General practitioners and gestational weight management

Fieldwick, Diana; Smith, Alesha; Paterson, Helen

doi:10.1080/01443615.2018.1530739

Cited by 5 publications

(6 citation statements)

References 23 publications

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“…Thus, it is not surprising that participants described encounters where women were prone to engaging in misinformation or may have exceeded gestational weight gain targets at the time of referral, thus increasing the risk of further medical monitoring and interventions later in gestation 25 . Our results are consistent with findings from a survey taken among general practitioners in NZ; primary care doctors reported it was uncommon for nutrition and weight management to be discussed with newly pregnant women due to limited time and knowledge of weight gain guidelines 26 . Considering many women seen in secondary care GDM services would have initially presented to a primary care provider with identifiable risk factors, a dearth of nutrition and lifestyle support available to women pre‐conception and in their first trimester of pregnancy is a blatant missed opportunity.…”

Section: Discussionsupporting

confidence: 90%

“…25 Our results are consistent with findings from a survey taken among general practitioners in NZ; primary care doctors reported it was uncommon for nutrition and weight management to be discussed with newly pregnant women due to limited time and knowledge of weight gain guidelines. 26 Considering many women seen in secondary care GDM services would have initially presented to a primary care provider with identifiable risk factors, a dearth of nutrition and lifestyle support available to women preconception and in their first trimester of pregnancy is a blatant missed opportunity.…”

Section: Discussionmentioning

confidence: 99%

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Health professionals' views and experiences around the dietary and lifestyle management of gestational diabetes in New Zealand

North

Crofts

Zinn

2022

Nutrition & Dietetics

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Aim: This study aimed to investigate New Zealand health professionals' views and experiences around the dietary and lifestyle management of gestational diabetes.Methods: Semi-structured interviews were conducted remotely with health professionals; sessions were recorded and transcribed. Core themes were extracted using inductive thematic analysis using a framework method. Results: Twenty-seven health professionals were interviewed (13 diabetes dietitians, 8 specialist diabetes midwives, 2 community midwives, 1 antenatal clinic midwife, 1 obstetrician and 2 endocrinologists). Themes were organised into three central domains: (a) Social and cultural barriers, (b) Service provision and (c) Nutrition advice. Enabling themes included professional collaboration, innovation and creating trusting and supportive environments. Key barriers identified included accessibility, cultural barriers, overwhelmed service, fragmentation and conflicting information and nutrition resource gaps.Conclusions: Findings highlight foremost a deficit in primary antenatal nutrition advice that may play a significant role in the fragmentation identified. Investment in community-inclusive services providing antenatal nutrition and diabetes education appears critical to overcome barriers associated with misinformation and poor outcomes. Pathways to include nutrition education from various primary care health providers should be investigated to ease the burden from specialist gestational diabetes clinicians and allow effective delegation of dietetic resources. Revision of current nutrition guidelines for the management of gestational diabetes in New Zealand is needed to facilitate consistent messaging and standards of care.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Health professionals' views and experiences around the dietary and lifestyle management of gestational diabetes in New Zealand

North

Crofts

Zinn

2022

Nutrition & Dietetics

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“… 8 , 22 However, uncertainty regarding an operational definition of basic nutrition care was reported by some primary healthcare practitioners, who found it difficult to differentiate their professional roles. 8 , 13 , 18 Clarification of the scope of practice of healthcare practitioners in relation to nutrition may relieve uncertainty and enhance confidence in the delivery of such information. 21 Professional associations could consider the development of a position statement or guiding principles to achieve this outcome.…”

Section: Discussionmentioning

confidence: 99%

“…Secondly, a recurrent sub-theme across the studies reviewed was the perceived value and impact of primary healthcare practitioners on patient health outcomes. 18 , 22 , 26 Perspectives were positive about the impact of dietary counselling on changing patients’ eating patterns, where healthcare practitioners strongly agreed that nutrition is a key determinant of health outcomes. 18 , 22 , 26 , 27 This concurs with the view of the WHO that the provision of nutrition services is associated with improved maternal, infant, and child health, a lower risk of chronic disease and improved life expectancy.…”

Section: Discussionmentioning

confidence: 99%

“… 18 , 22 , 26 Perspectives were positive about the impact of dietary counselling on changing patients’ eating patterns, where healthcare practitioners strongly agreed that nutrition is a key determinant of health outcomes. 18 , 22 , 26 , 27 This concurs with the view of the WHO that the provision of nutrition services is associated with improved maternal, infant, and child health, a lower risk of chronic disease and improved life expectancy. 33 Recognition of the crucial role of dietary interventions in the prevention and treatment of non-communicable diseases can influence the frequency of dietary counselling by primary healthcare practitioners.…”

Section: Discussionmentioning

confidence: 99%

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A review of primary healthcare practitioners’ views about nutrition: implications for medical education

Carter

Harnett²,

Krass³

et al. 2022

Int J Med Educ

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Objectives This study aimed to review literature that reports on the perspectives and opinions of Australian and New Zealand primary healthcare practitioners on their role in nutrition counselling of their patients. Methods A systematic search of relevant articles reporting on attitudes towards nutrition counselling by Australian and New Zealand doctors/physicians, nurses including midwives, pharmacists and dentists was conducted. The search included literature from the past ten years until March 2021 and identified 21 relevant papers, with most of the studies including medical practitioners and nurses. Results Three main themes were identified from qualitative and quantitative data, which included education and training, practitioner experiences and challenges. Consistent with previous literature, health care practitioners acknowledged their important role in the provision of dietary advice to patients. Challenges that influenced the provision of this advice included insufficient education and training, time constraints and limited knowledge and confidence. Time constraints during normal consultations led to a low priority of nutrition counselling. An absence of assessment opportunities to demonstrate nutrition competence and limited coverage of specific nutrition-related advice during training were also reported. Conclusions Primary healthcare practitioners acknowledge the importance of playing a role in the provision of nutrition advice but require education and access to evidence-based information that can be utilised effectively within the time constraints of standard consultations. Medical education curricula can be improved to provide more emphasis on nutrition education, including relevant assessment opportunities.

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