PERSONALISED DIETARY COUNSELLING?
PATIENTS’ NEEDS AND EXPECTATIONS OF DIETETIC CONSULTATION - QUALITATIVE EXPLORATORY APPROACH

 

Magdalena Poraj-Weder¹, Grazyna Wasowicz²

^1,2 Faculty of Psychology, University of Warsaw, Warsaw, Poland

 

Abstract

The aim of the study was to achieve a better understanding of patients’ expectations of dietary counselling and to assess the extent to which health proffessionals understand these needs. In particular, our goal was to present motives for weight loss, as perceived by patients and health professionals, based on Self-Determination Theory (Deci, Ryan, 2000), and confront patients’ expectations related to psychological support, with health professionals’ potential to fulfil these expectations. The study was conducted using individual, semi-structured, in-depth interviews (IDIs) (Angrosino, 2010; Kvale, 2010). Two groups of respondents were examined: 6 individuals changing their eating habits and 7 health professionals. The thematic analysis (TA; Braun & Clark, 2006; Clark et al., 2015) deductive method was used to analyze collected data.

Results show that patients’ motivation is mostly results-oriented (e.g., weight loss). While controlled motivation is sufficient to achieve short-term results (i.e., weight loss a better figure), autonomous motivation and a high level of internalization of the principles underlying the change are required to achieve self-efficacy and a permanent reconstruction of one's attitude towards nutrition. The results of the study show that health professionals are aware of this rule and define the goals of the change accordingly: they strive to foster the individual’s autonomy in nutrition. However, they sometimes ignore the current (external) motivational status of the patient, set inappropriate (self-efficacy-oriented) goals, and fail to encourage perseverance. Such mismatch between the goals set by a health professional and the motivation exhibited by the patient may lead to relapse into old habits or merely the short-term generally low effectiveness of the change program.

Keywords: dietary behavior, health professionals, patients, motivation, self-determination theory