{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T14:35:01Z","timestamp":1789137301804,"version":"build-2803163510"},"reference-count":29,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,6,17]],"date-time":"2021-06-17T00:00:00Z","timestamp":1623888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Newcastle Department of Rural Health","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Adapting to living with coeliac disease requires individuals to learn about and follow a strict gluten-free diet. Utilising a qualitative inductive approach, this study aimed to explore the perspectives of adults diagnosed with coeliac disease who have accessed dietetic services in a rural outpatient setting. A purposive sample of adults with coeliac disease who had accessed dietetic services from two rural dietetic outpatient clinics were recruited. Semi-structured interviews were conducted by telephone. Data were thematically analysed. Six participants were recruited and interviewed. Three key themes emerged: (i) optimising individualised support and services, (ii) adapting to a gluten-free diet in a rural context, and (iii) managing a gluten-free diet within the context of interpersonal relationships. Key issues identified in the rural context were access to specialist services and the increased cost of gluten-free food in more remote areas. The findings of this study have highlighted the difficulties associated with coeliac disease management and how dietetic consultation has the potential to influence confidence in management and improve lifestyle outcomes. Further qualitative research is required to expand on the findings of this study and inform future dietetic practice that meets the expectations and individual needs of people with coeliac disease in rural settings.<\/jats:p>","DOI":"10.3390\/nu13062074","type":"journal-article","created":{"date-parts":[[2021,6,17]],"date-time":"2021-06-17T11:20:26Z","timestamp":1623928826000},"page":"2074","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Patient Perspectives of Living with Coeliac Disease and Accessing Dietetic Services in Rural Australia: A Qualitative Study"],"prefix":"10.3390","volume":"13","author":[{"given":"Rachelle","family":"Lee","sequence":"first","affiliation":[{"name":"School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia"},{"name":"Dubbo Health Service, Western NSW Local Health District, Dubbo, NSW 2830, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elesa T.","family":"Crowley","sequence":"additional","affiliation":[{"name":"Department of Rural Health, College of Health Medicine and Wellbeing, University of Newcastle, Tamworth, NSW 2340, Australia"},{"name":"Tamworth Rural Referral Hospital, Hunter New England Local Health District, Tamworth, NSW 2340, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surinder K.","family":"Baines","sequence":"additional","affiliation":[{"name":"School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Heaney","sequence":"additional","affiliation":[{"name":"School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia"},{"name":"Department of Rural Health, College of Health Medicine and Wellbeing, University of Newcastle, Tamworth, NSW 2340, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4340-2320","authenticated-orcid":false,"given":"Leanne J.","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Rural Health, College of Health Medicine and Wellbeing, University of Newcastle, Tamworth, NSW 2340, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,17]]},"reference":[{"key":"ref_1","unstructured":"Australian Institute of Health and Welfare (2021, March 11). Rural and Remote Health, Available online: https:\/\/www.aihw.gov.au\/reports\/rural-health\/rural-remote-health\/contents\/rural-health."},{"key":"ref_2","first-page":"311","article-title":"Food cost and availability in a rural setting in Australia","volume":"4","author":"Burns","year":"2004","journal-title":"Rural Remote Health"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1111\/j.1747-0080.2012.01604.x","article-title":"How do mothers juggle the special dietary needs of one child while feeding the family?","volume":"69","author":"Crowley","year":"2012","journal-title":"Nutr. Diet."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1016\/S0140-6736(09)60254-3","article-title":"Coeliac disease","volume":"373","author":"DiSabationo","year":"2009","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/S0140-6736(03)14027-5","article-title":"Coeliac Disease","volume":"362","author":"Green","year":"2003","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1177\/2050640614559263","article-title":"The gluten-free diet and its current application in coeliac disease and dermatitis herpetiformis","volume":"3","author":"Ciacci","year":"2014","journal-title":"United Eur. Gastroenterol. J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1007\/s10620-006-9258-2","article-title":"The Canadian celiac health survey","volume":"52","author":"Cranney","year":"2007","journal-title":"Digest Dis. Sci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1111\/j.1365-277X.2007.00815.x","article-title":"Sharing life with a gluten-intolerant person\u2013the perspective of close relatives","volume":"20","author":"Sverker","year":"2007","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1111\/j.1365-2036.2008.03820.x","article-title":"Systematic review: The evidence base for long-term managament of coeliac disease","volume":"28","author":"Haines","year":"2008","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1533","DOI":"10.1016\/j.jada.2003.08.027","article-title":"Celiac diet: Its impact on quality of life","volume":"103","author":"Lee","year":"2003","journal-title":"J. Am. Diet. Assoc."