Development of a nutrition counselling care map for dyslipidemia.
OBJECTIVE
Care maps or clinical pathways for nutrition therapy of dyslipidemia could add to current practice guidelines, by providing templates for feasible and recommended diet counselling processes. A care map was therefore developed by engaging expert and generalist dietitians and external experts from across Canada in a multi-stage consensus process.


METHODS
First, a qualitative study was undertaken with a convenience sample of 12 practitioners to identify possible diet care options, using hypothetical client scenarios and cognitive analysis. Second, these care options were rated for five case scenarios considered typical (overweight clients, with or without clinical cardiovascular disease and other comorbidities, potentially motivated to change, consuming high-fat diets, and facing various major barriers to eating behaviour change). The rating was conducted through a survey of participants. Highly appropriate, recommended, and feasible options for counselling were ranked through a two-round modified Delphi process, with teleconference discussions between rounds.


RESULTS
Forty-nine professionals started the consensus process; 39 (80%) completed all aspects. Numerous care processes were appropriate for all clients, with additional focus on barriers for low-income clients, sodium intake for clients with hypertension, and smoking cessation in smokers.


CONCLUSIONS
The resulting care map, "Dietitians' Quick Reference Guide for Clinical Nutrition Therapy for Overweight Clients with Dyslipidemia," provides a basis for current practice and new effectiveness studies.
Brauer
Paula M
PM
Department of Family Relations & Applied Nutrition, University of Guelph, Guelph, ON, Canada.
Hanning
Rhona M
RM
Arocha
Jose F
JF
Royall
Dawna
D
Grant
Andrew
A
Dietrich
Linda
L
Martino
Roselle
R
D000328:Adult; D003376:Counseling / Q000379:methods / Q000458:organization & administration* / Q000592:standards; D003697:Delphi Technique; D004046:Dietetics / Q000379:methods* / Q000592:standards; D050171:Dyslipidemias / Q000178:diet therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic