Healthcare Professionals' Perceptions of Lifestyle Medicine in Specialized Care: A Survey-Based Study in a Dutch Hospital.

BackgroundThe UK Department of Health introduced the National Health Service (NHS) Health Check Programme in April 2009 in an attempt to improve primary and secondary prevention of cardiovascular disease in the UK population and to reduce health inequalities. Healthcare professionals' attitudes towards giving lifestyle advice will influence how they interact with patients during consultations. We therefore sought to identify the attitudes of primary care healthcare professionals towards the delivery of lifestyle advice in the context of the NHS Health Check Programme.MethodsFifty-two primary care healthcare professionals undertook a Q sort with 36 statements that represented a range of viewpoints about the importance of lifestyle change, medication, giving lifestyle advice in the primary care setting, and the individual, social and material factors that might impact on lifestyle related behaviour change. Sorts were analysed by-person using principal components analysis and varimax rotation.ResultsFive statistically independent factors (accounts) reflected distinct views on the topic. Account 1 was supportive of initiatives like the NHS Health Check, and emphasised the importance of professionals working collaboratively with patients to facilitate lifestyle change. Account 2 expressed views on the potential overuse of statin medication and placed responsibility for lifestyle change with the patient. Account 3 viewed the healthcare professional role to be one of educator, emphasising the provision of information. Account 4 perceived lifestyle change to be difficult for patients and emphasised the need for healthcare professionals to be role models. Account 5 was inconsistent about the value of lifestyle change, or the role of healthcare professionals in promoting it, a finding that may be due to ambivalence about the health check or to lack of engagement with the Q sort task. We found no strong associations between any of the factors and, gender, role, age or ethnicity.ConclusionsOur findings suggest that healthcare professionals hold viewpoints that may influence how they interact with patients during health checks. When implementing programmes like the NHS Health Check, it would be useful to take healthcare professionals’ views into account. Attitudes and beliefs could be explored during training sessions, for example.

Lifestyle medicine potential for reversing a world of chronic disease epidemics: from cell to community.

Health promotion practice in health care has a high priority in the endeavour to achieve equal opportunities for health and diversity in health among the population. The purpose of the study was to investigate whether there is any connection between the lifestyle advice given by healthcare professionals and the lifestyle change of the population, focusing on age, gender and education level. The study is based on the data from a national population survey in Sweden in which 52595 patients who had attended health care were interviewed by phone. The participants were asked whether healthcare professionals had raised the subject of lifestyle during the visit and whether the advice they gave had contributed to a lifestyle change. The results indicated that lifestyle issues were raised with 32.2% of those who attended health care, particularly among men, younger patients and those with a high education level. When lifestyle issues were raised, the advice contributed to 39.2% of patients making a lifestyle change, to a higher extent among men, older patients and those with a low education level. The study shows that lifestyle advice given by healthcare professionals, during both emergency and outpatient healthcare visits, is an important contributor to patients' lifestyle change.

“It’s not easy” — A qualitative study of lifestyle change during pregnancy

Introduction

The diabetes counselling course at Knuston Hall: a 30‐year journey

Beyond diet and exercise: another option for patients with obesity and polycystic ovary syndrome?

Lifestyle modification can reduce breast cancer recurrence risk and improve quality of life. However, few studies have explored patients' experiences of lifestyle behaviour changes following breast cancer, specifically the information and support received regarding lifestyle changes. To explore this topic, interviews were conducted (n = 21 women) and analysed thematically based on the Framework Approach. Themes included: Impact of cancer and behaviour change complexities; Impact of lifestyle messaging from healthcare professionals; Desire for empowering lifestyle advice and Shaping future lifestyle interventions. Lifestyle advice was either not provided, or perceived as unhelpful, with some being discouraged from making changes during treatment. If advice was received, emphasis tended to be in relation to physical activity and diet, with little mention of alcohol consumption. Personalised and empowering interventions are needed for patients and healthcare professionals to increase awareness regarding benefits of lifestyle changes after breast cancer, particularly regarding alcohol reduction, and to promote behaviour change.

Lifestyle Modification for the Management of Obesity

Objective: Hypertension awareness among healthcare professionals (HCPs) regarding lifestyle modification is still low. According to research, the best method to solve this problem is to sensitize and train HCPs regarding the different modalities of lifestyle management. This study aims to see how a structured training program aimed at HCPs is effective in improving knowledge of hypertension in the advice of lifestyle changes to their patients. Design and Methods: The sample size (n = 30) HCPs was determined using a quasi-experimental method. The Hypertension Knowledge-Level Scale (HK-LS), a modified structured questionnaire from the World Health Organization (WHO), was used to assess understanding of hypertension, knowledge of lifestyle modification, and practice. A 7-module, 12-week online course was delivered to the HCPs and a pre-test and post-test was administered to assess the change in knowledge regarding the awareness of lifestyle modifications. Results: The result showed that the t-test of the pre-knowledge about hypertension among HCPs differed significantly from post-knowledge after intervention (t = 4.90, p = 0.001). In addition, there is a significantly different between the pre and post-knowledge levels about lifestyle modification after intervention (t = 3.62, p = 0.001). A significant difference was also observed between the pre and post their advice of lifestyle modification to their patient after intervention (t = 3.56, p = 0.001). Conclusions: The health care providers, especially the allied healthcare professionals must be trained in a structured way to improve their knowledge of lifestyle modification specifically in hypertension as part of the primary prevention of hypertension.

