IrSPEN 2020 Award for Best Overall Research Project, BSc Human Nutrition and Dietetics (join Trinity-TU Dublin) programme

Aine Ryan (Bsc) has been awarded the prize for best overall research project 2020 for her final year project in the BSc Human Nutrition & Dietetics course 2020

Áine Ryan is a CORU registered dietitian who graduated this year with a BSc (Hons) in Human Nutrition and Dietetics from Technological University Dublin and Trinity College Dublin. Her research to date includes evaluating the dietary information provided to patients undergoing gastrointestinal surgery resulting in the formation of an ileostomy. This research was conducted with a focus on the patients’ perspective, striving to support patient centred care. Since graduating Áine has undertaken a role as a Community Dietitian. She has a keen interest in evidence based care which underpins her work. Áine hopes to present her research at future symposiums and work towards publishing this research. Áine looks forward to an exciting career in the field of nutrition and dietetics.

Research Summary:

An Evaluation of the Provision of Dietary Information to Patients with an Ileostomy in a Large Tertiary Hospital in Ireland

This study adds to the growing body of evidence regarding dietary education for patients with an ileostomy. Dietary education forms an integral part of patient advice following ileostomy formation. However, due to the lack of current, high-quality evidence, much of the dietary recommendations for ileostomates are based on anecdotal evidence and the opinion of the experts. Internationally, a low fibre diet has been traditionally recommended in the initial postoperative period. However, guidelines are often ambiguous and conflicting, which increases the risk of patients over restricting their diet. This study aimed to evaluate the dietary education provided to new ileostomates from a patient’s perspective. The objectives were; to find out if patients found the education provided by the hospital dietitian clear and useful, to identify the sources of information through which patients obtain dietary education, and to identify the ideal peri-operative timing and method of education. Participants were recruited in hospital after surgery and invited to complete a postal questionnaire 4-8 weeks after surgery.

Participants in this study generally considered the advice clear and useful, however, the difficulty with extrapolating the benefit of dietary adaptations in the presence of ongoing stoma complications was raised. Hesitance to re-introduce fibre containing foods was evident among this patient group. Follow up dietary counselling may alleviate fear and prompt patients to expand their dietary choices, lessening unnecessary long-term dietary restrictions. Interdisciplinary education may be beneficial in establishing a multidisciplinary consensus on dietary guidelines for patients with a new ileostomy. The internet is likely a growing source of information, therefore guidance surrounding reliable online sources of information should be provided to patients. Individual dietary education post-operatively is valued by new ileostomates. However, pre-operative dietary advice has the potential to be of additional benefit.  We suggest that stoma nurses and dietitians explore the best method of joint care to optimise resource use. This may enable dietary education provision both pre- and post-operatively and ensure patients are provided with professional support at the important time points in adapting to their new ileostomy.

The insight gained from this study will be used to guide service improvement at this hospital and may contribute, along with further research, to the development of national guidelines for this patient group.

I wish to acknowledge the contributions of Dr. Aileen Kennedy, Technological University Dublin, Ms. Caitriona Caulfield and Ms. Elaine Leahy, Department of Clinical Nutrition at St. James’s Hospital, Dublin.