外来栄養指導の実際と勤務年数による困難状況への対応の比較 －臨床心理学的視点からの考察－

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  • The State of Outpatient Nutrition Guidance, and the Comparison in response to Situations Preventing Nutrition Guidance Process by the Dietitians` years of service. -A clinical-psychological perspective-
  • ガイライ エイヨウ シドウ ノ ジッサイ ト キンム ネンスウ ニ ヨル コンナン ジョウキョウ エ ノ タイオウ ノ ヒカク : リンショウ シンリガクテキ シテン カラ ノ コウサツ

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The aim of this study is to understand the practice of outpatient nutrition guidance in medical institutions, and to consider the difference in response to situations preventing the process of nutrition guidance between dietitians with more than 10 years of experience and dietitians with less than 10 years of experience. 　We conducted a web-based questionnaire to dietitians who have experience in providing outpatient nutrition guidance, and got 26 responses. 　Majority of outpatient nutrition guidance were taken place in “Private room for clinical nutrition department”（61.5%）, other answers were in “multipurpose private room” “consultation room” and “bedside”. Most popular person in charge of providing nutrition guidance, was “the dietitian in charge of the client”（61.5%）, showing tendency of continuous support by familiar dietitian. Information between other professionals were basically shared through electronic medical records, furthermore by face to face when necessary（77%）. 　We compared the responses regarding situations preventing nutrition guidance process between dietitians with less than 10 years of experience, and dietitians with more than 10 years of experience. Relatively, when a conversation gets stuck, dietitians with less than 10 years of experience tended to continue the conversation by asking closed questions. And when a client showed resistive behavior, they tended to seek for a solution by check the client’s recognition and understanding of the guidance. On the other hand, when a conversation gets stuck, dietitians with more than 10 years of experience tended to change topic, and/or showed sympathy while keeping waiting attitude. And when a client showed resistive behavior, or when the treatment plan gets delayed, they tended to seek solution through multidisciplinary cooperation.

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