Dietary intake at stake: Clients’ adjusted diagnostic explanations during dietary treatment of malnutrition (risk)
In this article, we show how elderly clients in Dutch dietary consultations adjust dietitians’ history taking questions that suggest a cause for weight loss. Using conversation analysis and discursive psychology, we analyzed the history taking phase of recorded primary care conversations of 7 dietit...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-06-01
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| Series: | SSM: Qualitative Research in Health |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667321523001543 |
| _version_ | 1797383613683073024 |
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| author | Alyanne Barkmeijer Hedwig te Molder Joyce Lamerichs Harriët Jager-Wittenaar |
| author_facet | Alyanne Barkmeijer Hedwig te Molder Joyce Lamerichs Harriët Jager-Wittenaar |
| author_sort | Alyanne Barkmeijer |
| collection | DOAJ |
| description | In this article, we show how elderly clients in Dutch dietary consultations adjust dietitians’ history taking questions that suggest a cause for weight loss. Using conversation analysis and discursive psychology, we analyzed the history taking phase of recorded primary care conversations of 7 dietitians with 17 clients with malnutrition (risk). In response to the dietitian's history taking question, clients repeatedly present: 1) a problem in which weight loss is presented as unexpected and a conscious reduction in dietary intake is (therefore) not an issue, 2) a problem for which they cannot be held responsible, but which at the same time acts as a reason for reduced dietary intake, 3) a problem in which higher dietary intakes have been recommended by a third party that have proved impracticable. In these adjusted diagnostic explanations, clients emphasize the multidimensionality of their weight loss, which concurrently provides an explanation as to why they cannot be (solely) held responsible for their reduced dietary intake. Clients’ adjusted diagnostic explanations make relevant an evaluation by the dietitian. Dietitians’ subsequent lack of uptake leads to clients recycling diagnostic explanations to still get a response from the dietitian. Our findings offer insight into improving client-centered counseling by paying attention to clients’ adjusted diagnostic explanations. |
| first_indexed | 2024-03-08T21:23:35Z |
| format | Article |
| id | doaj.art-cd8c6bd17b054f0abd06390aeb6284af |
| institution | Directory Open Access Journal |
| issn | 2667-3215 |
| language | English |
| last_indexed | 2024-03-08T21:23:35Z |
| publishDate | 2024-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | SSM: Qualitative Research in Health |
| spelling | doaj.art-cd8c6bd17b054f0abd06390aeb6284af2023-12-21T07:38:40ZengElsevierSSM: Qualitative Research in Health2667-32152024-06-015100370Dietary intake at stake: Clients’ adjusted diagnostic explanations during dietary treatment of malnutrition (risk)Alyanne Barkmeijer0Hedwig te Molder1Joyce Lamerichs2Harriët Jager-Wittenaar3Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Petrus Driessenstraat 3, 9714 CA, Groningen, the Netherlands; Hanze University of Applied Sciences, School of Health Care Studies, Program of Nutrition and Dietetics, Petrus Driessenstraat 3, 9714 CA, Groningen, the Netherlands; Corresponding author. Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Petrus Driessenstraat 3, 9714 CA, Groningen, the Netherlands.Vrije Universiteit Amsterdam, Faculty of Humanities: Language, Literature, and Communication, De Boelelaan 1105, 1081 HV, Amsterdam, the NetherlandsWindesheim University of Applied Sciences, Research Group Mental Healthcare and Society, Campus 2, 8017 CA, Zwolle, the NetherlandsHanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Petrus Driessenstraat 3, 9714 CA, Groningen, the Netherlands; Radboud University Medical Center, Department of Gastroenterology and Hepatology, Dietetics, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the NetherlandsIn this article, we show how elderly clients in Dutch dietary consultations adjust dietitians’ history taking questions that suggest a cause for weight loss. Using conversation analysis and discursive psychology, we analyzed the history taking phase of recorded primary care conversations of 7 dietitians with 17 clients with malnutrition (risk). In response to the dietitian's history taking question, clients repeatedly present: 1) a problem in which weight loss is presented as unexpected and a conscious reduction in dietary intake is (therefore) not an issue, 2) a problem for which they cannot be held responsible, but which at the same time acts as a reason for reduced dietary intake, 3) a problem in which higher dietary intakes have been recommended by a third party that have proved impracticable. In these adjusted diagnostic explanations, clients emphasize the multidimensionality of their weight loss, which concurrently provides an explanation as to why they cannot be (solely) held responsible for their reduced dietary intake. Clients’ adjusted diagnostic explanations make relevant an evaluation by the dietitian. Dietitians’ subsequent lack of uptake leads to clients recycling diagnostic explanations to still get a response from the dietitian. Our findings offer insight into improving client-centered counseling by paying attention to clients’ adjusted diagnostic explanations.http://www.sciencedirect.com/science/article/pii/S2667321523001543Dietary counselingDietitianMalnutritionConversation analysisDiscursive psychology |
| spellingShingle | Alyanne Barkmeijer Hedwig te Molder Joyce Lamerichs Harriët Jager-Wittenaar Dietary intake at stake: Clients’ adjusted diagnostic explanations during dietary treatment of malnutrition (risk) SSM: Qualitative Research in Health Dietary counseling Dietitian Malnutrition Conversation analysis Discursive psychology |
| title | Dietary intake at stake: Clients’ adjusted diagnostic explanations during dietary treatment of malnutrition (risk) |
| title_full | Dietary intake at stake: Clients’ adjusted diagnostic explanations during dietary treatment of malnutrition (risk) |
| title_fullStr | Dietary intake at stake: Clients’ adjusted diagnostic explanations during dietary treatment of malnutrition (risk) |
| title_full_unstemmed | Dietary intake at stake: Clients’ adjusted diagnostic explanations during dietary treatment of malnutrition (risk) |
| title_short | Dietary intake at stake: Clients’ adjusted diagnostic explanations during dietary treatment of malnutrition (risk) |
| title_sort | dietary intake at stake clients adjusted diagnostic explanations during dietary treatment of malnutrition risk |
| topic | Dietary counseling Dietitian Malnutrition Conversation analysis Discursive psychology |
| url | http://www.sciencedirect.com/science/article/pii/S2667321523001543 |
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