Implementing process-guided methods in nutrition counselling and dietetic therapy – What does current practice look like?

Peer reviewed / Manuscript (original) submitted: 14 March 2022 / Revision accepted: 2 September 2022

Results of a descriptive pilot study

Introduction

Overweight and obesity affect 54% of all adults in Germany. This is a major risk factor for diet-related diseases that pose major challenges to the health system [1]. Nutrition counselling and dietetic therapy (NCDT) can help prevent and treat these diseases [2].
It is recommended to use a process-guided model to ensure high-quality NCDT [2]. The reasons for this recommendation are that it facilitates: a standardized approach, structured dietetic interventions [2], more predictable dietetic outcomes and greater transparency [3]. This approach makes it possible to provide evidence of the effectiveness of dietetic interventions [4].

Various process models have been developed for NCDT in Europe and the USA [3], including the German-Nutrition Care Process (G-NCP) published by the Verband der Diätassistenten - Deutscher Bundesverband e. V. (German Association of Dietitians) [5] and most recently the Dietetic Care Process (DCP), developed as part of the EU-funded Improvement of Education and Competences in Dietetics (IMPECD) project [6].
The DCP is a harmonized European model for training and professional practice in the area of dietetics. It is made up of five steps: (1) Dietetic Assessment, which falls into the four categories of Client History, Diet History, Behavioral-Environmental, Clinical Status; (2) Dietetic Diagnosis; (3) Planning Dietetic Intervention; (4) Implementing Dietetic Intervention; (5) Dietetic Outcome Evaluation [6, 7] (• Figure 1). ...

Abstract

This study investigates the extent to which process-guided methods are applied in Germany, taking into consideration the structural context of nutrition counselling and dietetic therapy (NCDT).
A questionnaire with 92 questions was developed to survey nutrition professionals online. 95 responses were included in the evaluation. Closed questions were evaluated quantitatively, and open questions were evaluated qualitatively.
Almost half of the participants (48.4%) had already been using process-guided methods. The majority of respondents collected the data from the four categories of Dietetic Assessment: Client History 95.8%, Diet History 94.7%, Behavioral-Environmental 92.6%, Clinical Status 63.2%. 83.2% of participants made dietetic diagnoses, and at least 90% set goals, measures to be taken and monitoring parameters. 73.3% said they carried out an evaluation.
Process-guided methods are not yet widely applied and should be promoted further. Research on transfer into practice has the potential to identify discrepancies between theory and practice, from which it may be possible to derive tailor-made solutions.

Keywords: nutrition counselling, dietetic therapy, process model, process-guided methods, Dietetic Care Process

Full text PDF (free version)

https://creativecommons.org/licenses/by-nc-nd/4.0/legalcode