Beyond Nutrition.Subjective Global Assessment

Medical Nutrition

1. Beyond Nutrition-Understanding Beyond Nutrition-Understanding
Social meaning of foodSocial meaning of food
DR. Atta ur Rehman
Clinical Dietitian
KKH-NGHA

2. ObjectiveObjective
Demonstrate
counseling skills
required in the
clinical setting

3. Varieties of CounselingVarieties of Counseling
Supportive counselling
Informative counseling
Educational counseling
Crisis counseling
Post trauma counseling
Counseling in spiritual distress
Counseling in emotional distress
Confessional distress

4. Counseling interventionsCounseling interventions
Prescriptive
Informative interventions
Confronting interventions
Cathartic interventions
Catalytic interventions
Supportive intervention

5. Outcome of Effective CounselingOutcome of Effective Counseling
The person
comes to see himself differently
accepts himself and his feelings more fully
becomes more self-confident and self
directing
becomes more flexible, less rigid in his
perceptions.
adopts more realistic goals for himself

6. Outcome of Effective CounselingOutcome of Effective Counseling
behaves in a more mature fashion.
becomes more acceptant of others.
becomes more open to the evidence ,both to
what is going on outside of himself and to
what is going on inside of himself
charges in his basic personality characteristics
in constructive ways."

7. "It’s good to talk"

8. Counseling SkillsCounseling Skills
Skill-I Listening and attending
Skill-II Client-centered skills
Skill-III Helping with feelings

9. Counseling Skills-ICounseling Skills-I
Listening and attendingListening and attending
The best counselling is that which
involves the counsellor solely listening
to the other person
Attending is the act of truly focusing on
the other person
There are 3 hypothetical zones of
attention

10. Listening and attendingListening and attending
Zones of attentionZones of attention
ZONE ONE: Attention out
The counselor listens to the client and paying attention
to verbal and non verbal cues
ZONE TWO: attention in
The counsellor is caught up with his/her own thoughts
and feelings. attention to client is partial
ZONE THREE: attention focused on fantasy
The counsellor is busy trying to work out theories about
the client. Rather than giving full attention, he/she is
interpreting what is going on.

11. The psychological approach to The psychological approach to
counselingcounseling
Psychodynamic App
Cognitive behaviour therapy
Humanistic
Transactional analysis
Gestalt therapy
Eclectic

12. The cognitive behavior therapyThe cognitive behavior therapy
The health professional who adopts the cognitive
behavioral approach to counseling will tend to:
Rely less on personal warmth and more on confrontation in
counseling relationship
Use a logical and rational approach to problem solving
Encourage the client to develop a realistic and pragmatic
outlook on life

13. Necessary personal qualities of the Necessary personal qualities of the
effective counseloreffective counselor
Unconditional positive regard
Empathic understanding
Warmth and genuineness
Concreteness
Immediacy

14. An eight stage map of counseling An eight stage map of counseling
relationshiprelationship
Meeting the client
Discussion of surface issues
Revelation of deeper issue
Ownership of feelings and possibly emotional
releases
Generation of insight future planning / problem
solving
Action by the client
Disengagements from the counseling relationship by
the client

15. Don’ts in the counsellingDon’ts in the counselling
Why
Should and oughts
Blame
Don't compare client's experience and
yours
Don’t invalidate clients feelings

16. feelings includingfeelings including
anger
fear
grief
embarrassment
joy/happiness
mood swings etc

17. Clinical evaluation remains the
oldest, simplest, and probably most
widely used method of nutritional
evaluation.Nevertheless,this method
of nutritional evaluation does not
appear to have been analyzed
critically before.

18. Infection,trauma,and possibly a
circulating suppressive factor may
make delayed cutaneous
hypersensitivity unreliable.

19. The first is the problem of separating the
effects of actual nutrient deprivation from
those of the disease process in altering the
measurements. For example, hepatic
disease,nephrosis, and Protein losing
enteropathy may all coexist in patients
undergoing nutritional assessment and
may reduce the serum levels of Albumin
and transferrin.

21. SUBJECTIVE GLOBAL SUBJECTIVE GLOBAL
ASSESSMENTASSESSMENT

32. Thank youThank you