'If you listen to me properly, I feel good': a qualitative examination of patient experiences of dietetic consultations.

BACKGROUND: There is considerable interest in healthcare research regarding communication skills and some debate surrounding the effectiveness of a patient-centred approach to care. Understanding patient experiences of consultations can help indicate how consultations can be modified to improve effectiveness. At present, there is little research exploring patient experience of dietetic consultations. The present study aimed to achieve a better understanding of patients' experiences of dietetic consultations using qualitative analysis. METHODS: Patients undergoing consultations with a dietitian were invited to discuss their experience of the consultation with a research dietitian who was not involved in their care. Individual interviews and focus groups were conducted and analysed using the Framework approach. RESULTS: Seventeen patients participated and described their experiences of consultations, which were varied and influenced by factors such as information given (resources, explanation, repetition, consistency); their dietitian's approach (prescriptive or nonprescriptive, use of behaviour change skills), behaviour (listening skills, body language) and appointment (expectations, involvement of the multidisciplinary team, length of time); and their own internal experience (confidence, guilt, frustration). Patients agreed that certain factors, such as good communication and rapport, receiving effective and reliable information and resources, and nonjudgmental, regular support, were important factors in creating a positive experience of their consultation. However, they differed in what they believed constituted these factors. CONCLUSIONS: Patients like dietitians to adopt a patient-centred approach, which might be either patient- or practitioner-led, and to take account of what they wanted from consultations, adapting these to meet their individual requirements.

Back pain in nursing and associated factors: a study.

This article reports on an assessment of back pain and associated factors undertaken with nursing staff on nine NHS hospital wards and two private wards. One hundred and sixty eight nurses completed a confidential, retrospective questionnaire. The results suggest that despite the implementation of the 1992 EC manual handling operations regulations, back pain among nurses still remains a problem and is often due to the cumulative effects of work pressures. There is little evidence that training in manual handling reduces the prevalence of back pain directly, since the factors influencing the occurrence of back pain are complex.