POSTER COMMUNICATIONS Rev Esp Nutr Hum Diet
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POSTER COMMUNICATIONS Rev Esp Nutr Hum Diet. 2016; 20(Suppl. 1): 413 - 420 413 17th International Congress of Dietetics Fundación Española www. de Dietistas-Nutricionistas renhyd.org POSTER COMMUNICATIONS APPLIED DIETETICS P-001: DEVELOPING A METHODOLOGICAL FRAMEWORK FOR ASSESSING DIETARY DATA QUALITY IN A HEALTHY LIFESTYLE CLINICAL TRIAL Vivienne Guan1,*, Yasmine Probst1, Elizabeth Neale1, Allison Humphries2, Linda Tapsell1 1School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Australia. 2Illawarra Health and Medical Research Institute, Faculty of Science, Medicine and Health, University of Wollongong, Australia. * Contact: [email protected] Introduction: Accurate and valid dietary intake data is the basis for investigating diet-disease relationships. Potential data discrepancies can be introduced both when collecting and analysing data despite rigorous quality assurance protocols. The aim of this pilot study was to develop a framework for assessing dietary data quality (DQ) in a healthy lifestyle clinical trial. Methods: A 1% random sample (n=4) of paper-based diet history records from participants (n=377) in a registered clinical trial was extracted as a pilot audit. All items listed on the source data underwent a 100% manual verification check with the food output analysis data from FoodWorks software. The observed discrepancies between input and output data relating to intake of food items, quantity and frequency were recorded. Discrepancies involving mixed-dish analyses were also assessed using the basic recipe information and yield factors. DQ assessment and management frameworks, and spreadsheet error classifications from the Information Sciences literature were adapted and simplified to propose a “fit-for-use” coding scheme and process model based on the observed discrepancy incidences related to intake of food items, quantity and frequency. Results: There APPLIED DIETETICS | were 17 discrepancy instances observed in the pilot sample, which included intake of food items (n=13), quantity (n=3) and frequency (n=1). A coding scheme comprised of four distinct sections was proposed to assess discrepancy types, food items, meaningfulness related to discrepancies and discrepancy reasons. The process model represented the DQ assessment process, proceeding through to multiple iterations of the proposed coding scheme. Practical application: Implementing a standardised dietary DQ assessment is likely to reduce discrepancies between source data and analysis output for dietary intake data. Though needs to carefully consider the methodology behind dietary assessment methods to which DQ is applied. The coding scheme and process model proposed here offers a systematic approach to evaluating dietary DQ in research setting. COMPETING INTERESTS: The authors of this document can confirm there is no conflict of interest. POSTER COMMUNICATIONS Rev Esp Nutr Hum Diet. 2016; 20(Suppl. 1): 413 - 420 17th International Congress of Dietetics 414 P-002: WHAT COMMUNICATION SKILLS DO DIETITIANS USE IN PRACTICE? Tracey Parkin1,*, Anne de Looy1, Paul Farrand2 1Plymouth University. 2University of Exeter. * Contact: [email protected] Introduction: Communication is essential for establishing patient engagement, with greater patient engagement being linked to increased recall and agreement on decisions made during the consultation. However discrepancy exists between professional’s perception of communication skill use and skills utilised in practice. This qualitative study will explore the communication skills used in practice and the relationship to agreement about decisions made during the consultation. Methods: Consultations between dietitians and patients were audio-recorded. Immediately following the consultation dietitians and patients independently recorded decisions made in a booklet. Patient and dietitian agreement about consultation decisions were collated. Qualitative analysis was conducted to compare the types of communication skills which resulted in greater agreement between dietitian and patient. (Communication skills included: reflection, clarification, summarising, paraphrasing, supportive and confirming statements and use of exploratory questions). Results: Twenty audio-recordings were analysed: ten with complete agreement and ten with complete disagreement about decisions. Reflections and clarifications were most frequent and accounted for 60% of the communication skills used. Consultations with agreement were 1½ times more likely to use reflections, clarifications, summarising, paraphrasing, supportive and confirming statements than consultations with disagreement. Consultations with agreement used exploratory questions to