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Deschênes, Sarah-Maude

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Sarah-Maude

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Université Laval. Département des sciences animales

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ncf11860840

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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.
  • PublicationRestreint
    Psychosocial factors and intention to use the nutrition care process among dietitians and dietetic interns
    (Diététistes du Canada, 2014-05-21) Lapointe, Annie; Galibois, Isabelle; Gagnon, Pierre; Desroches, Sophie; Deschênes, Sarah-Maude
    Purpose The theory of planned behaviour was used to explore the factors (i.e., attitude, subjective norm, and perceived behavioural control) affecting the intention of dietetic internship educators, new dietetic graduates, and dietetic interns to use the nutrition care process (NCP) in their clinical practice. Methods Participants (n=55) were recruited from the Bachelor of Science in Nutrition program at Université Laval. They completed an online quantitative questionnaire assessing their intention to use the NCP in their clinical practice, as well as associated psychosocial factors. Open-ended questions were also used to gain a further understanding of the salient beliefs underlying participants’ intention to use the NCP. Results Intention to use the NCP in practice and associated psychosocial factors were similar and favourable within the three participant groups. Subjective norm and perceived behavioural control were the psychosocial factors that significantly predicted an intention to use the NCP. The most cited perceived barrier to use of the NCP was a lack of knowledge, while the most cited facilitator was training opportunities. Conclusions Our results indicate that successful implementation of the NCP will likely require the development of theoretical and practical training activities for both pre-licensure students and experienced dietitians.