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Development of a nutrition counselling care map for dyslipidemia

机译:制定血脂异常的营养咨询服务图

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PURPOSE: Care maps or clinical pathways for nutrition therapy of dyslipidemia could add to current practice guidelines, by providing templates for feasible and recommended diet counselling processes. A care map was therefore developed by engaging expert and generalist dietitians and external experts from across Canada in a multi-stage consensus process. METHODS: First, a qualitative study was undertaken with a convenience sample of 12 practitioners to identify possible diet care options, using hypothetical client scenarios and cognitive analysis. Second, these care options were rated for five case scenarios considered typical (overweight clients, with or without clinical cardiovascular disease and other comorbidities, potentially motivated to change, consuming high-fat diets, and facing various major barriers to eating behaviour change). The rating was conducted through a survey of participants. Highly appropriate, recommended, and feasible options for counselling were ranked through a two-round modified Delphi process, with teleconference discussions between rounds. RESULTS: Forty-nine professionals started the consensus process; 39 (80%) completed all aspects. Numerous care processes were appropriate for all clients, with additional focus on barriers for low-income clients, sodium intake for clients with hypertension, and smoking cessation in smokers. CONCLUSIONS: The resulting care map, "Dietitians' Quick Reference Guide for Clinical Nutrition Therapy for Overweight Clients with Dyslipidemia," provides a basis for current practice and new effectiveness studies.
机译:目的:通过提供可行和推荐的饮食咨询过程的模板,血脂异常营养治疗的护理图或临床途径可以增加当前的实践指南。因此,由加拿大各地的专家和全能营养师以及外部专家共同参与的多阶段共识过程中,制定了一份护理图。方法:首先,使用假设的服务对象情况和认知分析,对12名从业者的便利样本进行了定性研究,以确定可能的饮食护理选择。其次,对这些护理方案进行了五种典型案例的评估(超重的患者,有或没有临床心血管疾病和其他合并症,有可能改变饮食习惯,食用高脂饮食,并面临饮食行为改变的各种主要障碍)。该评级是通过对参与者的调查进行的。通过两轮改进的Delphi流程对咨询的高度合适,推荐和可行的方案进行了排名,每轮之间进行电话会议讨论。结果:49位专业人员开始了共识过程; 39(80%)完成了所有方面。许多护理过程均适用于所有客户,另外重点关注低收入客户的障碍,高血压客户的钠摄入量以及吸烟者的戒烟。结论:由此产生的护理图谱“《饮食学家针对血脂异常超重患者的临床营养治疗快速参考指南》”为当前的实践和新的有效性研究提供了基础。

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