Healthcare Professionals’ Perspectives of Nonsurgical Care of Older Inpatients with Class II or III Obesity and Comorbidities: A Qualitative Study

Merridie Rees,1 Clare E Collins,1,2 Eleanor C Majellano,1,4 Vanessa M McDonald1,3,4 1College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW, Australia; 2Food and Nutrition Research Program, Hunter Medical Research Institute, Newcastle, NSW, Australia; 3Asthma and Breathin...

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Main Authors: Rees M, Collins CE, Majellano EC, McDonald VM
Format: Article
Language:English
Published: Dove Medical Press 2023-11-01
Series:Journal of Multidisciplinary Healthcare
Subjects:
Online Access:https://www.dovepress.com/healthcare-professionals-perspectives-of-nonsurgical-care-of-older-inp-peer-reviewed-fulltext-article-JMDH
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author Rees M
Collins CE
Majellano EC
McDonald VM
author_facet Rees M
Collins CE
Majellano EC
McDonald VM
author_sort Rees M
collection DOAJ
description Merridie Rees,1 Clare E Collins,1,2 Eleanor C Majellano,1,4 Vanessa M McDonald1,3,4 1College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW, Australia; 2Food and Nutrition Research Program, Hunter Medical Research Institute, Newcastle, NSW, Australia; 3Asthma and Breathing Research Program, Hunter Medical Research Institute, Newcastle, NSW, Australia; 4Medical and Interventional Services, Hunter New England Local Health District, Newcastle, NSW, AustraliaCorrespondence: Vanessa M McDonald, Hunter Medical Research Institute – Asthma and Breathing Research Program, Locked Bag 1000 New Lambton, Newcastle, NSW, 2305, Australia, Tel +61 40420146, Fax +6140420046, Email vanessa.mcdonald@newcastle.edu.auBackground: Older people with Class II or III obesity and comorbidities experience complex care needs with frequent hospital admissions. In 2019/20 the National Health Service in England reported a 17% increase in hospital admissions of patients with obesity compared to 2018/19. Gaps in care for this population have been identified.Purpose: The purpose of this study was to understand the experiences and perspectives of healthcare professionals delivering non-surgical care to older people with Classes II or III obesity admitted to a tertiary care hospital.Methods: Healthcare professionals delivering non-surgical care to older people admitted with Class II or III obesity with comorbidities were recruited from an Australian tertiary referral hospital. Qualitative semi-structured interviews were conducted with 24 healthcare professionals from seven disciplines between August and December 2019. The interviews were audio-recorded, transcribed, and reviewed by participants for accuracy. Thematic inductive data analysis was deductively mapped to the Theoretical Domains Framework (TDF).Results: Four major themes of Barriers, Facilitators, Current Practice, and Recommendations and 11 subthemes were identified and mapped to nine domains in the TDF. The Barriers subtheme identified perceived patient related factors, health system issues, and provider issues, while the Facilitators subtheme included a patient centred approach, knowledge, and resources in the subacute setting. The major Current Practice theme explored factors influencing clinical management, and the Recommendations subthemes included engaging patients, access to quality care, education and support, and obesity as a chronic disease.Conclusion: This novel application of the TDF provided broad insights related to the barriers and facilitators in delivering non-surgical care to this hospital population, from the perspective of healthcare professionals. Understanding how these barriers interact can provide strategies to influence behaviour change and assist in the development of a holistic multidisciplinary model of care.Keywords: model of care, theoretical domains framework, hospitalized, obesity
