Barriers associated with doctors' referral to dietitians in Gauteng, South Africa
Date
2006-12
Authors
Barron, Elise
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : University of Stellenbosch
Abstract
INTRODUCTION: The objective of this study was to explore the barriers that
doctors experience to referring patients to dietitians. The study sample (n = 700)
included a selection of all practicing medical doctors and specialists in the
Gauteng province of South Africa. Registration with the Health Professions
Council of South Africa (HPCSA) was a prerequisite.
METHOD: This was a quantitative study using a validated questionnaire e-mailed
to participating doctors in order to determine factors affecting their referral
practices. The first part of the questionnaire consisted of demographic and
general information about the respondent and the second and third parts
consisted of a series of closed-ended questions that related to specific issues of
nutrition information and dietitian referral practices respectively. The
questionnaire comprised a total of 21 questions. Subjects were sent the
questionnaire by e-mail and given four weeks to respond. Three reminder e-mails
were sent to encourage participation. Statistical analysis methods included:
Kruskal-Wallis, Pearson Chi-square, likelihood ratios, linear-by-linear
associations, as well as Goodman and Kruskal tau tests.
RESULTS: Of the questionnaires sent out, 134 (19%) out of 700 were finally
useable. Doctors who had a nutrition component in their training referred patients
to dietitians more often than those who did not and older doctors referred to a
dietitian less often (Chi-square tests, p < 0.05). A correlation was observed
between the duration of medical practice and frequency of referral (p = 0.03)
while gender had no influence on referral practice. A correlation (p < 0.001) was
also found between frequency of referral and university of study with symmetric
measures. Hyperlipidaemia, diabetes mellitus and obesity were identified as the
conditions doctors would most likely refer to a dietitian. For 45% of the doctors
insufficient time during consultation was the strongest barrier to providing
nutrition councelling to their patients. The barrier identified most commonly was
that doctors were unaware of dietitians in the vicinity of their practices (49%).
Sixty four percent of doctors believed that better marketing by dietitians would increase their referrals, and 21.4% believed that the title ‘nutritionist’ or ‘nutrition
specialist’ would be more suitable for the profession of dietetics.
CONCLUSION: The findings of the study indicate that a number of factors
contribute to the barriers that doctors experience to referring patients to
dietitians. Although the study was limited by a small sample, it nevertheless
draws attention to the responsibility of both dietitians and doctors to work
together toward providing patients with a more efficient team approach treatment
and care system. More qualitative studies are needed to explore the identified
barriers further, especially within the South African context, as well as to
establish appropriate recommendations to overcome the barriers to referral.
Description
Thesis (MNutr (Human Nutrition))--University of Stellenbosch, 2006.
Keywords
Dissertations -- Nutrition, Theses -- Nutrition, Dietitians -- Professional relationship, Dietitians -- South Africa, Physicians -- South Africa -- Attitudes