Practice Consideration
Practitioners arrive at Nutrition Diagnoses by applying reason and clinical judgment to data. From there the practitioner decides on strategies for the next stage of the NCP: Nutrition Intervention. One option for the Nutrition Intervention is counseling. The following are examples of ways in which the dietitian might engage.
Theoretical Basis/Approach (C-1)(1,2)
Cognitive-behavioral theory (C-1.1)
The patient has begun to discuss the dietary changes to achieve their goals.
For example,
“I suppose I will need to stop eating salted nuts."
Dietitian’s Background Thinking
>> In applying this approach, the dietitian might guide the discussion toward realistic goals for behavior change, and identify the skills and knowledge required to achieve those goals.
Further Reading
>> eNCPT Reference Sheet pages located at Academy of Nutrition and Dietetics. Nutrition Terminology Reference Manual (eNCPT): Dietetics Language for Nutrition Care. Theoretical Basis/Approach (C-1) Cognitive-Behavioral Theory (C-1.1)
https://www.ncpro.org/pubs/2023-encpt-en/codeC-1-CBT
Health belief model (C-1.2)(1,2)
The patient "knows hypertension is a serious condition" but points out that there are no symptoms.
Dietitian’s Background Thinking
>> In applying this approach, the dietitian might seek to explore the relationship between uncontrolled hypertension, even without symptoms, and its co-morbidities, susceptibility to those co-morbidities and how this might affect the patient’s ability to engage in the activities they enjoy.
Further Reading
>> eNCPT Reference Sheet pages located at Academy of Nutrition and Dietetics. Nutrition Terminology Reference Manual (eNCPT): Dietetics Language for Nutrition Care. Theoretical Basis/Approach (C-1) Health Belief Model (C-1.2)
https://www.ncpro.org/pubs/2023-encpt-en/codeC-1-HBM
Social learning theory (C-1.3)(1,2)
The patient does not want to follow a low sodium eating plan.
Dietitian’s Background Thinking
>> The dietitian is unsure whether the patient understands the importance of the diet changes required and the positive impact a low sodium diet will have on long-term health and quality of life. In applying this approach, the dietitian may help the patient identify others who have made the same changes and describe their success with a low-sodium eating plan such as DASH diet. The dietitian might also reinforce the anticipated benefits of the changes.
Further Reading
>> eNCPT Reference Sheet pages located at Academy of Nutrition and Dietetics Nutrition Terminology Reference Manual (eNCPT): Dietetics Language for Nutrition Care. Theoretical Basis/Approach (C-1) Social Learning Theory (C-1.3)
https://www.ncpro.org/pubs/2023-encpt-en/codeC-1-SLT
Transtheoretical model/stages of change (C-1.4)(1,2)
The patient is not actively talking about making lifestyle changes. However, they have indicated they know that changes are important to their health, by saying, “My mother had hypertension and she had to make changes to avoid salty foods.”
Dietitian’s Background Thinking
>> In applying the Transtheoretical model/stages of change (C-1.4), the dietitian will be looking to determine whether the patient is in the “Precontemplation”, “Contemplation” or “Action” stage. The dietitian will be devising strategies to move the patient toward “Action.”
Further Reading
>> eNCPT Reference Sheet pages located at Academy of Nutrition and Dietetics. Nutrition Terminology Reference Manual (eNCPT): Dietetics Language for Nutrition Care. Theoretical Basis/Approach (C-1) Transtheoretical Model/Stages of Change (C-1.4)
https://www.ncpro.org/pubs/2023-encpt-en/codeC-1-TMSC
References
1. Academy of Nutrition and Dietetics. Nutrition Terminology Reference Manual (eNCPT): Dietetics Language for Nutrition Care. Accessed 10 September 2024. Available from: https://www.ncpro.org/pubs/2023-encpt-en/
2. Academy of Nutrition and Dietetics. Nutrition Terminology Reference Manual (eNCPT): Dietetics Language for Nutrition Care. Intervention. 2023. Accessed 10 September 2024. Available from: https://www.ncpro.org/pubs/2023-encpt-en/page-055