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J Acad Nutr Diet. 2019 Nov;119(11):1882-1889. doi: 10.1016/j.jand.2019.04.017. Epub 2019 Jul 8.

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

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.

KEYWORDS:

Clinical decision making; Dietitians; Evidence-based practice; Knowledge translation; Qualitative research

PMID:
31296425
DOI:
10.1016/j.jand.2019.04.017

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