The Nigerian Dietary Screening Tool: A Step toward Improved Patient-Clinician Communication in Nigerian Hospitals: A Pilot Implementation Study.

Abstract

Implementing dietary screening tools into clinical practice has been challenging, including in Nigeria. This study evaluated the impact of the Nigerian dietary screening tool (NiDST) on patient-clinician communication and barriers to and facilitators of implementation. A mixed methods approach was used to collect data from patients (n = 151) and clinicians (n = 20) from outpatient clinics in Nigeria. Patients completed the validated 25-item NiDST prior to outpatient consultations. Both patients and clinicians completed the Measurement Instrument for Determinants of Innovations (MIDI) questionnaire to assess implementation determinants post-consultation. Semi-structured interviews were conducted for in-depth feedback. The fidelity of implementation was 92% for NiDST-reported dietary discussion, with a mean completion time of <6 min and an accepted marginal increase in consultation time (<10 min). For clinicians, 25% reported time constraints and their additional nutritional knowledge as barriers, while facilitators of NiDST implementation were the clarity and completeness of the NiDST, clinical relevance and improved patient-clinician communication, as reported by all the clinicians. Over 96% of patients reported the NiDST as quick to complete, with 90.7% reporting self-reflection on dietary intake. This study demonstrated the NiDST's potential to enhance patient-clinician communication and highlighted major facilitators of implementation in clinical practice to improve dietary discussion in Nigeria.