Active involvement of dietitian in outpatient nutrition guidance: qualitative study using KJ method

• Published in: Journal for the Integrated Study of Dietary Habits Vol. 35; no. 3; pp. 135 - 145
• Main Authors: Yoshino, Nahoko, Sakamoto, Natsumi
• Format: Journal Article
• Language: Japanese
• Published: THE JAPAN ASSOCIATION FOR THE INTEGRATED STUDY OF DIETARY HABITS 2024; 日本食生活学会
• ISSN: 1346-9770; 1881-2368
• DOI: 10.2740/jisdh.35.3_135

The purpose of this study is to clarify the dietitian's work for smooth progress in nutrition guidance.　A web-based questionnaire was distributed to dietitians with experience of outpatient nutrition guidance in hospital. The content of the questions includes three themes: situation chosen to report directly to the doctor (study1), difficult situations with patients and their family (study2-1) and useful response in overcoming the difficult situation (study2-2), and points to note in family attending consultation (study3).　We were able to obtain responses from 26 dietitians. Descriptive answers were categorized by KJ method.　Study1 was organized into five categories; client's behavior interfering their recovery, difficulty in continuing the guidance itself, information that the doctor doesn't know, and confirmation of the instruction, recommendation to make changes in the instruction.　Study2-1 was divided into six categories; poor communication in the family, defensive attitude of the client, highly specialized dialogue, consultation beyond the expertise of dietitian, normalization of the problem, poor changes due to the client's working style and/or financial situation.　Study2-2 was organized into five categories; supportive approach, active involvement, reset of the goal, cooperation with other professionals involved, and starting communication from surrounding topic.　Study3 was grouped into four categories; to consider and include the family's point of view, to consider the cultivated relationship between client and their family, to put the client in center, and to treat all family members and the client even.　The category was illustrated for each research and the relationship was examined. The results suggest that dietitians were actively and continuously assessing the client, cooperating with the doctor, and integrating the client and their family's opinion, to support the client's dietary modification.