Interprofessional Treatment of Malnutrition and Sarcopenia by Dietitians and Physiotherapists: Exploring Attitudes, Interprofessional Identity, Facilitators, Barriers, and Occurrence

Figures & data

Figure 1 Overview of measurement outcomes: problem domain, attitudes, interprofessional identity, facilitators, barriers and interprofessional treatment of malnutrition and sarcopenia.

Table 1 Demographic Characteristics of Respondents (n = 101)

	Practitioners		p value
	Dietitians (n = 48)	Physiotherapists (n=53)
Age, mean (SD)	42.9 (13.1)	38.4 (10.7)	0.061
Gender (female), n (%)	46 (96)	42 (79)	0.013
Work setting
- Primary care, n (%)	33 (69)	35 (66)	0.772
- Secondary care, n (%)	16 (33)	22 (42)	0.645
- Nursing home and rehabilitation, n (%)	11 (23)	8 (15)	0.315
- Other, n (%)	3 (6)	2 (4)	0.597

Notes: some dietitians and physiotherapists work in more than one work setting. Therefore, the sum of categories might be more than 100% of the total sample.

Abbreviation: SD, standard deviation.

Table 2 Comparing Interprofessional Treatment of Malnutrition and Sarcopenia by Dietitians and Physiotherapists (n = 101)

	Malnutrition					Sarcopenia
	Median	IQR	95% CI		p value	Median	IQR	95% CI		p value
			Lower limit	Upper limit				Lower limit	Upper limit
Treating patients			0.518	1.100	<0.001			−0.718	−0.386	0.927
Dietitians	4.0	4.0–4.0				3.5	3.0–4.0
Physiotherapists	3.0	3.0–4.0				4.0	3.0–4.0
Perceived shared problem domain			−0.245	0.320	0.858			−0.523	0.034	0.044
Dietitians	4.0	4.0–4.0				4.0	4.0–5.0
Physiotherapists	4.0	3.0–5.0				5.0	4.0–5.0
Interprofessional treatment			−0.232	0.506	0.551			−0.269	0.495	0.495
Dietitians	3.0	3.0–4.0				3.0	3.0–3.0
Physiotherapists	3.0	2.0–4.0				3.0	2.0–4.0

Notes: Degree to which health professionals treat these conditions, perceive each of them as shared problem domain and degree of interprofessional treatment; 5-point Likert scale: 1 = never; 2 = seldom; 3 = sometimes; 4 = relatively often; 5 = often; Mann–Whitney U-test .

Abbreviations: IQR, interquartile range; CI, confidence interval; D, dietitians; P, physiotherapists.

Table 3 Attitudes of Dietitians and Physiotherapists Towards Interprofessional Treatment of Malnutrition and/or Sarcopenia (n = 101)

Type of attitude	Attitudes Towards Interprofessional Collaboration
	Negative^a		Positive^b
	Dietitians (n = 48)	Physiotherapists (n = 53)	Dietitians (n = 48)	Physiotherapists (n = 53)
	n (%)	n (%)	n (%)	n (%)
1. Trust in expertise of other	2 (4.2)	1 (1.9)	41 (85.4)	48 (90.6)
2. Respect for the other	1 (2.1)	0 (0.0)	43 (89.6)	49 (92.5)
3. Willingness to collaborate interprofessional	4 (8.3)	2 (3.8)	35 (72.9)	46 (86.8)
4. Perceived added value of interprofessional collaboration	1 (2.1)	0 (0.0)	44 (91.7)	47 (88.7)
5. Perceived interdependence	13 (27.1)	17 (32.1)	5 (10.4)	5 (9.4)
6. Perceived autonomy	2 (4.2)	3 (5.7)	26 (54.2)	23 (43.4)

Notes: ^aVery unimportant or unimportant versus other responses; ^bVery important or important versus. Other responses; Chi² test: p < 0.05.

