Factors associated with consulting a dietitian for diabetes management: a cross-sectional study

BMC Health Services Research

Farah Naja²  Dana Mousa²  Hikma Shoaib²  Yara Mourad¹  Nahla Hwalla²  Lara Nasreddine²  Mohamad Alameddine¹ 

[1]Faculty of Health Sciences, Department of Health Management and Policy, American University of Beirut, Riad El-Solh, Beirut 1107 2020, Lebanon

[2]Faculty of Agricultural and Food Sciences, Department of Nutrition and Food Sciences, American University of Beirut, Riad El-Solh, Beirut 1107 2020, Lebanon

关键词: Lebanon;    Policy;    Dietitian;    Dietary counseling;    Human resources;    Diabetes management;    Planning and organizing care;   

Others  :  1134505
DOI  :  10.1186/1472-6963-13-504

 received in 2013-05-26, accepted in 2013-11-28,  发布年份 2013

【 摘 要 】

Background

Type 2 Diabetes (T2D) has reached epidemic levels in the Middle East region. Despite evidence that it improves health outcomes and saves health costs, dietary counseling for T2D remains grossly under-investigated in this region. The aim of this study was to assess the frequency and determinants of use of dietary counseling services by T2D patients in Lebanon and recommend corrective measures that may guide the planning, organization and delivery of care for chronic diseases in general and diabetes care in particular.

Methods

A non-experimental cross-sectional design was utilized to survey outpatients with T2D in two major health centers in Lebanon. Patients diagnosed with T2D were invited to complete a questionnaire consisting of five sections: socio-demographic characteristics, disease attributes, patients’ perceptions regarding T2D management, practice of lifestyle modifications, and referral by a physician to a dietitian. The outcome of interest was the use of dietary counseling services by T2D patients at least once since their diagnosis. Descriptive statistics and logistic regression analyses were used to evaluate the frequency and determinants of dietary counseling services utilization.

Results

A total of 332 T2D patients completed the questionnaire (response rate 94.6%). Although 75% of study participants believed that dietitians can assist them in changing their dietary habits, only 38% had consulted with a dietitian. Among study participants, only 34% were referred to a dietitian by their physician. The main determinants of the use of dietary counseling services were referral by a physician (OR: 112.25; 95% CI = 42.74-294.84), the presence of outpatient social or private health insurance (OR: 5.86; 95% CI = 2.40-14.25) and the belief that a dietitian can assist in changing dietary habits (OR: 3.74; 95% CI = 1.33-10.54).

Conclusions

The findings of this study show suboptimal use of dietary counseling services by T2D patients in Lebanon. Key determinants were physicians’ referral, financial support for outpatient care, and patients’ belief in the usefulness of dietary counseling. Suggested interventions entail enhancing the planning and organization of care through inter-professional collaboration between physicians and dietitians; promoting public financing for high quality outpatient care that includes dietary counseling; and promoting the value of dietary counseling and improving the public image of dietitians.

【 授权许可】

   
2013 Alameddine et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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