Patient-Provider Prenatal Nutrition Conversations Using a Human Factors Approach.

IF 1.8 4区 医学 Q2 NURSING
Katherine Erbe, Elizabeth Lerner Papautsky, Kylea Liese, Chang Park, Julienne Rutherford, Lisa Tussing-Humphreys, Yanqiao Li, Arissara Sawatpanich, Mary Dawn Koenig
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引用次数: 0

Abstract

Objective: To examine patient-provider nutrition conversations at initial prenatal visits.

Design: Convergent mixed methods observational study.

Setting: Two large metropolitan clinics in the midwestern United States.

Participants: Sixteen providers and 20 racially diverse pregnant women.

Methods: Guided by the Systems Engineering Initiative for Patient Safety (SEIPS) 2.0 model, we observed and audio-recorded initial prenatal visits with obstetric providers. Patients completed post-visit surveys and interviews, and providers completed post-visit interviews. Finally, we sent a practice-wide electronic survey to all providers. We completed quantitative data analysis for descriptive statistics of observation and survey results. We completed qualitative thematic analysis of visit and interview transcripts and combined and categorized results into components of the SEIPS 2.0 model.

Results: We identified multiple dynamic and interacting factors relevant to the work system and processes in the SEIPS 2.0 model in patient-provider conversations about nutrition. Although nutrition was covered in all visits, most conversations were provider-centered and covered basic, general recommendations related to a limited number of topics. Few individualized collaborative discussions that addressed contextual factors occurred.

Conclusion: Finding ways to incorporate and address contextual factors into patient-centered conversations about nutrition is vital to optimize the dietary habits of women, especially those from vulnerable populations. To do this, multidisciplinary teams that include nurse practitioners, nurses, obstetricians, and registered dietitians who can address the multiple social determinants of health that affect dietary choices are needed.

使用人为因素方法的患者-提供者产前营养对话。
目的:探讨患者与提供者在初次产前访视时的营养对话。设计:收敛混合方法观察性研究。地点:美国中西部的两个大城市诊所。参与者:16名提供者和20名不同种族的孕妇。方法:在患者安全系统工程倡议(SEIPS) 2.0模型的指导下,我们观察并录音了产科提供者的初次产前访问。患者完成了随访调查和访谈,提供者完成了随访访谈。最后,我们向所有供应商发送了一份全行业的电子调查。完成定量数据分析,对观察和调查结果进行描述性统计。我们完成了访问和访谈记录的定性专题分析,并将结果合并并分类为SEIPS 2.0模型的组成部分。结果:我们确定了与SEIPS 2.0模型中有关营养的工作系统和流程相关的多个动态和相互作用因素。虽然所有访问都涉及营养问题,但大多数对话都以提供者为中心,并涉及与有限主题有关的基本一般性建议。很少发生针对情境因素的个性化协作讨论。结论:寻找方法将环境因素纳入以患者为中心的营养对话中,对于优化女性,特别是弱势群体的女性的饮食习惯至关重要。为此,需要包括执业护士、护士、产科医生和注册营养师在内的多学科团队,他们可以解决影响饮食选择的多种健康社会决定因素。
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来源期刊
CiteScore
3.20
自引率
5.60%
发文量
0
审稿时长
43 days
期刊介绍: JOGNN is a premier resource for health care professionals committed to clinical scholarship that advances the health care of women and newborns. With a focus on nursing practice, JOGNN addresses the latest research, practice issues, policies, opinions, and trends in the care of women, childbearing families, and newborns. This peer-reviewed scientific and technical journal is highly respected for groundbreaking articles on important - and sometimes controversial - issues. Articles published in JOGNN emphasize research evidence and clinical practice, building both science and clinical applications. JOGNN seeks clinical, policy and research manuscripts on the evidence supporting current best practice as well as developing or emerging practice trends. A balance of quantitative and qualitative research with an emphasis on biobehavioral outcome studies and intervention trials is desired. Manuscripts are welcomed on all subjects focused on the care of women, childbearing families, and newborns.
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