mitchell et al 2011;Kahan & Manson 2017). A survey of New Zealand medical students, registrars and GPs suggested that confidence in providing nutrition advice was positively related to experience (Crowley et al 2015a). Thus a doctor's confidence in providing nutrition advice is likely to vary across their career and be dependent not only on their knowledge but also their specialty, and possibly their proximity to dietitians in their work environment.…”

General practitioners’ views on providing nutrition care to patients with chronic disease: a focus group study

“…One study has demonstrated that they feel confident to provide some aspects of nutrition care but are less confident with others. 17 However, the quantitative approach of this research allowed limited insight into why confidence to provide nutrition care is variable. Using a qualitative approach, another study reported that New Zealand GPs feel responsible for supporting patients in weight management, yet disempowered by their ability to do this.…”