The Perception and Attitude of Dietitians Regarding the Nutritional Needs of Cystic Fibrosis Patients

Abstract

Background: Cystic fibrosis (CF) is a genetic disorder that presents complex nutritional needs due to pancreatic insufficiency, increased metabolic demands, and chronic inflammation, posing significant challenges to patients' overall health. Dietitians play a pivotal role in managing these intricate nutritional requirements, tailoring interventions to support optimal growth and well-being despite the disease's multifaceted impact. On top of these longstanding complexities, the recent introduction of CFTR modulators is transforming CF care, creating new considerations and necessitating adaptations in nutritional management. Despite the critical role of dietitians, there is a lack of research exploring their perceptions, attitudes, and lived experiences in addressing these challenges. To our knowledge, this is the first study to investigate these aspects, aiming to provide insights that enhance CF nutritional management on a broader scale.

Purpose: The purpose of this study was to explore the perceptions, attitudes, and experiences of dietitians regarding the nutritional needs of patients with cystic fibrosis (CF). The goal was to understand how dietitians approach CF nutritional management based on their lived experiences and to identify the perceived challenges, gaps, and professional insights that shape their practice.

Methods: This qualitative study used semi-structured interviews to gather in-depth insights from eight licensed dietitians, each with a minimum of one year of clinical experience, working in various healthcare settings in the western region of Saudi Arabia. Participants were recruited via email using purposive and convenience sampling. Interviews were conducted and recorded via WebEx. Data were analyzed thematically following Braun and Clarke’s six-phase approach, with superordinate, sub-superordinate, and emergent codes used to identify patterns related to CF nutritional care.

Results: Thematic analysis identified eight superordinate themes: Perceived Understanding of CF Nutrition, Perceived Nutritional Priorities, Dietitians' Confidence and Preparedness, Dietitians' Perceptions of Others in CF Care, Guidelines, Perceived Challenges, Awareness of Advances in CF Care, and Lived Experiences of Managing CF Nutrition. Findings revealed a strong consensus on increased energy requirements and the use of high-calorie, high-fat, and high-protein diets, aligning with established literature. However, perceived gaps in awareness of CFTR modulators and evolving nutritional trends, along with variable confidence levels linked to limited clinical exposure, revealed the need for enhanced training. Common challenges included poor patient adherence and difficulty meeting nutritional targets, often addressed through supplements and practical education. The study underscores the importance of culturally relevant guidelines, interdisciplinary collaboration, and family involvement, offering implications for practice, education, and future research to improve CF nutritional care.

Conclusion: This study highlights the critical role of dietitians in navigating the complex and evolving landscape of cystic fibrosis nutritional care. The findings emphasize the need for improved education, clinical training, and access to updated guidelines to address current perceived gaps in knowledge and practice. By shedding light on dietitians’ experiences and challenges, this research contributes valuable insights that can inform curriculum development, continuing education, and policy initiatives aimed at strengthening CF nutritional care and patient outcomes.