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Knowledge Translation and Evidence-Based Practice: A Qualitative Study on Clinical Dietitians’ Perceptions and Practices in Switzerland

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Abstract

Background

Knowledge translation (KT) in health care is essential to promote quality of care and reduce the knowledge-to-practice gap. Little is known about KT among dietitians, and a better understanding of how this process pans out is fundamental to support their clinical practice.

Objective

To explore clinical dietitians’ perceptions and practices concerning preferences and access to information sources in clinical practice, KT activities, research in nutrition and dietetics, and evidence-based practice (EBP).

Design, participants, and setting

Eight interviews and two focus groups involving a total of 15 participants were conducted in 2013 among members of the Swiss Association for Registered Dietitians in the French- and German-speaking regions of Switzerland.

Analysis performed

Thematic analysis drawn from a constructivist grounded theory approach.

Results

Information from colleagues and experts of the field were favored when facing unfamiliar situations in clinical practice. Critically selecting evidence-based information was considered challenging, but dietitians declared they were at ease to integrate patients’ preferences and values, and their clinical expertise and judgment, in decision making, which are fundamental elements of EBP. A major reported barrier to KT was the perception that time to identify and read scientific literature was not expected during working hours and that instead, this time should be spent in clinical activities with patients. On the other hand, dietitians identified that their frequent involvement in educational activities such as knowledge dissemination or tailoring favored the integration of evidence into practice. Finally, dietitians struggled more to identify evidence-based information about counseling and communication than about biomedical knowledge.

Conclusions

Dietitians mentioned being involved in each step of the KT process (ie, synthesis, dissemination, exchange, and ethically sound application of knowledge). Barriers and facilitators identified in this study need to be explored in a larger population to develop strategies to facilitate KT and EBP in dietetics practice.

Section snippets

Methods

Our methodology is inspired by a constructivist approach of the Grounded Theory that supposes the construction of theories by going back and forth between the data collection and analysis and the literature.20 This approach is particularly suited when the research focuses on a process,21 such as KT in our study. We took a relativist position, considering KT perceptions as socially built and the researchers’ subjectivity as part of the study process.22 The research team members have, and are

Results

On the 832 ASDD members who received the invitation, only 15 contacted the research team to participate to an interview or a focus group during the planned study period (May to July 2013). Eight interviews and two focus groups were organized in the French (seven interviews, and one focus group with four participants) and German (one interview, and one focus group with three participants) speaking regions of Switzerland, at dietitians’ workplaces or meeting rooms. The interviews lasted 66±10

Discussion

Our study aimed to explore clinical dietitians’ perceptions and practices concerning (a) preferences for and access to information’s sources, (b) KT activities, and (c) research in nutrition and dietetics and EBP in the German- and the French-speaking parts of Switzerland.

According to whether the purpose is to keep knowledge up-to-date or to quickly find information when faced with an unusual clinical situation, participants mentioned two preferred information sources: formal CPD and colleague

Conclusion and Perspectives

In our study, dietitians mentioned being involved in each step of the KT process (ie, synthesis, dissemination, exchange, and ethically sound application of knowledge),1 and that it favors the integration of evidence into clinical practice. However, the perception that the identification and reading of professional information was difficult to integrate within working hours was highlighted, and information in the field of communication was not recognized as evidence based. These findings could

Acknowledgements

We are grateful to Julia Miéville and Tania Carron, IUMSP, for their help on the interviews and focus groups transcription.

Author Contributions

L. Soguel, T. Bengough, and B. Burnand designed the study. L. Soguel and T. Bengough collected the data. L. Soguel, T. Bengough, and C. Vaucher analyzed the data. S. Desroches and L. Soguel discussed the synthesis of the analyses. All authors discussed the results. L. Soguel wrote the first draft of the manuscript under the supervision of S. Desroches. All authors reviewed

L. Soguel is a PhD candidate, Institute of Nutrition and Functional Foods (INAF), School of Nutrition, Faculty of Agriculture & Food Sciences, Laval University, Quebec City, Canada; and an associate professor, Nutrition and Dietetics Department, University of Applied Sciences Western Switzerland (HES-SO), Geneva, Switzerland.

References (41)

  • P.W. Yoon et al.

    Clinical preventive services for patients at risk for cardiovascular disease, National Ambulatory Medical Care Survey, 2005-2006

    Prev Chronic Dis

    (2011)
  • International Confederation of Dietetics Association (ICDA). International Code of Ethics and Code of Good Practice....
  • European Federation of the Associations of Dietitians (EFAD). Revised Dietetic Competence and the Six Domains of...
  • International Confederation of Dietetics Association (ICDA). International Competency Standards for...
  • International Confederation of Dietetics Association (ICDA). Final Report of the International Confederation of...
  • T. Wilson

    Information overload: implications for healthcare services

    Health Informatics J

    (2001)
  • A. Hall et al.

    Information overload within the health care system: A literature review

    Health Info Libr J

    (2004)
  • J.M. Grimshaw et al.

    Knowledge translation of research findings

    Implement Sci

    (2012)
  • S.D. Scott et al.

    Systematic review of knowledge translation strategies in the allied health professions

    Implement Sci

    (2012)
  • Y.W. Chiu et al.

    Do registered dietitians search for evidence-based information? A nationwide survey of regional hospitals in Taiwan

    Asia Pac J Clin Nutr

    (2012)
  • Cited by (0)

    L. Soguel is a PhD candidate, Institute of Nutrition and Functional Foods (INAF), School of Nutrition, Faculty of Agriculture & Food Sciences, Laval University, Quebec City, Canada; and an associate professor, Nutrition and Dietetics Department, University of Applied Sciences Western Switzerland (HES-SO), Geneva, Switzerland.

    C. Vaucher is a research associate, Department Epidemiology and Health Systems, and Cochrane Switzerland, Centre for Primary Care and Public Health and University of Lausanne, Lausanne, Switzerland; and a PhD candidate, University of Lausanne, Faculty of Social and Political Sciences, Institute of Social Sciences, THEMA lab, Lausanne, Switzerland.

    T. Bengough is a research associate, Department Epidemiology and Health Systems, and Cochrane Switzerland, Centre for Primary Care and Public Health and University of Lausanne, Lausanne, Switzerland; a researcher, Austrian Public Health Institute, Vienna, Austria; and a PhD candidate, Katholic University Leuven, Centre for Sociological Research, Faculty of Social Sciences, Leuven, Belgium.

    B. Burnand is a full professor, Department Epidemiology and Health Systems, and Cochrane Switzerland, Centre for Primary Care and Public Health and University of Lausanne, Lausanne, Switzerland.

    S. Desroches is a professor, INAF, School of Nutrition, Faculty of Agriculture & Food Sciences, Laval University, Quebec City, Canada.

    STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.

    FUNDING/SUPPORT This project was funded by the Geneva School of Health Sciences, University of Applied Sciences Western Switzerland (HES-SO); the Institute of Social and Preventive Medicine (IUMSP) and Cochrane Switzerland, Lausanne University Hospital (CHUV); and the Swiss Foundation for Nutrition Research (SFEFS), which supported L. Soguel with a 1-year PhD scholarship. The Swiss Association for Registered Dietitians (ASDD) offered a 50% reduction on the fee for the congress Nutridays 2014 to all participants and sent the recruitment e-mail to all the members for free.

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