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![References
UK Department of Health (2006) Care pathway for the management of
overweight and obesity. London: DH.
Weigh Management Interest Group, INDI (2007) Position of the Irish
Nutrition and Dietetics Institute: weigh management. Available at:
http://www.indi.ie/docs/979_94_wmig.pdf [accessed March 16th 2012]
Grace C, Pearson D et al. (2008) DOM, UK: The Dietetic Weight
Management Intervention for Adults in the One to One Setting: is it time
for a radical rethink? Available at: www.domuk.org/docs/dietetic-
interventionfinalversion301007.doc [accessed March 18th, 2012]
Grace, C. (2011), A review of one-to-one dietetic obesity management
in adults. Journal of Human Nutrition and Dietetics, 24: 13–22.
doi: 10.1111/j.1365-277X.2010.01137.x](https://image.slidesharecdn.com/reflectivepracticepresentation-121230191326-phpapp01/85/Reflective-Practice-Presentation-10-320.jpg)
![References
Rolfe et al. (2001) Framework for reflective practice, as cited by Students
Learning with Communities: information for students: resources. Available
at: http://www.communitylinks.ie/students-learning-with-
communities/information-for-students/resources/
[accessed March 23rd, 2012]
Gibbs et al. (1988) Gibb’s Reflective Cycle, as cited by Students Learning
with Communities: information for students: resources. Available at:
http://www.communitylinks.ie/students-learning-with-
communities/information-for-students/resources/
[accessed March 23rd, 2012]](https://image.slidesharecdn.com/reflectivepracticepresentation-121230191326-phpapp01/85/Reflective-Practice-Presentation-11-320.jpg)
More Related Content
Reflective Practice Presentation
- 1. Dietetics Reflective practice Orna O’Brien March 2012
- 2. Description Action plan Feelings Gibb’s Reflective Cycle Conclusion Evaluation Analysis Gibbs et al. (1988)
- 3. Framework for reflective practice Rolfe et al. (2001)
- 4. Description (summary ofpatient case) PC: 36yo , referred to Community dietetics dept. by GP, for weight loss advice Dx: Wt: 138kg (rising) Ht: 1.76m Obesity III (BMI 44kg/m2) PMHx: Sleep apnoea x 1y (untreated) Dyslipidaemia (total cholesterol↑, LDL↑., HDL↓, Trigs↑) SOBOE, attended PLAN in past, ? mild learning difficulty Social Hx: Lives alone, unemployed non-smoker, non-drinker, poor mobility 2 to weight Nutritional Why did pt. feel he was here; previous wt loss attempts; acceptability Ax: of weight/being weighed. Little confidence in weight loss ability. Explained benefits of 5-10% wt loss. Diet Ax: Poor meal pattern, portion size+++, treats+, good F&V, PA 3/7 (cycling/walking 45mins), night eating. Goals set: Breakfast (porridge measurements, toppings, fruit, water) Biscuits (buy ½ packet, have after evening snack) Plate model Sleep clinic discussion (potato portions)
- 5. Feelings On Initially Reflection
- 6. Evaluation Positive • Sensitive, non-judgementalattitude and approach1 • Expanded knowledge • Insight into human behaviour Negative •Bad judgement – put my own assumptions ahead of the patient’s capabilities •Readiness to change 1 DOM, UK (2008, 2011)
- 7. Analysis Significant learning Flexible Practical experience Input Research1,2,3 from others What Did my What did I was I advice base my trying to help? actions on? achieve? 1 Dept. of Health, UK (2006); 2 INDI (2007); 3 DOM, UK (2008)
- 8. Conclusion How does thislearning experience integrate into my dietetic practice? • Lessened the gap between theory I learned in college and practice I learned in placement • Improved quality of care for patients through patient-tailored assessment and goals
- 9. Action plan • Assessreadiness to change: • Understanding patients thoughts on referral o Is your weight affecting your life in any • Expectations of treatment way at the moment? (UK DH, 2006) • Motivation to change lifestyle • Weight history • Referral to relevant health services • Dieting history • Patient understanding of obesity • If patient not ready to change: • Potential barriers to o Reassure that I am available to talk change about it when he/she is ready • Eating patterns o Briefly advise on the risk of overweight • Current lifestyle: dietary intake and physical & benefits of weight loss activity o Offer an appointment in, e.g. 6 • Support networks months.
- 10. References UK Department ofHealth (2006) Care pathway for the management of overweight and obesity. London: DH. Weigh Management Interest Group, INDI (2007) Position of the Irish Nutrition and Dietetics Institute: weigh management. Available at: http://www.indi.ie/docs/979_94_wmig.pdf [accessed March 16th 2012] Grace C, Pearson D et al. (2008) DOM, UK: The Dietetic Weight Management Intervention for Adults in the One to One Setting: is it time for a radical rethink? Available at: www.domuk.org/docs/dietetic- interventionfinalversion301007.doc [accessed March 18th, 2012] Grace, C. (2011), A review of one-to-one dietetic obesity management in adults. Journal of Human Nutrition and Dietetics, 24: 13–22. doi: 10.1111/j.1365-277X.2010.01137.x
- 11. References Rolfe et al.(2001) Framework for reflective practice, as cited by Students Learning with Communities: information for students: resources. Available at: http://www.communitylinks.ie/students-learning-with- communities/information-for-students/resources/ [accessed March 23rd, 2012] Gibbs et al. (1988) Gibb’s Reflective Cycle, as cited by Students Learning with Communities: information for students: resources. Available at: http://www.communitylinks.ie/students-learning-with- communities/information-for-students/resources/ [accessed March 23rd, 2012]
- 12.
Editor's Notes
- #4 Rolfe et al 2001:Descriptive reflectionReflection on theoryAction-based reflection
- #5 Supervised by senior community dietitianA 36yo gentleman presented to the community dietetics dept. for weight loss adviceAs you can see, he was class 3 obese, and had many co-morbidities as a result of his weightPoor social supportTrouble losing weight in the past – little confidence, but important to himNutritional Ax: tried to draw out where the patient was mentally at – I found this useful in prior experiences. Happy to accept wt loss advice @ this time as was unhappy/frustrated with weight and was impacting on lifestyle.Made 3 very small goalsSupervising dietitian signalled to me to wrap up
- #6 Initial:Confident in weight reduction adviceRelief that there were clear areas for improvement in diet historySatisfaction that I had linked eating patterns (binge eating and night eating)Frustration @ supervising dietitian because I felt I was doing well.On reflection:Disappointment about areas I focused on.In hindsight, I should have spent more time assessing his past failures, and his readiness to change.Realisation – of significant learning experience – will talk about later.
- #7 Insight into human behaviour (confidence, motivation)I should have focused more on assessing his readiness to change, motivators, perceived barriers and support.More time would have been needed to successfully complete a behavioural lifestyle assessment: 45-60minutes (DOM, UK 2008)Cognitive behavioural approach – self monitoring, stimulus control, goal setting, problem solving, cognitive restructuring, social support (DOM, UK 2008)
- #10 Assessment of barriers to change:Sleep apnoea, poor social support, lack of confidenceHow I should have addressed these:Referral to Sleep Clinic, explore more social support options, ? Psychological input re overeating.Psych referral: “some of my patients find it helpful to talk to the...”