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spelling doaj.art-448175e493184dbdba4fcdc17a561c192023-11-07T17:06:36ZengDove Medical PressJournal of Multidisciplinary Healthcare1178-23902023-11-01Volume 163339335587996Healthcare Professionals’ Perspectives of Nonsurgical Care of Older Inpatients with Class II or III Obesity and Comorbidities: A Qualitative StudyRees MCollins CEMajellano ECMcDonald VMMerridie Rees,1 Clare E Collins,1,2 Eleanor C Majellano,1,4 Vanessa M McDonald1,3,4 1College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW, Australia; 2Food and Nutrition Research Program, Hunter Medical Research Institute, Newcastle, NSW, Australia; 3Asthma and Breathing Research Program, Hunter Medical Research Institute, Newcastle, NSW, Australia; 4Medical and Interventional Services, Hunter New England Local Health District, Newcastle, NSW, AustraliaCorrespondence: Vanessa M McDonald, Hunter Medical Research Institute – Asthma and Breathing Research Program, Locked Bag 1000 New Lambton, Newcastle, NSW, 2305, Australia, Tel +61 40420146, Fax +6140420046, Email vanessa.mcdonald@newcastle.edu.auBackground: Older people with Class II or III obesity and comorbidities experience complex care needs with frequent hospital admissions. In 2019/20 the National Health Service in England reported a 17% increase in hospital admissions of patients with obesity compared to 2018/19. Gaps in care for this population have been identified.Purpose: The purpose of this study was to understand the experiences and perspectives of healthcare professionals delivering non-surgical care to older people with Classes II or III obesity admitted to a tertiary care hospital.Methods: Healthcare professionals delivering non-surgical care to older people admitted with Class II or III obesity with comorbidities were recruited from an Australian tertiary referral hospital. Qualitative semi-structured interviews were conducted with 24 healthcare professionals from seven disciplines between August and December 2019. The interviews were audio-recorded, transcribed, and reviewed by participants for accuracy. Thematic inductive data analysis was deductively mapped to the Theoretical Domains Framework (TDF).Results: Four major themes of Barriers, Facilitators, Current Practice, and Recommendations and 11 subthemes were identified and mapped to nine domains in the TDF. The Barriers subtheme identified perceived patient related factors, health system issues, and provider issues, while the Facilitators subtheme included a patient centred approach, knowledge, and resources in the subacute setting. The major Current Practice theme explored factors influencing clinical management, and the Recommendations subthemes included engaging patients, access to quality care, education and support, and obesity as a chronic disease.Conclusion: This novel application of the TDF provided broad insights related to the barriers and facilitators in delivering non-surgical care to this hospital population, from the perspective of healthcare professionals. Understanding how these barriers interact can provide strategies to influence behaviour change and assist in the development of a holistic multidisciplinary model of care.Keywords: model of care, theoretical domains framework, hospitalized, obesityhttps://www.dovepress.com/healthcare-professionals-perspectives-of-nonsurgical-care-of-older-inp-peer-reviewed-fulltext-article-JMDHmodel of caretheoretical domains frameworkhospitalizedobesity
spellingShingle Rees M
Collins CE
Majellano EC
McDonald VM
Healthcare Professionals’ Perspectives of Nonsurgical Care of Older Inpatients with Class II or III Obesity and Comorbidities: A Qualitative Study
Journal of Multidisciplinary Healthcare
model of care
theoretical domains framework
hospitalized
obesity
title Healthcare Professionals’ Perspectives of Nonsurgical Care of Older Inpatients with Class II or III Obesity and Comorbidities: A Qualitative Study
title_full Healthcare Professionals’ Perspectives of Nonsurgical Care of Older Inpatients with Class II or III Obesity and Comorbidities: A Qualitative Study
title_fullStr Healthcare Professionals’ Perspectives of Nonsurgical Care of Older Inpatients with Class II or III Obesity and Comorbidities: A Qualitative Study
title_full_unstemmed Healthcare Professionals’ Perspectives of Nonsurgical Care of Older Inpatients with Class II or III Obesity and Comorbidities: A Qualitative Study
title_short Healthcare Professionals’ Perspectives of Nonsurgical Care of Older Inpatients with Class II or III Obesity and Comorbidities: A Qualitative Study
title_sort healthcare professionals rsquo perspectives of nonsurgical care of older inpatients with class ii or iii obesity and comorbidities a qualitative study
topic model of care
theoretical domains framework
hospitalized
obesity
url https://www.dovepress.com/healthcare-professionals-perspectives-of-nonsurgical-care-of-older-inp-peer-reviewed-fulltext-article-JMDH
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AT majellanoec healthcareprofessionalsrsquoperspectivesofnonsurgicalcareofolderinpatientswithclassiioriiiobesityandcomorbiditiesaqualitativestudy
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