P29: AUCKLAND DISTRICT HEALTH BOARD CLINICAL IMMUNOLOGY AND ALLERGY SERVICE FOR ADULTS PATIENT EXPERIENCE SURVEY

Abstract

This audit captures experiences of adult immunology patients who received support from a dietitian using a 'whole person' approach that widens its focus beyond supposed dietary triggers of hypersensitivity. During consultations, attempts were made to explore underlying emotional drivers of hypersensitivity, and help patients build a better relationship with food. A confidential survey was sent to 59 adult patients who had consulted with the dietitian between June 2014 and June 2015. Twenty people (34%) responded, male to female 20:80. They mainly presented with food allergies, intolerances and irritable bowel syndrome, and also inadequate nutrient intake, overweight or immune deficiency. Seventy-five percent of participants reported an improvement in their medical conditions, 55% with improvement in symptoms and 10% being cured of them. Ninety percent felt satisfied or very satisfied with the nutrition advice they received. Seventy-five percent reported improved nutritional balance although one person said it got worse. They wanted to lose weight. Seventy-five percent of the participants felt very satisfied or satisfied with their experience of the whole person approach although 10% felt dissatisfied. Appreciation was expressed for feeling empathically listened to and understood, for receiving a new model from which to understand food-related problems (including the role of unresolved feelings and stress), for having space to cry, for being treated with compassion, respect and dignity, and for feeling empowered to get well. The team approach was enjoyed. Three (15%) participants, who were less psychologically minded, wanted to focus upon dietary manipulation. Some participants confessed it was difficult facing into internal distress and external stressors. Building a trusting relationship with the patient was helpful for addressing sensitive issues. The audit demonstrated that a dietitian working relationally with a whole person approach was effective for improving food-related sensitivity without encouraging dependence upon overly-restrictive diets in individuals open to exploring their emotional world.