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Vaillancourt, Hugues

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Vaillancourt

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Hugues

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Institut sur la nutrition et les aliments fonctionnels, Université Laval

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ncf11367513

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  • PublicationAccès libre
    Assessing patients' involvement in decision making during the nutritional consultation with a dietitian
    (John Wiley & Sons Ltd, 2014-07-17) Lapointe, Annie; Vaillancourt, Hugues; Desroches, Sophie; Deschênes, Sarah-Maude; Légaré, France
    Background Shared decision making (SDM) represents an interesting approach to optimize the impact of dietary treatment, but there is no evidence that SDM is commonly integrated into diet-related health care. Objective To assess the extent to which dietitians involve patients in decisions about dietary treatment. Methods We audiotaped dietitians conducting nutritional consultations with their patients, and we transcribed the tapes verbatim. Three trained raters independently evaluated the content of the nutritional consultations using a coding frame based on the 12 items of the French-language version of the OPTION scale, a validated and reliable third-observer instrument designed to assess patients’ involvement by examining specific health professionals’ behaviours. Coding was facilitated by the qualitative research software NVivo 8. We assessed internal consistency with Cronbach’s alpha and inter-rater reliability with the intraclass correlation coefficient (ICC). Results Of the 40 dietitians eligible to participate in the study, 19 took part. We recruited one patient per participating dietitian. The overall mean OPTION score was 29 ± 8% [range, 0% (no patient involvement in the decision] to 100% [high patient involvement)]. The mean duration of consultations was 50 ± 26 min. The OPTION score was positively correlated with the duration of the consultation (r = 0.65, P < 0.01). Internal consistency and inter-rater reliability were both good (Cronbach’s alpha = 0.72; ICC = 0.65). Conclusion This study is the first to use a framework based on the OPTION scale to report on dietitians’ involvement of patients in decisions about patients’ dietary treatment. The results suggest that involvement is suboptimal. Interventions to increase patients’ involvement in diet-related decision making are indicated.
  • PublicationAccès libre
    Exploration of shared decision‐making processes among dieticians and patients during a consultation for the nutritional treatment of dyslipidaemia
    (Blackwell Science, 2014-08-18) Lapointe, Annie; Vaillancourt, Hugues; Gagnon, Marie-Pierre; Desroches, Sophie; Deschênes, Sarah-Maude; Légaré, France
    Background: Shared decision making (SDM) holds great potential for improving the therapeutic efficiency and quality of nutritional treatment of dyslipidaemia by promoting patient involvement in decision making. Adoption of specific behaviours fostering SDM during consultations has yet to be studied in routine dietetic practice. Objective: Using a cross-sectional study design, we aimed to explore both dieticians’ and patients’ adoption of SDM behaviours in dietetic consultations regarding the nutritional treatment of dyslipidaemia. Methods: Twenty-six dieticians working in local health clinics in the Quebec City metropolitan area were each asked to identify one dyslipidaemic patient they would see in an upcoming consultation. Based on the Theory of Planned Behaviour (TPB), questionnaires were designed to study two targeted SDM behaviours: ‘to discuss nutritional treatment options for dyslipidaemia’ and ‘to discuss patients’ values and preferences about nutritional treatment options for dyslipidaemia’. These questionnaires were administered to the dietician–patient dyad individually before the consultation. Associations between TPB constructs (attitude, subjective norm and perceived behavioural control) towards behavioural intentions were analysed using Spearman’s partial correlations. Results: Thirteen unique patient-dietician dyads completed the study. Perceived behavioural control was the only TPB construct significantly associated with both dieticians’ and patients’ intentions to adopt the targeted SDM behaviours (P < 0.05). Conclusions: As perceived behavioural control seems to determine dieticians’ and patients’ adoption of SDM behaviours, interventions addressing barriers and reinforcing enablers of these behaviours are indicated. This exploratory study highlights issues that could be addressed in future research endeavours to expand the knowledge base relating to SDM adoption in dietetic practice.