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A longitudinal ethnographic study of hospital staff attitudes and experiences of change in nutrition care
Author(s) -
Ottrey E.,
Palermo C.,
Huggins C. E.,
Porter J.
Publication year - 2020
Publication title -
journal of human nutrition and dietetics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.951
H-Index - 70
eISSN - 1365-277X
pISSN - 0952-3871
DOI - 10.1111/jhn.12734
Subject(s) - medicine , thematic analysis , focus group , intervention (counseling) , psychological intervention , nursing , behaviour change , health care , behavior change , qualitative research , perception , medical education , psychology , social science , pathology , marketing , neuroscience , sociology , economic growth , economics , business
Abstract Background Change promotes quality in healthcare, yet adopting change can be challenging. Understanding how change in nutrition care is adopted may support better design and implementation of interventions that aim to address inadequate food intake in hospital. The present study followed the process of change in a healthcare organisation, exploring staff attitudes, beliefs and experiences of the implementation of a mealtime intervention. Methods In total, 103 h of fieldwork were conducted in this longitudinal ethnographic study over a 4‐month period. Over 170 staff participated, with data captured using observation, interviews and focus groups. Data were analysed using an inductive, thematic approach, informed by implementation theory. Results Attitudes and experiences of change in nutrition care are described by three themes: (i) staff recognised the inevitability of change; (ii) staff cooperated with the intervention, recognising potential value in the intervention to support patient care, where increased awareness of their mealtime behaviours supported adopting practice changes; and (iii) some staff were able to reflect on their practice after implementing the intervention, whereas others could not. A model illustrating the interconnectedness of factors influencing implementation emerged from the research, guiding future nutrition care intervention design and supporting change. Conclusions The requirement to address the underlying perceptions of staff about the need to change should not be underestimated. Increased efforts to market the change message to specific staff groups and physical behavioural reinforcement strategies are needed. Nutrition care in the future should focus on helping staff feel positive about making practice changes.