examine patient’s thoughts, feelings and self-care management practices. These questions were four times more frequent in consultations with agreement compared to consultations with disagreement. Conclusions, discussion and/or practical application: In ‘successful’ consultations indicated by greater agreement between dietitian and patient about decisions, dietitians employed a number of active listening skills and utilised exploratory questions to understand the patient’s perspective. Agreement about decisions can act as a simple indicator of communication skill use. Disagreement about decisions may indicate the need for further communication skills training. COMPETING INTERESTS: The authors of this document can confirm there is no conflict of interests. P-004: DIETITIAN LED COELIAC ANNUAL REVIEW CLINICS CONCLUSION – THE USE OF DIETITIANS TO UNDERTAKE ANNUAL MEDICAL REVIEW OF COELIACS IS A SAFE AND COSE EFFECTIVE SOLUTION FOR FUTURE SUSTAINABLE SERVICE DELIVERY Pauline Mulholland1,*, Dr Grant Caddy1, Dr Tim Harding1, Adele Nichol1, Noelle Power1, Justine Prosser1 1South Eastern HSC Trust. * Contact: [email protected] Introduction: There has been a major increase in referrals to Gastroenterology clinics over the last 5yrs and consequent challenges with regards to capacity to review patients with chronic diseases. Collaborative working resulted in the pilot of a Dietitian-led coeliac review clinic to improve consultant capacity. An Extended Scope Practice Dietitian (ESP) was trained to undertake the medical annual reviews. Objectives and target population: The objective was to test the safety, effectiveness and efficiency of an ESP Dietitian undertaking the medical annual coeliac review. Previous theories and investigations: The APPLIED DIETETICS British Society of Gastroenterology (BSG) and NICE (National Institute for Clinical Effectiveness) recommend coeliac’s have | a medical review annually. Review frequency within South Eastern Trust has increased beyond the 12 months up to 3 years. Intervention(s): A protocol was developed and review patients identified. The dietitian was trained in venepuncture and to develop skills discussed selected patients with the Consultant within one week of clinic. A user satisfaction survey was designed. Evaluation and Results: 123 patients were reviewed by the dietitian with only 23 (18%) requiring medical intervention. The ESP Dietitians liaised with GP’s/Consultants regarding outstanding tests including: pneumococcal Vaccination (61%); bone density – (27 patients referred for DEXA scans); red flag symptoms (23 patients). The user satisfactory survey indicated that: 98% felt the annual review by the Dietitian was beneficial; 100% were satisfied with the diet related questions and felt they were provided with enough information; 100% were satisfied with their appointment at the Dietitian-led coeliac clinic; 86% were POSTER COMMUNICATIONS Rev Esp Nutr Hum Diet. 2016; 20(Suppl. 1): 413 - 420 17th International Congress of Dietetics 415 happy to be reviewed at the Dietitian-led coeliac clinic in the future. Conclusions of authors and discussion: This initiative was well received by patients and demonstrates safe and efficient use of dietetic services to review patients with coeliac disease. This may provide cost-effective sustainable coeliac disease services for future planning. COMPETING INTERESTS: The authors of the document can confirm there is no conflict of interest. P-005: A RETROSPECTIVE INVESTIGATION OF THE EFFECT OF FIBRE MODIFICATION ADVICE FOR PATIENTS RECEIVING CHEMOTHERAPY AND RADIOTHERAPY TREATMENT Eleanor Holmes1,*, Dawn Harrington1, Lindsey Bottle2 1Faculty of Health & Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7XH. 2Nutrition and Dietetic Department, The Royal Surrey County Hospital, Guildford, Surrey, GU2 7XX. * Contact: [email protected] Introduction: Whilst oncology treatments reduce mortality, the side effects can impact on a patient’s quality of life, particularly those that effect the gastrointestinal (GI) tract causing GI upset including constipation and diarrhoea. It is thought that 95% of patients receiving treatments develop GI changes (including constipation and diarrhoea), with 50-80% reporting effects on quality of life. The low irritant, high fibre (LIHF) diet is used to alleviate the GI symptoms of other disorders with similar symptoms, however to date, there is no published evidence to support the use in oncology patients. Aim is to evaluate the effects of a (LIHF) diet in patients suffering side effects from chemotherapy and radiotherapy. Methods: A retrospective analysis of patients referred to Oncology Dietitians at the Royal Surrey County Hospital in Guildford was conducted. One hundred and seven oncology patients met inclusion criteria (65% females,