During this session, once we had a recap on the groups progress since the last online meeting, the main focus was on nutrition.
Reflective Summary
During this clinical reflection I am going to use Bourtons Development Framework which identifies three key questions in the reflective process; ‘what?’, ‘so what?’ and ‘now what?’ which can enable me to critically reflect rather than describe (Skinner & Mitchell, 2016).
To start with, it was satisfying to see that the group had made a real effort to improve activity levels, within the first week. Even though some members of the group did not complete any extra exercise, due to other commitments, it was equally as reassuring to see that they had planned to, which is a really good start. An interesting method for increasing step count can be done within the workplace, as it is an appropriate setting for promoting lifestyle physical activity (US Department of Health and Human Services, 2008). In order to change physical active behaviours of employees, different strategies such as counselling, goal setting, self-monitoring, feedback, education and team competitions can be used as interventions, where the majority reported an increase in step count (De Cokcer, De Bourdeaudhuij & Cardon, 2010). A similar concept could be introduced into online health and well being programmes and within exercise classes to promote an increase in physical activity.
The main discussion within the session was around the different sections on the eat well plate. There is currently a debate around the eat well plate whether it needs to be updated, however its important to remember it is only a guide. Changes have been made within the past few years; In July 2015 the UK Scientific Advisory Committee on Nutrition (SACN) produced a report on dietary carbohydrates. They concluded that the mean population intake of free sugars should be reduced from 11% to 5% of dietary energy and fibre intake should be increased from 24 to 30 grams per day (Scarborough et al., 2016). It has also been suggested that carbohydrate intake should be reduced. Several trails shows that low-carbohydrate, high-protein diet resulted in more weight loss over 3 to 6 months compared to a conventional high-carbohydrate, low-fat diet (Sack et al., 2009).
I believe it is of huge importance to educate the group so they understand why we need to eat certain foods or what should be avoided.
Our final discussion regarded food labels; A new label scheme using a colour coding system has been implemented in the UK. Green, amber and red signals show if a product is high, medium or low in fat, saturated fat, salt, sugar and energy. This method is thought to be effective as it allows a quicker identification of healthier options and at a glance colour codes can be easily interpreted (Violoa, Bianchi, Croce & Ceretti, 2016). The problem with food labels is that components that should be consumed in limited amounts are interspersed with other food that often lack in peoples diet (Temple & Fraser, 2014). This can make it confusing.
| Areas for Improvement | Action Plan |
| Need to become more confident regarding basic nutrition advice | Look at the research surrounding nutrition, what should be included in diets and what should be avoided |
| Find out if it is better to advise people to drink water in terms of cups per day or litres | Use evidence-based practice to see which measurement (cups or litres) gets people to drink more |
| Explain to your client why you are thinking and doing a certain treatment, rehabilitation exercise etc | Educating the client is important; in my next appointment I will explain to the client what I will do in the session and why (what should the client get out of it) |
Closing the Loop
I have learnt that if I am not confident with nutrition, I know people that are so can get my clients in touch with them or advise helpful websites to them. With every client now I will always ask what they want to get out of the session so I know why they have to come to see me.
References
De Cocker, K. A., De Bourdeaudhuij, I. M., & Cardon, G. M. (2010). The effect of a multi-strategy workplace physical activity intervention promoting pedometer use and step count increase. Health education research, 25(4), 608-619.
Sacks, F. M., Bray, G. A., Carey, V. J., Smith, S. R., Ryan, D. H., Anton, S. D., … & Leboff, M. S. (2009). Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. New England Journal of Medicine, 360(9), 859-873.
Scarborough, P., Kaur, A., Cobiac, L., Owens, P., Parlesak, A., Sweeney, K., & Rayner, M. (2016). Eatwell Guide: modelling the dietary and cost implications of incorporating new sugar and fibre guidelines. BMJ open, 6(12), e013182.
Skinner, M., & Mitchell, D. (2016). “What? So What? Now What?” Applying Borton and Rolfe’s Models of Reflexive Practice in Healthcare Contexts. Health and Social Care Chaplaincy, 4(1), 10-19.
Temple, N. J., & Fraser, J. (2014). Food labels: a critical assessment. Nutrition, 30(3), 257-260.
US Department of Health and Human Services. (2008). Physical activity guidelines for americans. US Department of Health and Human Services. Washington, DC.
Viola, G. C. V., Bianchi, F., Croce, E., & Ceretti, E. (2016). Are food labels effective as a means of health prevention?. Journal of Public Health Research, 5(3).