Rationale: In this scoping review we aimed to identify and map available evidence concerning counseling strategies that contribute to effective dietary counseling. Dietary counseling, as component of dietary treatment, is important to empowerclients in achieving dietary treatment goals.Methods: Following the PRISMA SCR-Scoping Reviews Statement and Checklist, a systematic search in electronic databases (CINAHL, PsychInfo, Pubmed/Medline, Web of Science, SOC Index, Embase, and Psychology & Behavioral Sciences) was performed in March 2020. No date restriction for year of publication was applied to allow for inclusivity. Studies were included if they were peer-reviewed,quantitative and qualitative, had a primary analysis of empirical work,written in English or Dutch, and focused on dietary counseling in 1-on-1 consultations between dietitians and adult clients (≥18 years). Only studies which gave a description of the effective strategies of dietary counseling were included.Results: Analysis of recurring themes in the 28 included studies revealed seven core counseling strategies that effectively contribute to dietary counseling: 1) connecting to motivation, 2) tailoring the modality of dietary counseling, 3)providing recurring feedback, 4) using integrated dietetic support tools, 5) showing empathy, 6) including clients’ preferences, wishes, and expectations during decision-making, and 7) dietitians having high self-efficacy.Conclusion: Multiple counseling strategies contributing to effective dietary counseling have been identified and mapped. Insights from this scoping review provide a foundation for dietitians to effectively carry out dietary counseling. To work towards effective dietary counseling, further development of an integrated approach that includes combinations of strategies that form a unified whole is required.
Purpose: This study aims to capture the complex clinical reasoning process during tailoring of exercise and dietary interventions to adverse effects and comorbidities of patients with ovarian cancer receiving chemotherapy. Methods: Clinical vignettes were presented to expert physical therapists (n = 4) and dietitians (n = 3). Using the think aloud method, these experts were asked to verbalize their clinical reasoning on how they would tailor the intervention to adverse effects of ovarian cancer and its treatment and comorbidities. Clinical reasoning steps were categorized in questions raised to obtain additional information; anticipated answers; and actions to be taken. Questions and actions were labeled according to the evidence-based practice model. Results: Questions to obtain additional information were frequently related to the patients’ capacities, safety or the etiology of health issues. Various hypothetical answers were proposed which led to different actions. Suggested actions by the experts included extensive monitoring of symptoms and parameters, specific adaptations to the exercise protocol and dietary-related patient education. Conclusions: Our study obtained insight into the complex process of clinical reasoning, in which a variety of patient-related variables are used to tailor interventions. This insight can be useful for description and fidelity assessment of interventions and training of healthcare professionals.
MULTIFILE
12/31/2023
Purpose: Head and neck cancer (HNC) treatment often leads to physical and psychosocial impairments. Rehabilitation can overcome these limitations and improve quality of life. The aim of this study is to obtain an overview of rehabilitation care for HNC, and to investigate factors influencing rehabilitation provision, in Dutch HNC centers, and to some extent compare it to other countries. Methods: An online survey, covering five themes: organizational structure; rehabilitation interventions; financing; barriers and facilitators; satisfaction and future improvements, among HNC healthcare- and financial professionals of Dutch HNC centers. Results: Most centers (86%) applied some type of rehabilitation care, with variations in organizational structure. A speech language therapist, physiotherapist and dietitian were available in all centers, but other rehabilitation healthcare professionals in less than 60%. Facilitators for providing rehabilitation services included availability of a contact person, and positive attitude, motivation, and expertise of healthcare professionals. Barriers were lack of reimbursement, and patient related barriers including comorbidity, travel (time), low health literacy, limited financial capacity, and poor motivation. Conclusion: Although all HNC centers included offer rehabilitation services, there is substantial practice variation, both nationally and internationally. Factors influencing rehabilitation are related to the motivation and expertise of the treatment team, but also to reimbursement aspects and patient related factors. More research is needed to investigate the extent to which practice variation impacts individual patient outcomes and how to integrate HNC rehabilitation into routine clinical pathways.
MULTIFILE
04/30/2024
