Understanding the practices and needs of nutrition counseling by focus group interviews - Using gout as an example

This study represents one of the three methods used in the nutrition counseling need assessments research series from 1999 to 2000. We developed a structured agenda and conducted three focus group interviews consisting of eight dietitians, ten gout patients, and seven university educators in each section. All three groups indicated that there were increased recognition and needs for nutrition counseling for gout, as well as other metabolic disorders, by patients and medical staff. The dietitian group emphasized the inconsistent and incompatible policies of nutrition counseling services in hospital management, the national health insurance policy and reimbursement systems. Improvements in understanding and training in interviewing and counseling skills are essential. The patient group expressed opinions regarding good compliance from physician referrals to nutrition counseling, but without personal incentives. Most gout patients suggested counseling contents need to be understandable and doable; also extra payments are acceptable. University faculty members encouraged young students to enhance interpersonal communication training and related multidisciplinary cooperation in practical teaching; however, they stated the reality of academic hiring. Finally, we have six suggestions for the future development of nutrition counseling policy. 1) Chronic disease prevention and treatment policies should be enhanced with nutrition education components. 2) Hospitals and public health agencies need to have sufficient nutrition personnel to deliver high-quality nutrition services. 3) The nutrition service quota in the national hospital evaluation system should be increased. 4) Dietitians conducting nutrition counseling by national health insurance program should be reimbursed. 5) Procedures of medical nutrition therapy for various metabolic disorders should be standardized. 6) The understanding and practices of behavior modification and counseling-related theories should be improved. 7) The "health education medical chart" concept in chronic disease control and patient follow-up should be promoted.