J Acad Nutr Diet. 2018 Jun;118(6):1047-1056. doi: 10.1016/j.jand.2017.06.366. Epub 2017 Aug 17.
Lifestyle change can be influenced through effective interaction between care receiver and care provider. The physical environment where the interaction occurs can affect the dynamics of long-term therapeutic treatment. There have been no studies on the perception of the physical environment in nutritional treatment.
Our aim was to ascertain the impact of the physical environment on the dynamics and communication between dietitian and patient based on perceptions of dietitians.
We conducted qualitative constructivist phenomenological research.
In-depth interviews (n=10) and eight focus groups (n=62) were held with dietitians who offer treatment in a physical environment designed according to the medical model and/or in a physical dynamic environmental design according to the dynamic model.
Most dietitians in Israel treat their patients in a physical environment arranged according to the medical model. The participants reported that the physical environment affects the interaction. However, the idea of transforming the physical environment according to the dynamic model raised reservations. Barriers include upsetting therapeutic boundaries, challenging professional authority, and lack of therapeutic tools suitable for the change.
Changes in the spatial design in which the therapeutic interaction occurs might support the dietitians' transformation from counseling into therapy. The barriers toward such change suggest that professional training is needed to enable dietitians to overcome them. We recommend conducting further research to evaluate the current physical environment, as well as raising dietitians' awareness and training them to work in the new environment, reflecting a counseling/therapeutic mindset. These changes should be followed by additional research among practitioners to report on their effects.
生活方式的改变可以通过护理人员和护理提供者之间的有效互动来实现。互动发生的物理环境会影响长期治疗的动态。目前还没有关于营养治疗中物理环境感知的研究。
我们旨在根据营养师的看法，确定物理环境对营养师和患者之间的动态和沟通的影响。
我们进行了定性建构主义现象学研究。
对根据医疗模式设计的物理环境中或根据动态模型设计的物理动态环境中进行治疗的营养师进行了深入访谈（n=10）和 8 个焦点小组（n=62）。
以色列的大多数营养师在根据医疗模式安排的物理环境中治疗患者。参与者报告说，物理环境会影响互动。然而，根据动态模型改变物理环境的想法引起了一些保留意见。障碍包括扰乱治疗界限、挑战专业权威以及缺乏适合这种变化的治疗工具。
治疗互动发生的空间设计的改变可能会支持营养师从咨询转变为治疗。这些变化面临的障碍表明需要进行专业培训，以使营养师能够克服这些障碍。我们建议进行进一步的研究，以评估当前的物理环境，并提高营养师的意识并培训他们在新环境中工作，以反映咨询/治疗的思维方式。这些变化应之后在从业者中进行进一步的研究，以报告其效果。
