The demand and supply of nutritional advice and guidance in Scottish family planning services

Recent changes to the health services have led to an increased provision of clinical care in family planning clinics. While some women may only requir e contraceptive services, others may demand advice on a breadth of lifestyl e issues, including diet and nutrition. Obesity affects 17% of women of chi ldbearing age in Scotland and being overweight during pregnancy has signifi cant health risks. A postal survey of 227 nurses identified as working in family planning clin ics in Scotland was conducted in 1998. After a mail shot and one reminder a net response rate of 64% (n = 145) was achieved Overall, it was found that obesity was perceived as the most extensive problem in Lt omen of childbea ring age. Seventy nurses (48%) reported that, in addition to offering famil y planning services, they gave dietary advice 'frequently' or 'always' to t heir clients without being asked. There were differences in nutrition-relat ed activities in consultations between nurses offering family planning serv ices only and those who routinely offered nutritional advice. Over half (61 %) of the nurses reported that they would give advice regarding weight mana gement even if the patients were nor seeking help, although there was no si gnificant difference between the two comparison groups. In some cases, the nutritional advice offered to clients highlighted a deficit in training. Most nutrition education came from diploma and/or training courses and scie ntific literature, followed by 'experience'. Those nurses already embracing a nutritional advice and guidance role were more interested in further nut rition training (p = 0.018) than the other nurses. However, overall, 67% of the nurses wished to train further in nutrition and weight management. The findings suggest that family planning nurses should be supported to dev elop nutritional advice and guidance skills, and that there is a pressing n eed for training in public health nutrition and weight management for nurse s working in family planning services.