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Define nutrition counseling and nutrition education.

Terms in this set (32)

Describe four methods to assess readiness to change.
Stage of Change algorithm: questions to determine stage of change for adopting a new lifestyle change. Readiness-to-change open-ended questions: using simple open-ended questions to assess readiness to change.Readiness-to-change graphic: use of a visual aid such as rule or chart; client will identify a spot on the graphic that indicates readiness to change. Readiness-to-change scale question: use of a scale of 0 to 10 to rate readiness to change
Describe each of the four phases of the nutrition counseling algorithm in Figure 4.2.
Involving phase: establish rapport, review agenda, invite inputExploration-Education phase: assess food behavior and activity patterns, provide education and show results, assess readiness to changeResolving phase: tailor intervention approach Level 1 Not motivated, not ready; goal is to raise doubtLevel 2 Unsure, low confidence; goal is to build confidenceLevel 3 Motivated, confident read; goal is to develop action planClosing phase: support self-efficacy, summarize issues/strengths, arrange follow-up
Explain the "a typical day" strategy.
Similar to a diet recall, but this method encourages clients to drive the assessment discussion and to tell their story.
Why should a client be allowed to do the initial evaluation after receiving feedback on an assessment?
This allows for the client to process the information and to check for comprehension. This also allows for self-exploration and personal reflection.
Identify goals and tasks for the resolving phase for each of the three motivational levels in the motivational nutrition counseling algorithm.
Level 1 Not motivated, not ready; goal is to raise doubt Level 2 Unsure, low confidence; goal is to build confidence Level 3 Motivated, confident read; goal is to develop action plan8
8. Explain the components of the FRAMES method for brief interventions.
Feedback—give feedback to the risks and negative consequence Responsibility—emphasize that the individual is responsible for making decisions Advice—give straightforward advice Menu—give options to choose from, fostering client's involvement in decision-making Empathy—be empathetic, respectful, nonjudgmental Self-efficacy—Express optimism that the client can modify behavior
Explain why the arrows for assessment, intervention, and evaluation of a client are reciprocal in the model for a nutrition counseling program in Figure 4.1.
The assessment, intervention, and evaluation are part of each counseling session until the decision is made to conclude the program.
Identify the two components of readiness to make a behavior change.
Assessment of importance and confidence, which measures the level of importance and level of confidence of client related to change.
While engaging in the goal-setting process, what are three messages a counselor should convey to a client?
Several courses of action are available to you. You are the best judge of what will work. We will work together to review the options and select a course of action.
Define SMART goals.
S—Specific goals address the what, why, and how.M—Measurable goals are concrete and observable.A—Attainable goals usually mean small changes that are under the control of the client.R—Rewarding goals are stated positively.T—Time based, putting an end point on a goal gives a clear target.
Name the three steps involved in completing a dietary evaluation.
food intake data collection data analysis interpretation of analysis
Explain the SOAP documentation method.
A documentation style that provides objective and subjective data, assessment, and an end plan of action and expected outcomes.
Identify and explain the four components of the NCP.
Nutrition Assessment: Collection of timely and appropriate data; analysis and interpretation of the collected data. Includes food/nutrition-related history, anthropometrics, biochemical data, tests procedures, nutrition-focused physical findings, client history, and comparative standards. Nutrition Diagnosis: Identifies and describes a specific problem that can be resolved or improved through treatment and nutrition intervention.Nutrition Intervention: Resolves or improves the identified nutrition diagnosis(es) or nutrition problem(s) by planning and implementing appropriate interventions. Nutrition Monitoring and Evaluation: Practitioner evaluates the effectiveness of a nutrition intervention by engaging in monitoring, measuring and evaluating changes in nutrition care indicators.
PES Statement.
"Related to" and "as evidenced by"
What are the benefits of tracking food behavior goals?
Some people enjoy recording everything they eat and reviewing the material at the end of the day. Some clients may enjoy the intense analytical activity and want to continue this form of journaling for an extended period.
Identify five topics a nutrition counselor can review with a client to provide guidance for record keeping.
Provide training: Clients gain a better understanding of the process when hands-on activities are included as well as complete instructions of how to keep a journal.Use estimates: Clients should understand that approximations are acceptable.Set meaningful and achievable goals: Clients are more likely to be successful in record keeping if the first goal is modest, such as two days a week. Then, gradually increase journaling activity in subsequent weeks.Provide a variety of record-keeping options: Clients can devise their own record-keeping system.Provide nonjudgmental feedback: Clients should always be praised for their journaling work, and counselors should always review their clients' journals with no hint of criticism.
Explain the ABCs of eating behavior and behavior chains.
A: Antecedent (stimulus, cue, trigger) B: Behavior (response, eating) C: Consequence (punishment, reward)
Identify four factors to consider when guiding clients in the use of rewards.
Rewards should be individualized. ● Rewards should be well defined—what and how much. ● Rewards should be timed to come after the behavior, not before. ● Rewards should be given as soon as possible after the behavior is accomplished.
Explain the following behavior change strategies: cue management, countering, rewards, modeling, problem solving, contracting, and encouragement.
