A nurse is helping an obese patient alter dietary habits, but the patient does not seem to follow through with agreed-upon recommendations. Which action by the nurse would be most beneficial?
a. Ask the patient about foods that have special meanings.
b. Describe the health risks of not staying on the regimen.
c. Encourage the patient to keep a food log during the day.
d. Review dietary teaching to see what is not understood.
A
Dietary habits are particularly difficult to change because food is often imbued with social and cultural meaning. Furthermore, if the patient is the person doing the cooking for the family, the dietary choices affect all members, who may also not like the prescribed regimen. The nurse could assess the meaning that food has for this patient and make alterations in the recommendations so that special foods can be enjoyed in their traditional manner on limited occasions.
People respond much more favorably to messages about the benefits that accrue from making changes; they do not respond as well to threats of vague future repercussions.
Keeping a food log does help patients lose weight, but finding out whether certain foods have special meanings would be more helpful than just having the patient keep a journal of what foods were eaten.
The patient may have some misunderstandings in regard to the dietary teaching, but the nurse should assess for these, not assume they exist.
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