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1111\/jhn.12062","article-title":"Living with coeliac disease: A grounded theory study","volume":"27","author":"Rose","year":"2014","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1111\/j.1365-277X.2005.00591.x","article-title":"Controlled by food\u2019- lived experiences of coeliac disease","volume":"18","author":"Sverker","year":"2005","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1136\/gutjnl-2013-306578","article-title":"Diagnosis and management of adult coeliac disease: Guidelines from the British Society of Gastroenterology","volume":"63","author":"Ludvigsson","year":"2014","journal-title":"Gut"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1111\/jhn.12754","article-title":"Facilitators and barriers to adherence to gluten-free diet among adults with celiac disease: A systematic review","volume":"33","author":"Jaana","year":"2020","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1111\/j.1365-277X.2006.00659.x","article-title":"The impact of a gluten-free diet on adults with coeliac disease: Results of a national survey","volume":"19","author":"Zarkadas","year":"2006","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1585","DOI":"10.3390\/nu5051585","article-title":"Is dietitian use associated with celiac disease outcomes?","volume":"5","author":"Mahadev","year":"2013","journal-title":"Nutrients"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1111\/jhn.12009","article-title":"Coeliac disease: The path to diagnosis and the reality of living with the disease","volume":"26","author":"Taylor","year":"2013","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1111\/1747-0080.12105","article-title":"Coeliac disease and the gluten-free diet in New Zealand: The New Zealand coeliac health survey","volume":"71","author":"Sharp","year":"2014","journal-title":"Nutr. Diet."},{"key":"ref_19","unstructured":"National Rural Health Alliance Inc. (2021, March 11). Under Pressure and under-Valued: Allied Health Professionals in Rural and Remote Areas. Available online: ruralhealth.org.au\/sites\/default\/files\/position-papers\/position-paper-04-11-05.pdf."},{"key":"ref_20","first-page":"10","article-title":"Dietetic workload in rural acute care settings","volume":"67","author":"Brown","year":"2010","journal-title":"Nutr. Diet."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1111\/jhn.12203","article-title":"Motives for adherence to a gluten-free diet: A qualitative investigation invovling adults with coeliac disease","volume":"27","author":"Dowd","year":"2014","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1111\/j.1365-277X.2012.01244.x","article-title":"\u2018If you listen to me properly, I feel good\u2019: A qualitative examination of patient experiences of dietetic consultations","volume":"25","author":"Hancock","year":"2012","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1111\/jhn.12378","article-title":"Outcomes in coeliac disease: A qualitative exploration of patients\u2019 views on what they want to achieve when seeing a dietitian","volume":"29","author":"Madden","year":"2016","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1097\/ACM.0000000000000388","article-title":"Stanards for reporting qualitative research: A synthesis of recommendations","volume":"89","author":"Harris","year":"2014","journal-title":"Acad. Med."},{"key":"ref_25","unstructured":"Australian Government Department of Health (2021, March 11). Modified Monash Model, Available online: https:\/\/www.health.gov.au\/sites\/default\/files\/documents\/2019\/12\/modified-monash-model---fact-sheet.pdf."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1177\/1098214005283748","article-title":"A General Inductive Approach for Analyzing Qualitative Evaluation Data","volume":"27","author":"Thomas","year":"2006","journal-title":"Am. J. Eval."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1111\/jhn.12597","article-title":"Experiences of coeliac disease in a changing gluten-free landscape","volume":"32","author":"King","year":"2018","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1111\/j.2044-8287.2012.02069.x","article-title":"Psychosocial aspects of coeliac disease: A cross-sectional survey of a UK population","volume":"17","author":"Ford","year":"2012","journal-title":"Br. J. Health Psychnol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1046\/j.1471-6712.2003.00228.x","article-title":"Perceptions of health-related quality of life of men and women living with coeliac disease","volume":"17","author":"Hallert","year":"2003","journal-title":"Scand. J. Caring Sci."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/6\/2074\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:17:42Z","timestamp":1760163462000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/6\/2074"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,17]]},"references-count":29,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,6]]}},"alternative-id":["nu13062074"],"URL":"https:\/\/doi.org\/10.3390\/nu13062074","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,17]]}}}