Promoting change in clinical care.

Stocking, Barbara

doi:10.1136/qshc.1.1.56

Cited by 94 publications

(50 citation statements)

References 2 publications

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“…This supports previous research which has emphasised a role for learner centred approaches to changing professionals' behaviour. 16,17 Therefore, in terms of bringing about change, both types of educational package appeared to in¯uence both practice nurse and patient outcomes. However, the results indicate differential effects of the different approaches with the style of package determining the type of change.…”

Section: Discussionmentioning

confidence: 99%

The relative effectiveness of two styles of educational package to change practice nurses' management of obesity

Ogden¹,

Hoppe²

1997

Int J Obes

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OBJECTIVE: To examine the impact of two styles of educational package on practice nurses' management of obesity. SUBJECTS AND MEASURES: A questionnaire was completed by 66 practice nurses concerning their obesity related beliefs and the content and style of their weight related practices before and one month after being randomly allocated to either the`learner centred' group (who received a lea¯et and were invited to attend an interactive seminar), the`expert group' (who received the lea¯et) or the control group. At the one month follow up, practice nurses were also asked to give a brief questionnaire to ®ve consecutive patients, who they saw for weight loss advice, concerning the content and style of the consultation. After 6 months, practice nurses, and patients were sent a questionnaire about their consultation style and weight loss, respectively. RESULTS: The packages had no differential effects on practice nurses' beliefs about obesity. However, practice nurses in the`learner group' reported spending longer on their consultations and being more patient centred. Their patients rated themselves as more satis®ed with the consultation and reported that they were offered calorie controlled diets less often. In contrast, practice nurses in the`expert group' reported giving weight loss advice more frequently, being less patient centred and their patients reported greater con®dence in, and likelihood of, weight loss and reported that they were more likely to be offered traditional weight loss interventions. The packages had no differential effects on patient weight. CONCLUSION: Practice nurses' and patients' beliefs and behaviour and the style of their interactions can be changed by both expert and learner centred educational packages. The style of packages should be chosen in terms of both the available resources and the desired outcomes.Keywords: educational packages; changing beliefs; obesity management; practice nurses IntroductionWith increased focus on health promotion at the level of primary care, primary health care professionals, particularly practice nurses, have to make daily decisions about weight related issues. Such professionals, however, report feeling unskilled when offering weight management and dietary change advice, and state that they ®nd dealing with weight issues dif®cult, inconvenient and professionally unrewarding. 1±3 They also report holding negative and stereotypical attitudes towards obese patients. 3,4 Further, practice nurses show a discrepancy between their assessments of the processes involved in their advice giving and the resulting outcomes, with high ratings for the standard of their advice contrasting with low ratings for their success in bringing about change. 5 This is supported by research highlighting that the actual success rates from primary health care interventions for weight loss are poor. 6 The literature therefore suggests that practice nurses need to be better equipped to manage weight related problems. However, any attempt to modify a health professionals beliefs an...

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Section: Discussionmentioning

confidence: 99%

The relative effectiveness of two styles of educational package to change practice nurses' management of obesity

Ogden¹,

Hoppe²

1997

Int J Obes

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“…what is the best method of implementing guidelines? Although it is argued for long that single strategies are less likely to change clinical practice [23], this is not much comfort. Multifaceted interventions are costly and more difficult to implement.…”

Section: Guidelines and Behaviour Changementioning

confidence: 99%

Falling on stony ground? A qualitative study of implementation of clinical guidelines’ prescribing recommendations in primary care

2008

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“…Successful change usually requires techniques such as providing informa tion, education, peer review or audit, use of opinion leaders or financial incentives (Stocking, 1992). In the implementation of the use of the HoNOS rating scale we used all of these techniques except financial incentives.…”

Section: Discussionmentioning

confidence: 99%

Using the Health of the Nation Outcome Scales in clinical practice

James

Kehoe

1999

Psychiatr. bull.

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Aims and methodTo describe the implementation of a plan to use a validated outcome measure in the care and treatment of people with severe mental illness within a district general hospital psychiatric service. Multiple techniques were necessary to promote actual change of practice.ResultsA survey of practice found 77% of full Care Programme Approach patients to have recorded Health of the Nation Outcome Scales (HoNOS) scores in their care plans one year after the beginning of the implementation plan.Clinical implicationsIt is possible to incorporate the use of HoNOS in to everyday practice but it takes a lot of time, effort and resources. Mental health services may require a clearer indication from the NHS Executive regarding the use of such outcome scales before committing themselves.

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Promoting change in clinical care.

Cited by 94 publications

References 2 publications

The relative effectiveness of two styles of educational package to change practice nurses' management of obesity

The relative effectiveness of two styles of educational package to change practice nurses' management of obesity

Falling on stony ground? A qualitative study of implementation of clinical guidelines’ prescribing recommendations in primary care

Using the Health of the Nation Outcome Scales in clinical practice

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