Evidence map›Paper›PMID 30890125›Full record

ArticleBMC health services research2019

A qualitative exploration of factors influencing medical staffs' decision-making around nutrition prescription after colorectal surgery.

Megan Rattray, Shelley Roberts, Ben Desbrow, Martin Wullschleger, Tayla Robertson, Ingrid Hickman, Andrea P Marshall

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
2.2field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Megan RattraySchool of Allied Health Sciences, Griffith University, Gold Coast Campus, QLD, 4222, Australia. megan.rattray@griffithuni.edu.au.ORCID http://orcid.org/0000-0002-8124-1054
Shelley RobertsSchool of Allied Health Sciences, Griffith University and Gold Coast Hospital and Health Service, Griffith, QLD, 4222, Australia.
Ben DesbrowSchool of Allied Health Sciences, Griffith University, Gold Coast Campus, QLD, 4222, Australia.
Martin WullschlegerDepartment of Trauma, Gold Coast University Hospital, Gold Coast, 4222, Australia.
Tayla RobertsonDepartment of Nutrition and Dietetics, Princess Alexandra Hospital, Gold Coast, QLD, Australia.
Ingrid HickmanDepartment of Nutrition and Dietetics, Princess Alexandra Hospital and Mater Research Institute, University of Queensland, Gold Coast, QLD, Australia.
Andrea P MarshallMenzies Health Institute Queensland, Griffith University and Gold Coast Health, Gold Coast, 4222, Australia.
Griffith University · AUGold Coast Hospital · AUPrincess Alexandra Hospital · AUThe University of Queensland · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEnhanced Recovery After Surgery (ERAS) guidelines recommend early oral feeding with nutritionally adequate diets after surgery. However, studies have demonstrated variations in practice and poor adherence to these recommendations among patients who have undergone colorectal surgery. Given doctors are responsible for prescribing patients' diets after surgery, this study explored factors which influenced medical staffs' decision-making regarding postoperative nutrition prescription to identify potential behaviour change interventions.

methodsThis qualitative study involved one-on-one, semi-structured interviews with medical staff involved in prescribing nutrition for patients following colorectal surgery across two tertiary teaching hospitals. Purposive sampling was used to recruit participants with varying years of clinical experience. The Theoretical Domains Framework (TDF) underpinned the development of a semi-structured interview guide. Interviews were audio recorded, with data transcribed verbatim before being thematically analysed. Emergent themes and sub-themes were discussed by all investigators to ensure consensus of interpretation.

resultsTwenty-one medical staff were interviewed, including nine consultants, three fellows, four surgical trainees and five junior medical doctors. Three overarching themes emerged from the data: (i) Prescription preferences are influenced by perceptions, experience and training; (ii) Modifying prescription practices to align with patient-related factors; and (iii) Peers influence prescription behaviours and attitudes towards nutrition.

conclusionsIndividual beliefs, patient-related factors and the social influence of peers (particularly seniors) appeared to strongly influence medical staffs' decision-making regarding postoperative nutrition prescription. As such, a multi-faceted approach to behaviour change is required to target individual and organisational barriers to enacting evidence-based feeding recommendations.

Indexed as

Clinical Decision-MakingColorectal SurgeryMedical Staff, HospitalNutritional SupportPractice Patterns, Physicians'AdultAustraliaConsultantsFemaleGuideline AdherenceHospitals, TeachingHumansInterviews as TopicMaleMiddle AgedNutritional StatusEarly oral feedingEnhanced recovery after surgeryPerioperative nutrition carePostoperative nutrition care

Identifiers

PMID30890125
PMCPMC6425714
OpenAlexW2941631817

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.