Discussion on the process of a consultation
Health professionals play a vital part in providing services beneficial to society; which helps in improving the nutritional status of people. A health professional in this case a nutritionist should possess good communication and educational skills, in order to be able to interpret and or apply nutritional sciences to language and lifestyles of people to benefit their wellbeing. Empathy, genuineness, unconditional positive regard, attentiveness, active listening are just a few of the qualities a nutritionist should have in preparation for consultations or counselling.
Consultations involve a series of conversations with an individual, over a period of time, relating and developing the individual’s knowledge in nutrition, gaining an understanding of the health, habits or lifestyle the individual may have, by assisting the individual to overcome problems that cannot be solved on their own. (Holli et al, 1991)
Eating habits can be influenced by a number of factors such as family and culture, interpersonal (individual patterns, food selection, personal taste), intrapersonal (social, environmental, economic), community local shops, food selection…all part of a complex behavioural system.
Therefore good nutritional Counselling requires understanding why the client eats the way they do, then using this knowledge to develop suitable interventions. (Gibney et al, 2004)
Fig. 1 Suggested framework for an initial consultation.
Before the day of the consultation the nutritionist would have received a referral from the individuals GP and prearranged for a suitable room or space to hold the consultation as the individual should feel comfortable be able to talk.
Figure 1 shows the process of a consultation, initially beginning with the nutritionist greeting the client pleasantly in a professional manner, stating who they are, why the consultation is taking place, the duration of the session and what will be covered in the session. A nutritional assessment follows on from the meet and greet, this consist of a current diet, drug and social history which is then analysed. From the analysis a nutritional intervention is derived from the options or plans available to initiate change. By identifying the favoured changes but most importantly the realistic ones, the client can reward themselves but moreover keeping up with the changes they have planned to undergo. The client must take ownership and also be actively involved in the negotiating and setting of appropriate changes in food habits.
Nutritional monitoring evaluation stage will focus on how well the client has adapted to the plan accordingly. The evaluation is measured by the clinical outcomes against the targets set.
By the end of the session both the client and nutritionist should have negotiated appropriate follow up sessions which are recommended for permanent change however only if the client if the feels the need to be seen again.
It is important the nutritionist has a written record of the session but also provides the client with a written form of the changes which they plan to work on, otherwise it is soon forgotten by the client after the consultation. (Thomas et al, 2007) If continuing with the consultations over a long period of time- this may give the client time to change eating habits resulting in good nutrition habits; a complex task in itself which requires permanent changes, changes that lead to food intakes that alter the risk factors for disease and provide better health and economic benefits.
The whole point of nutrition counselling is to not only explore all the influences on the eating habits the client faces, to also understand the clients motivation for change, and to help the client to modify and manage food choices and eating habits by the creating of individual ‘s action plans. (Ewles et la, 1997)
Fig.2 shows the relationship between consultations to health,