BackgroundDespite increasing prevalence, early-onset type 2 diabetes (EOT2D) has received little clinical and qualitative research attention within England. This qualitative study aimed to explore and understand the unmet needs of people living with early-onset type 2 diabetes (PEOT2D) and their diabetes care within England.MethodsUsing semi-structured interviews, data was collected, transcribed and analysed from 25 PEOT2D and 25 healthcare professionals (HCPs). Taking an abductive approach, data for both cohorts were analysed and interpreted according to four constructs of Normalisation Process Theory (NPT): coherence (sense-making), cognitive participation (engagement), collective action (enactment) and reflexive monitoring (formal and informal appraisal).ResultsOur findings revealed several unmet needs in current treatment and care for PEOT2D. The main unmet need was access to specialist care. Having GP (general practitioner) practices as their main caregivers presented a significant barrier to this population successfully carrying out their diabetes self-care. HCPs in specialist roles expressed similar views and were keen to see PEOT2D receive access to holistic and specialist care via a multidisciplinary team. Data interpretation according to the four constructs of NPT found that implementation of this approach would involve fostering an environment of support that allowed HCPs across the primary and secondary interface to do the following: (1) provide consultations incorporating person-centred care, shared decision-making, and non-judgemental and non-stigmatising behaviours and (2) work in an integrated and synchronous manner using streamlined referrals, interprofessional collaborations and team-based learning. Provision of tailored financial, human (additional staffing) and learning resources was found to be integral to allow creation of tailored multidisciplinary teams, and individual and collective skill enhancement of both specialist and primary care providers.ConclusionAlthough both PEOT2D and specialist care providers are keen for young adults with EOT2D to receive access to specialist and holistic care, there are several resource barriers that must be addressed to allow implementation of their desired approach to treatment and care. Further qualitative research with primary care providers (for example, GPs and practice nurses) involved in EOT2D care is needed to understand if (and how) their views and experiences differ from those providing specialist care.

Introduction: Endometriosis is estimated to affect around one in 10 women in the UK and an estimated 200 million women worldwide. Despite evidence in the current literature around the benefits of using dietary and lifestyle interventions there has been limited research into incorporating these into person-centred care for the condition. Studies have supported a reduction in endometriosis pain when anti-inflammatory and anti-oestrogen dietary interventions were introduced. Also pain reduction has been reported in small studies on gluten free diets. Further studies have also identified that diets high in cruciferous vegetables, fresh fruit and antioxidants helped to reduce oestrogen, oxidative stress, and inflammatory processes. The researcher team comprised of two researchers, both diagnosed with endometriosis. So, this is a patient-led research project, devised as self-management of the condition has been important in managing both of the researchers’ symptoms. Aims: To explore the potential role for nutrition and lifestyle medicine in endometriosis as a self-management tool, and the barriers and challenges women with endometriosis face which prevent them from implementing beneficial nutrition and lifestyle changes. Methods: A qualitative methodology was used, with an anonymous online survey including open questions as the form of data collection. Snowball and purposive sampling were used to obtain participants. The inclusion criteria were women who live in the UK, 18 years or over who have diagnosed endometriosis. The data was analysed using inductive coding and thematic analysis. Results: A total of 42 participants completed the online survey. Eight subordinate themes were derived from 80 data codes and developed into four main superordinate themes: 1. Advice and support provided from healthcare professionals or nutrition professionals, 2. Diet and lifestyle changes already implemented and effects, 3. Endometriosis symptoms and 4. Barriers and motivation to change. The study found that women with diagnosed endometriosis received either no or poor-quality advice from their medical or health care professionals in relation to dietary changes. Most of the advice sought and implemented was from a variety of self-researched sources such as books, online websites and endometriosis support groups. Women had tried and reported benefits from a variety of different dietary or lifestyle interventions including, removal of gluten, increasing fruit and vegetable consumption, walking, yoga, Pilates, and meditation. There appeared to be very little or no professional support for patients with endometriosis in terms of implementing person centred nutrition or lifestyle goals. Conclusion: The existing dietary advice to women with endometriosis remains poor and participants specifically highlighted their desire for more evidence-based support with this. Identifying barriers to implementing dietary and lifestyle interventions will likely assist and facilitate the implementation of nutrition and lifestyle person-centred goals. Due to the wide variety of symptoms women with endometriosis can experience, a more individualised nutrition and lifestyle approach alongside existing care can provide a key role in improving practice in this area. More studies are needed on both nutritional and lifestyle approaches to managing endometriosis. This project has demonstrated that patient-led research has the potential to inform practice and shape research priorities.

