Attitudes of family medicine physicians toward the Turkish-validated 12-item attitude scale for the clinical nutrition care process: a national cross-sectional analysis

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OBJECTIVE: Malnutrition in older adults drives functional decline, higher morbidity, and rising healthcare costs. Although family medicine specialists are well placed to manage community nutritional risk, their clinical engagement is often limited. The aim of this study was to evaluate their attitudes toward the clinical nutrition care process and identify professional factors influencing these views. METHODS: We conducted a national cross-sectional survey among family medicine specialists in Turkey using the Turkish-validated 12-item Attitude Scale for the Clinical Nutrition Care Process. The scale evaluates two primary dimensions: Physician duties (Factor 1) and Non-physician duties (Factor 2), with total scores ranging from 12 to 60. Professional characteristics, including work setting, clinical nutrition training, and self-perceived competence, were also assessed. Statistical associations were explored using Welch's t-test, Welch analysis of variance, and Pearson correlation. RESULTS: Overall, 410 specialists participated (65.6% female; mean age 37.0±5.9 years). Although 71.2% (n=292) had clinical nutrition training, only 30.0% (n=123) used nutrition screening tools, and 32.4% (n=133) reported self-perceived competence in malnutrition management. The mean total attitude score was 40.76±6.48, moderately positive. Work setting affected attitudes (p=0.025): home health scored higher than outpatient clinics (42.23±6.09 vs. 40.04±6.88). Screening-tool use and self-perceived competence were significantly associated with more favorable attitudes toward interprofessional duties (Factor 2) (p=0.008; p=0.016). CONCLUSION: Despite generally positive attitudes, a major gap remains between clinical perception and delivering nutritional care in primary practice. Low use of screening tools and limited perceived competence indicate an urgent need for interventions that combine hands-on training with institutional support to improve community nutritional management.

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