Implementing shared decision-making in nutrition clinical practice: A theory-based approach and feasibility study

Sophie Desroches,Marie-Pierre Gagnon,Sylvie Tapp,France Légaré

doi:10.1186/1748-5908-3-48

Sophie Desroches, Marie-Pierre Gagnon + Show 2 more

Open Access

https://doi.org/10.1186/1748-5908-3-48

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Abstract

BackgroundThere are a growing number of dietary treatment options to choose from for the management of many chronic diseases. Shared decision making represents a promising approach to improve the quality of the decision making process needed for dietary choices that are informed by the best evidence and value-based. However, there are no studies reporting on theory-based approaches that foster the implementation of shared decision making in health professions allied to medicine. The objectives of this study are to explore the integration of shared decision making within real nutritional consultations, and to design questionnaires to assess dieticians' intention to adopt two specific behaviors related to shared decision making using the Theory of Planned Behavior.MethodsForty dieticians will audiotape one clinical encounter to explore the presence of shared decision making within the consultation. They will also participate to one of five to six focus groups that aim to identify the salient beliefs underlying the determinants of their intention to present evidence-based dietary treatment options to their patients, and clarify the values related to dietary choices that are important to their patients. These salient beliefs will be used to elaborate the items of two questionnaires. The internal consistency of theoretical constructs and the temporal stability of their measurement will be checked using the test-retest method by asking 35 dieticians to complete the questionnaire twice within a two-week interval.DiscussionThe proposed research project will be the first study to: provide preliminary data about the adoption of shared decision making by dieticians and theirs patients; elicit dieticians' salient beliefs regarding the intention to adopt shared decision making behaviors, report on the development of a specific questionnaire; explore dieticians' views on the implementation of shared decision making; and compare their views regarding the implementation of shared decision making in different clinical settings.It is anticipated that the results generated by the proposed research project will significantly contribute to the emergence of shared decision making in nutrition through a theory-based approach.

Highlights

There are a growing number of dietary treatment options to choose from for the management of many chronic diseases
Relevance of investigating the implementation of shared decision making into allied health professionals' clinical practice In a recent study that aimed to implement Shared decision making (SDM) in primary care, Légaré et al identified the nature of the decisions that were discussed in 903 clinical encounters in primary care [24]
It is anticipated that the results generated by the proposed research project will significantly contribute to the emergence of SDM in nutrition through a theory-based approach

Summary

Introduction

There are a growing number of dietary treatment options to choose from for the management of many chronic diseases. Diet-based treatment options: the case of cardiovascular diseases According to the World Health Organization, poor nutrition is among the top 10 risk factors contributing to global mortality [1]. The rapid and unregulated amount of nutrition messages that is currently emerging in cyberspace, television, newspapers and magazines is confusing for the general population [10]. It is in this context of increased number of dietary options that the need for patient guidance from dieticians is expected to increase in the near future

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