Table 4 Interprofessional Identity of Dietitians and Physiotherapists per Profession and per Work Setting (n = 101)

Profession and Work Setting		n				Dimensions of Interprofessional Identity
			Interprofessional Identity			Interprofessional Belonging			Interprofessional Commitment			Interprofessional Beliefs
			Median	IQR	95% CI	Median	IQR	95% CI	Median	IQR	95% CI	Median	IQR	95% CI
-Dietitians		48	4.0**	3.7–4.4	−0.44368–05272	4.0***	4.0–4.7	−0.64338 - −0.09876	4.0*	3.6–4.5	−0.52703–0.02860	4.0	3.8–4.4	−0.36941–0.12078
-Physiotherapists		53	4.3**	4.0–4.6		4.8***	4.3–5.0		4.3*	4.0–4.8		4.0	3.8–4.3
-Primary care	Yes	65	4.3	3.8–4.5	−0.06312–0.36214	4.5	4.0–5.0	−0.29712–0.30380	4.0*	3.8–4.4	0.00056–0.58991	4.0	3.6–4.3	−0.11063–0.41054
	No	36	4.3	3.9–4.6		4.5	4.0–5.0		4.3*	4.0–4.9		4.0	3.8–4.4
-Secondary care	Yes	36	4.4	3.9–4.7	−0.39729–0.01126	4.5	4.0–5.0	−0.42744–0.15175	4.3*	3.8–4.9	−0.61508 - −0.04846	4.0	3.8–4.5	−0.36245–0.14357
	No	65	4.2	3.8–4.4		4.5	4.0–5.0		4.0*	3.8–4.4		4.0	3.8–4.3
Specific groups (partial overlap with former groups)
-Nursing home	Yes	17	4.3	4.0–4.6	−0.18680–0.32779	4.3	4.0–4.6	−0.04455–1.06445	4.5*	4.0–5.0	−0.54077–0.17684	4.0	3.8–4.4	−0.43043–0.19744
Rehabilitation	No	84	4.3	3.8–4.5		4.5	4.0–4.5		4.0*	3.8–4.5		4.0	3.8–4.3

Notes: Response format = 5-point Likert scale (1= strongly disagree; 2 = disagree; 3 = neutral/no opinion; 4 = agree; 5 = strongly agree); linear transformation of mean Likert scores. Yes = working in this setting; No = not working in this setting; Mann–Whitney U-test: *p <0.05; **p <0.01; ***p <0.001.

Abbreviations: IQR, interquartile range (lower limit–upper limit); CI, confidence interval.

Table 5 Reported Barriers and Facilitators of Interprofessional Treatment of Malnutrition and/or Sarcopenia (n = 101)

Type of antecedent	Antecedents of interprofessional collaboration
	Barrier^a		Facilitator^b
	Dietitians (n = 48)	Physiotherapists (n = 53)	Dietitians (n = 48)	Physiotherapists (n = 53)
	n (%)	n (%)	n (%)	n (%)
1. Role clarity	8 (17)*	1 (2)	27 (56)	41 (77)*
2. Clarity other expertise	3 (6)	1 (2)	34 (71)	46 (87)
3. Intergroup hierarchy	9 (19)	7 (13)	12 (25)	9 (17)
4. Willingness of others to collaborate interprofessional	5 (10)	4 (8)	35 (73)	46 (87)
5. Efficient means of communication	32 (67)	44 (83)	3 (6)	2 (4)
6. Available time	43 (90)	42 (80)	0 (0)	2 (4)
7. Accessibility	18 (38)	17 (32)	5 (10)	11 (8)
8. Financial compensation	28 (58)	27 (51)	1 (2)	2 (4)
9. Differences in liability	7 (15)	11 (21)	0 (0)	1 (2)
10. Differences in payment and remuneration	15 (31)	16 (30)	0 (0)	2 (4)
11. Interprofessional knowledge	26 (54)	37 (70)	3 (6)	4 (8)
12. Interprofessional skills	21 (44)	31 (59)	3 (6)	5 (9)
13. Interprofessional experience	23 (48)	32 (60)	4 (8)	3 (6)
14. Bureaucracy	33 (69)	35 (66)	3 (6)	2 (4)
15. Clarity about clinical responsibility	10 (21)	18 (34)	7 (15)	2 (4)
16. Obtaining extra care for patient	27 (56)	37 (70)	3 (6)	6 (11)

Notes: Analysis per antecedent (barriers or facilitator) = ^aBarrier or no barrier; ^bFacilitator or no facilitator; Chi² test: *p < 0.05.