Analysis of Recent Papers in Hypertension

British Journal of NursingVol. 32, No. 5 RegularsLifestyle medicine: a modern medical discipline full of optimismEllen Fallows, Alex Maxwell, Rob LawsonEllen FallowsE-mail Address: [email protected]GP and Vice-President, British Society of Lifestyle MedicineSearch for more papers by this author, Alex MaxwellGP and President, British Society of Lifestyle MedicineSearch for more papers by this author, Rob LawsonChair, British Society of Lifestyle MedicineSearch for more papers by this authorEllen Fallows; Alex Maxwell; Rob LawsonPublished Online:13 Mar 2023https://doi.org/10.12968/bjon.2023.32.5.268AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Alegría-Torres JA, Baccarelli A, Bollati V. Epigenetics and lifestyle. Epigenomics. 2011;3(3):267-77. https://doi.org/10.2217/epi.11.22 Crossref, Medline, Google ScholarEgger GBinns ARössner SSagner M (eds). Lifestyle medicine: lifestyle, the environment and preventive medicine in health and disease paperback. London: Academic Press; 2017 Google ScholarFurman D, Campisi J, Verdin E et al.. Chronic inflammation in the etiology of disease across the life span. Nat Med. 2019;25(12):1822-1832. https://doi.org/10.1038/s41591-019-0675-0 Crossref, Medline, Google ScholarJacka FN, O’Neil A, Opie R et al.. A randomised controlled trial of dietary improvement for adults with major depression (the ‘SMILES’ trial). BMC Med. 2017;15(1):23. https://doi.org/10.1186/s12916-017-0791-y Crossref, Medline, Google ScholarJarbøl DE, Larsen PV, Gyrd-Hansen D et al.. Determinants of preferences for lifestyle changes versus medication and beliefs in ability to maintain lifestyle changes. A population-based survey. Prev Med Rep. 2017;6:66–73. https://doi.org/10.1016/j.pmedr.2017.02.010 Crossref, Medline, Google ScholarLean ME, Leslie WS, Barnes AC et al.. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. Lancet. 2018;391(10120):541-551. https://doi.org/10.1016/S0140-6736(17)33102-1 Crossref, Medline, Google ScholarOrnish D. Avoiding revascularization with lifestyle changes: The Multicenter Lifestyle Demonstration Project. Am J Cardiol. 1998;82(10B):72T-76T. https://doi.org/10.1016/s0002-9149(98)00744-9 Crossref, Medline, Google ScholarRidge K (chair). Good for you, good for us, good for everybody. A plan to reduce overprescribing to make patient care better and safer, support the NHS, and reduce carbon emissions. (The report of the National Overprescrining Rreview.) 2021. https://tinyurl.com/3drvj7hu (accessed 1 March 2023) Google ScholarRodriguez-Castaño GP, Caro-Quintero A, Reyes A, Lizcano F. Advances in gut microbiome research, opening new strategies to cope with a western lifestyle. Front Genet. 2017;7:224. https://doi.org/10.3389/fgene.2016.00224 Crossref, Medline, Google ScholarSaneei P, Salehi-Abargouei A, Esmaillzadeh A, Azadbakht L. Influence of Dietary Approaches to Stop Hypertension (DASH) diet on blood pressure: a systematic review and meta-analysis on randomized controlled trials. Nutr Metab Cardiovasc Dis. 2014;24(12):1253-1261. https://doi.org/10.1016/j.numecd.2014.06.008 Crossref, Medline, Google ScholarSrour B, Kordahi MC, Bonazzi E, Deschasaux-Tanguy M, Touvier M, Chassaing B. Ultra-processed foods and human health: from epidemiological evidence to mechanistic insights. Lancet Gastroenterol Hepatol. 2022;7(12):1128-1140. https://doi.org/10.1016/S2468-1253(22)00169-8 Crossref, Medline, Google ScholarTreadwell JS, Wong G, Milburn-Curtis C, Feakins B, Greenhalgh T. GPs’ understanding of the benefits and harms of treatments for long-term conditions: an online survey. BJGP Open. 2020;4(1):bjgpopen20X101016. https://doi.org/10.3399/bjgpopen20X101016 Crossref, Medline, Google Scholar FiguresReferencesRelatedDetails 9 March 2023Volume 32Issue 5ISSN (print): 0966-0461ISSN (online): 2052-2819 Metrics History Published online 13 March 2023 Published in print 9 March 2023 Information© MA Healthcare LimitedPDF download

Evidence and consensus-based clinical practice guidelines for management of overweight and obesity in midlife women: An AIIMS-DST initiative.