TY - JOUR
T1 - Perceptions, barriers and facilitators regarding nutritional care for patients with chronic limb threatening ischemia
T2 - a focus group study among healthcare professionals
AU - Kolen, Aniek M
AU - Jager-Wittenaar, Harriët
AU - Geertzen, Jan H B
AU - Damman, Jeanne
AU - Dijkstra, Martijn L
AU - Keller, B Paul J A
AU - Kooijman, Maria
AU - Tjalsma-de Vries, Marlies
AU - de Vries, Jean-Paul P M
AU - Wikkeling, Otmar R M
AU - Wong, Sin Wun
AU - Dekker, Rienk
AU - Krops, Leonie A
N1 - Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.
PY - 2024/10/16
Y1 - 2024/10/16
N2 - Background: Nutrition and nutritional care are essential for optimal outcomes, and, therefore of importance for patients with chronic limb threatening ischemia (CLTI) given their high risk of complications. However, insight is lacking in how healthcare professionals directly involved in the care of patients with CLTI perceive nutritional care, as well as in the perceived barriers and facilitators regarding optimal nutritional care. Methods: In this qualitative study with a phenomenological approach, 3 online focus groups were conducted with various healthcare professionals directly involved in the care of patients with CLTI. Sample size was guided by information power. Focus group recordings were transcribed verbatim, and reflexive thematic analysis was performed. Results: Seventeen healthcare professionals participated, including vascular surgeons, fellows in vascular surgery, a medical doctor and researcher, nurse specialized in wound care, general nurse, physical therapists, dietitians, and nutrition assistants. Four themes were generated: (1) nutritional care is crucial for optimal clinical outcomes and a healthy life, (2) insufficient attention to undernutrition and nutritional care by healthcare professionals, (3) patient-related factors challenge healthcare professionals in providing nutritional care, and (4) need for optimizing the organizational process related to nutritional care. Perceived barriers regarding nutritional care included knowledge deficits, nutritional care not being part of the healthcare professionals’ routine, missing tools to identify undernutrition, patient-related factors, and time constraints. Facilitators regarding nutritional care included more scientific evidence regarding the effect of nutritional care on clinical outcomes and optimization of organizational processes related to nutritional care. Conclusions: Healthcare professionals perceive nutritional care as important for optimal outcomes, but nutritional care is not routinely implemented in the care of patients with CLTI. This lack of implementation of nutritional care may be due to the barriers perceived in various domains. The findings of this study stress the need to optimize nutritional care, with the aim of improving outcomes in the CLTI population.
AB - Background: Nutrition and nutritional care are essential for optimal outcomes, and, therefore of importance for patients with chronic limb threatening ischemia (CLTI) given their high risk of complications. However, insight is lacking in how healthcare professionals directly involved in the care of patients with CLTI perceive nutritional care, as well as in the perceived barriers and facilitators regarding optimal nutritional care. Methods: In this qualitative study with a phenomenological approach, 3 online focus groups were conducted with various healthcare professionals directly involved in the care of patients with CLTI. Sample size was guided by information power. Focus group recordings were transcribed verbatim, and reflexive thematic analysis was performed. Results: Seventeen healthcare professionals participated, including vascular surgeons, fellows in vascular surgery, a medical doctor and researcher, nurse specialized in wound care, general nurse, physical therapists, dietitians, and nutrition assistants. Four themes were generated: (1) nutritional care is crucial for optimal clinical outcomes and a healthy life, (2) insufficient attention to undernutrition and nutritional care by healthcare professionals, (3) patient-related factors challenge healthcare professionals in providing nutritional care, and (4) need for optimizing the organizational process related to nutritional care. Perceived barriers regarding nutritional care included knowledge deficits, nutritional care not being part of the healthcare professionals’ routine, missing tools to identify undernutrition, patient-related factors, and time constraints. Facilitators regarding nutritional care included more scientific evidence regarding the effect of nutritional care on clinical outcomes and optimization of organizational processes related to nutritional care. Conclusions: Healthcare professionals perceive nutritional care as important for optimal outcomes, but nutritional care is not routinely implemented in the care of patients with CLTI. This lack of implementation of nutritional care may be due to the barriers perceived in various domains. The findings of this study stress the need to optimize nutritional care, with the aim of improving outcomes in the CLTI population.
KW - perceptions
KW - barriers
KW - facilitators
KW - nutritional care
KW - patients
KW - ischemia
KW - focus groep
KW - healthcare professionals
KW - percepties
KW - barrières
KW - faciliteerders
KW - voedingszorg
KW - patiënten
KW - ischemie
KW - focus groep
KW - zorgprofessionals
U2 - 10.1016/j.avsg.2024.09.052
DO - 10.1016/j.avsg.2024.09.052
M3 - Article
C2 - 39424174
SN - 0890-5096
VL - 110
SP - 84
EP - 94
JO - Annals of Vascular Surgery
JF - Annals of Vascular Surgery
IS - Part B
ER -