Cue Management: deals with the antecedent component of a behavior chain by prearranging cues to increase a desired response or to suppress a detrimental one.Countering: a technique of exchanging healthy responses for problem behaviors, addresses the behavior portion of the behavior chain.Rewards: provide positive consequences, commonly thought to be more effective than negative consequences, such as punishment. Modeling: by observing others accomplish a goal similar to their own, clients' beliefs in their ability to imitate the behavior increase.
Problem solving: a process that involves a counselor and client working together to identify a behavior chain, detecting barriers to change, brainstorming possible options, and weighing the pros and cons of the alternatives.Contracting: an agreement between a counselor and a client to implement a particular goal.Encouragement: generally well received. Some counselors have provided encouragement creatively using emails, cards, notes, voicemail, personalized signs, text messages, notes, or electronic recordings.
How does obstacle thinking hamper behavior change?
Leads to self-destructive behavior, making a difficult situation worse or giving up and retreating from problems.
What are cognitive distortions?
Destructive thinking pattern.
Explain the integrated approach to learning advocated by Funnell and Anderson.
Review role of client as self-manager and role of counselor as a source of expertise, support, and inspiration. Elicit client concerns and questions. Discuss clients' experiences and understanding of their condition. Identify what the client wants from the counselor. Ascertain educational topics client would like to be addressed. Explore behaviors the client wishes to alter. Present information to address concerns and questions. Discuss strategies to address the behavioral aspects of the concerns
Describe physical activity and physical fitness.
Physical activity relates to a set of performance and health-related attributes connected to the ability to perform activity. Performance related attributes include agility, balance, coordination, power, and speed.Physical Fitness is a set of attributes relating to the ability to perform physical activity; often viewed as cardiorespiratory fitness; components include flexibility, suitable body composition, muscular strength, and muscular endurance.
Identify the two most common risks associated with exercise and explain how to best prevent the harmful effects.
Musculoskeletal injuries are the most common harmful side effect of physical activity. Such injuries can generally be prevented by gradually working up to the desired intensity level and avoiding excessive physical activity.Sudden cardiac deaths, though extremely rare, are a serious concern. These occurrences are most often associated with primarily sedentary individuals who have preexisting coronary heart disease and engage in vigorous activity. Engaging in regular physical activity reduces the risks of cardiac events.
Explain the major conclusions of the 2018 Physical Activity Guidelines (see Exhibit 8.1).
High volumes of moderate-to-vigorous physical activity help remove the excess risk of mortality associated with high volumes of sitting. Moderate physical activity is roughly 150 kcal of energy. Activities/duration vary based on vigor:o Car washing, 45-60 mino Gardening, 30-45 mino Walking 2 miles in 30 mino Basketball game, 15-20 mino Running 1.5 miles in 15 mino Stair climbing, 15 min
Explain two ways to monitor the level of physical exertion.
Perceived exertion, also known as the talk test. A physical effort of moderate intensity would be perceived as somewhat hard and the individual could talk but not sing.Heart rate. Measure heart rate during or immediately after exercise and compare that rate to a target heart rate or a target zone.
Explain how to determine maximum heart rate, target heart rate, and target zone.
First determine your maximum heart rate by calculation: 220 - your age = maximum heart rate. Next select a desired level of exertion. A heart rate that corresponds to a particular percentage of MHR can be calculated or read off a standardized chart to determine the target heart rate or the target zone
Why do older adults particularly benefit from strength and flexibility training?
The benefits are the ability to remain independent in performing routine daily activities, preserving bone, and reducing the risk of falling. The benefits of flexibility training are continued physical function contributing to independent living.
Explain when a client should obtain a physician's approval before engaging in physical activity counseling.
Clients with any symptoms of cardiovascular or metabolic disease. Clients recovering from coronary heart disease. Clients with severe bone or joint problems. Clients who begin an exercise program and experience dizziness, chest pain, undue shortness of breath, difficulty breathing, or unusual discomfort.
When should physical activity be delayed?
Women in the third trimester of pregnancy or who are experiencing a high-risk pregnancy or clients experiencing acute symptoms (such as fever) during an illness or infectious disease.
Explain the physical activity counseling algorithm.
The algorithm looks at the levels of readiness to change and the counseling approach to use. Level 1 is not ready with the goal to raise doubt about present level of activity. Level 2 is unsure with the goal of building motivation and confidence. Level 3 is ready with the goal of resolving ambivalence and elicit a firm commitment. Level 4 is active with the goal to continue the activity program.
Identify physical activity counseling strategies for each of the four motivational levels discussed in the section on physical activity counseling protocols.
Level 1: Summarize benefits. Personalize benefits. Request permission to discuss change. Change talk—reasons to be active, identify barriers. Summarize. Offer advice. Express support. Level 2: Explore ambivalence (pros and cons). Look to the past. Look to the future. Summarize. Ask next step. If appropriate: Select goal. Develop action plan.Level 3: Praise positive behaviors. Review current activity, if appropriate. Explore change options—elicit client's ideas, look to the past, review options. Select goal. Develop action plan.
Level 4: Praise positive behaviors. Compare current activity program to standards. If appropriate, review sport-specific needs. Relapse prevention—rate confidence to continue, discuss barriers and social supporters, prepare for setbacks. Select goal, if appropriate. Develop action plan.
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