DEPARTMENT OF NUTRITION SCIENCES

KULLIYYAH OF ALLIED HEALTH SCIENCES

AHND 3322
COUNSELLING SKILLS FOR DIETITIANS

ASSIGNMENT: REFLECTION FROM

COUNSELLING OBSERVATION

Instructor: Asst. Prof. Dr. Aliza Haslinda binti Hamirudin

Student’s name: Fatimah binti Masri

Matric number: 1512656

SEMESTER 2 2018/2019
 The case that I choose for this assignment is a follow-up case involving a Malay man
(on wheelchair) who has type 2 Diabetes Mellitus (on insulin) and also hypertension. During
the counselling session with the dietitian, his daughter (aged about 30 years old) is also there.
Throughout the counselling session, his daughter always complaint on her father’s eating habit,
whereby his father constantly skip lunch and always have irregular meal times by having
routine habit of snacking biscuits and kueh at whenever time he like. If he does take the lunch,
he will only eat some biscuits, which is improper and unbalanced meal for that meal time. He
also loves to eat sweet local fruits as snacks such as mango. Besides that, the daughter also
complaint about the insulin injection whereby her father always forgot whether or not he had
injected the insulin. Her father tends to inject two time; before and after eating, because her
father always not sure that he had inject the insulin before he eats the meal. During the
counselling session, the daughter had done most of the talk compared to the patient. She is also
very supportive and really want her father to follow the dietitian’s advice so that her father can
have a better quality of life.

There are many types of verbal communication that have been shown during the
counselling session. The most obvious one is the voice tone of the dietitian when the patient’s
daughter said that her father can not hear well. Initially the dietitian’s voice tone is lower, but
when he knew that the patient can not hear well, he raised up his voice tone so that the patient
can hear. Secondly, the dietitian used a slower voice speed as the patient is an elderly patient
(so that the patient can follow and understand what he said). Then, the dietitian also uses
analogy while questioning the patient to make the patient understand about the given advices.
On the other hand, the patient also used verbal communication by asking the dietitian about the
proper way of eating for his current diseases. Overall, the patient has moderate voice tone and
speed when talking to the dietitian. Meanwhile, the patient’s daughter also communicates
verbally by commenting about her father’s eating habit. She has a higher voice tone and speed
compared to her father as she is more optimistic and motivated to change his father’s lifestyle.

Besides that, there are also some non-verbal communication that have been shown
during the counselling session. One of them is the eye contact. The dietitian, the patient and
his daughter really make use of the eye contact during the session. None of them especially the
patient looks down or elsewhere around the room. They making the eye contact and look at
each other while discussing about the matter seriously. Then, the dietitian does a body position
by leaning forward to the patient. The patient only leaned his back against the wheelchair but
whenever he wants to ask some questions to the dietitian, he will sit straight. Furthermore, the
dietitian used some mild hand gestures whenever he wanted to explain something to the patient.
In term of facial expression, the patient showed a slight pouty face as the dietitian commented
about his current eating behaviour which is not good for his disease. Although some of the time
the patient confronted about an issue discussed, the dietitian kept maintaining a warm facial
expression and smiled throughout the counselling session. On top of that, the patient also
showed a harsh attitude towards the dietitian by throwing a small sachet of Stevia to him while
asking whether or not that product is good for his diabetes. As expected, the dietitian did not
confront or angry but instead, he responded politely about that matter.

In my opinion, the patient might not comply to the given advice. This has been shown
from his behaviour throughout the counselling session whereby he was so ego and always kept
mentioning that he did not take heavy meals, therefore he questioned how suppose it can
alleviate his diseases. Then, when asked about his HbA1c status, although he said that he
wanted to reduce it, it was not convincing enough as he did not utter it confidently and the way
he sounded were not quite motivated. The possible risks to this patient for non-compliance
towards the given advice includes his developed routine habit of snacking that is really hard to
change and also his work shift that some times made him eating heavy meal late at night,
leading to a reduced efficacy of insulin injection at that current time.