Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden.
Centre for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden.
J Hum Nutr Diet. 2024 Feb;37(1):217-226. doi: 10.1111/jhn.13246. Epub 2023 Oct 5.
Nutrition counselling is characterised by a collaborative approach where the patient and the dietitian establish goals that promote health and self-management. Little is known about goal-setting in nutrition interventions of patients at risk of malnutrition. The present study aims to describe the perspectives and needs of patients at risk of malnutrition regarding goals of nutrition interventions.
Semi-structured interviews were conducted with 15 patients from three primary care centres and one hospital in mid-Sweden selected through purposive sampling. Interview transcripts were analysed using reflexive thematic analysis following the six-phase guidelines of Braun and Clarke to identify patterns of shared meaning and themes in the data.
The findings highlight that the participants rarely reflected on their personal goals of the nutrition intervention. Instead, they strived to maintain strength and energy, with the nutrition counselling being seen as supportive in managing nutrition impact symptoms. They described discrepancies between their perspectives and the dietitian's regarding weight goals and the diet prescribed to gain weight.
The study findings suggest that elucidating patients' goals is key to counteracting the discrepancies between the dietitians' clinically oriented goals and patients' perspectives. Goal-setting is part of the dietitian's structured working process, whereas the patient's lifeworld is complex and unstructured. To provide person-centred nutrition care, new strategies and tools are needed to facilitate collaborative goal-setting. These approaches will bridge the gap between clinical goals and patients' individual needs, promoting better alignment and improved outcomes.
营养咨询的特点是一种协作方法,患者和营养师共同设定促进健康和自我管理的目标。对于有营养不良风险的患者的营养干预措施中的目标设定,人们知之甚少。本研究旨在描述有营养不良风险的患者对营养干预目标的观点和需求。
通过目的性抽样,从瑞典中部的三个初级保健中心和一家医院中选择了 15 名患者进行半结构化访谈。使用 Braun 和 Clarke 的六阶段指南对访谈记录进行分析,以确定数据中共享意义和主题的模式。
研究结果表明,参与者很少反思自己对营养干预的个人目标。相反,他们努力保持体力和精力,认为营养咨询有助于管理营养影响症状。他们描述了他们的观点与营养师对体重目标和增重所规定的饮食之间的差异。
研究结果表明,阐明患者的目标是对抗营养师以临床为导向的目标与患者观点之间差异的关键。目标设定是营养师结构化工作流程的一部分,而患者的生活世界是复杂和无结构的。为了提供以患者为中心的营养护理,需要新的策略和工具来促进协作式目标设定。这些方法将弥合临床目标和患者个体需求之间的差距,促进更好的一致性和改善结果。