Aisling A Geraghty1, Sarah Browne1, Ciara M E Reynolds1, Sharon Kennelly2, Lucy Kelly3, Kimberley McCallum3, Laura McBean1, Barbara Clyne4, Gerard Bury5, Catriona Bradley6, Laura McCullagh7, Laura A Bardon8, Celine Murrin1, Carla Perrotta9, Eileen R Gibney8, Patricia Dominguez Castro1, Clare A Corish10. 1. (1)School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland and UCD Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland. 2. (2)National Primary Care Division, Community Funded Schemes Service Improvement, Mountmellick Primary Care Building, Co Laois, Republic of Ireland. 3. (3)School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland. 4. (4)Health Research Board Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Republic of Ireland. 5. (5)School of Medicine, University College Dublin, Dublin, Republic of Ireland. 6. (6)Irish Institute of Pharmacy, Royal College of Surgeons in Ireland, Dublin, Republic of Ireland. 7. (7)Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St James's Hospital, Dublin, Republic of Ireland. 8. (8)School of Agriculture and Food Science, University College Dublin, Dublin, Republic of Ireland and UCD Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland. 9. (9)School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland. 10. (1)School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland and UCD Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland. Electronic address: clare.corish@ucd.ie.
Abstract
BACKGROUND: Language and communication have an impact on how a clinical condition is treated and experienced, from both the health care professional (HCP) and patient perspective. Malnutrition is prevalent among community-dwelling older adults, yet perceptions of patient understanding of the term malnutrition to date remain underexplored. OBJECTIVE: This qualitative study explored the use and perceptions of the term malnutrition among HCPs and older adults at risk of malnutrition. DESIGN: Semi-structured interviews and focus groups were conducted with HCPs and older adults with a prescription for oral nutritional supplements (ONS) in the community, to explore perspectives. PARTICIPANTS AND SETTING: HCPs with experience of working with older adults were recruited in primary care centers, general practitioner practices, community health organizations, and community pharmacies in County Dublin, Ireland, between 2018 and 2019. Older adults, aged ≥60 years, with a current or previous prescription for ONS were recruited from daycare centers. One-to-one interviews were conducted with general practitioners (n = 16) and patients (n = 13), and focus groups were conducted with other HCPs, including dietitians (n = 22), nurses (n = 22), pharmacists (n = 9), physiotherapists (n = 12), occupational therapists (n = 6), and speech and language therapists (n = 4). DATA ANALYSIS: Data from interviews and focus groups were transcribed verbatim and analyzed using thematic analysis. RESULTS: There was mutual agreement between HCPs and patients on the main theme, "malnutrition is a term to be avoided." There were three subthemes with varying input from the different HCP groups and patients: "Malnutrition is a term a patient doesn't want to hear"-malnutrition has negative connotations that imply neglect and stigma; "malnutrition is a clinical term which patients don't understand"-with perceptions that it is better to substitute the term with simpler motivating messages; and "lack of confidence identifying malnutrition"-expressed by non-dietetics HCPs who believed they had insufficient expertise on malnutrition to communicate effectively with patients. CONCLUSIONS: HCPs and patients perceived negative connotations with the term malnutrition, and HCPs used alternatives in practice. Additional consultation with HCPs and patients is recommended to explore appropriate language for conveying health risks associated with malnutrition. Future research should also address how current communication challenges can be addressed as part of strategic management programs or interventions to prevent and treat malnutrition.
BACKGROUND: Language and communication have an impact on how a clinical condition is treated and experienced, from both the health care professional (HCP) and patient perspective. Malnutrition is prevalent among community-dwelling older adults, yet perceptions of patient understanding of the term malnutrition to date remain underexplored. OBJECTIVE: This qualitative study explored the use and perceptions of the term malnutrition among HCPs and older adults at risk of malnutrition. DESIGN: Semi-structured interviews and focus groups were conducted with HCPs and older adults with a prescription for oral nutritional supplements (ONS) in the community, to explore perspectives. PARTICIPANTS AND SETTING: HCPs with experience of working with older adults were recruited in primary care centers, general practitioner practices, community health organizations, and community pharmacies in County Dublin, Ireland, between 2018 and 2019. Older adults, aged ≥60 years, with a current or previous prescription for ONS were recruited from daycare centers. One-to-one interviews were conducted with general practitioners (n = 16) and patients (n = 13), and focus groups were conducted with other HCPs, including dietitians (n = 22), nurses (n = 22), pharmacists (n = 9), physiotherapists (n = 12), occupational therapists (n = 6), and speech and language therapists (n = 4). DATA ANALYSIS: Data from interviews and focus groups were transcribed verbatim and analyzed using thematic analysis. RESULTS: There was mutual agreement between HCPs and patients on the main theme, "malnutrition is a term to be avoided." There were three subthemes with varying input from the different HCP groups and patients: "Malnutrition is a term a patient doesn't want to hear"-malnutrition has negative connotations that imply neglect and stigma; "malnutrition is a clinical term which patients don't understand"-with perceptions that it is better to substitute the term with simpler motivating messages; and "lack of confidence identifying malnutrition"-expressed by non-dietetics HCPs who believed they had insufficient expertise on malnutrition to communicate effectively with patients. CONCLUSIONS: HCPs and patients perceived negative connotations with the term malnutrition, and HCPs used alternatives in practice. Additional consultation with HCPs and patients is recommended to explore appropriate language for conveying health risks associated with malnutrition. Future research should also address how current communication challenges can be addressed as part of strategic management programs or interventions to prevent and treat malnutrition.
Authors: Liz Payne; Daniela Ghio; Elisabeth Grey; Joanna Slodkowska-Barabasz; Philine Harris; Michelle Sutcliffe; Sue Green; Helen C Roberts; Caroline Childs; Sian Robinson; Bernard Gudgin; Pam Holloway; Jo Kelly; Kathy Wallis; Oliver Dean; Paul Aveyard; Paramjit Gill; Mike Stroud; Paul Little; Lucy Yardley; Leanne Morrison Journal: BMC Fam Pract Date: 2021-11-11 Impact factor: 2.497