Dietitians always
have difficulty in making changes on patients' eating habits. If the prescribed diets are not applied by patients, there will be more problems to occur such as
the symptoms of the diseases become more severe and complications from the diseases
will exist.
Dietitians may know patients who are resistant to change by listening to patients’ statements. For examples;
“I like to eat Nasi
lemak, it is very delicious and I eat it almost every day. We are Malaysians
right?”
“Why I have to worry
about my weight if my friends are fatter than me?”
“I don’t think that
fruits and vegetables can give benefits for me”
They deny with the facts that actually give
benefits to them. They feel fear and worry to change their behavior. May be
they found a lot of barriers that lead them not to change. However, they will
be motivated to change if there is a good process of negotiation in which the
patient coherent the benefits and costs involved.
Communication technique
which is called Motivational Interviewing is needed in order to engage patients
who are not interested to change their behavior especially on eating habits. It
is a method for helping people recognize problems and to get a person moving
along the path to change. First is to build rapport and establish relationship.
This can increase the trust level between patients and dietitians.
“Good morning Mr. Ali. How do you do
today? I have been informed by Dr. Saiful about your diagnosis. Will you let me know if
you are all right if I asked you these questions now?”
Next is to involve the work commitment and planning to change. Tell
patients about the pro and cons of the particular suggestions. Convey empathy by using a
reflective listening to show understanding. Make a supportive environment by
building patients' confidence that change is possible. Help patients to set their goals and it should
be achieved within specific period of time. Patients’ family members also have
to take part to make it more successful. Remind the family members to give a healthy
environment at home such as to serve healthy food and let them involve in doing physical
activity. Follow up is very important to assess changes in food intake, BMI
changes and others. This is how to know either patients’ comply or not with the
diet interventions. Be more active in giving more information about food to patients.
(This is written for
my beloved classmates, future dietitians. You guys must be good dietitians and
not to forget to say “good luck” in your exam ^^).
References:
Australian Family Physician, Psychological Strategies
Today’s Dietitian, The Magazine for Nutrition Professionals
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