The struggle to balance system and lifeworld: Swedish dietitians’ experiences of a standardised nutrition care process and terminology

ABSTRACT

In this study, we explored Swedish dietitians’ experiences of a standardised Nutrition Care Process (NCP) and terminology from the perspective of Habermas’ concepts of system and lifeworld. Seven focus group discussions were analysed thematically. In this paper, we argue that dietitians seem to mainly connect the NCP with a system perspective, highlighting aspects such as professionalism, measurability and clarity of the patient record as helpful outcomes from the NCP standardisation. We also see a tension between system and lifeworld, as dietitians emphasised the importance of the dietitian–patient relationship, stating that a patient’s complex situation does not always fit into the pre-defined NCP terms and measurements. Several approaches were identified whereby dietitians tried to reach a balance between the system and lifeworld. We argue that strategies for achieving this balance need more attention in the education and implementation of standardised care processes and terminologies.

KEYWORDS:

• Nutrition Care Process
• dietitian
• professionalism
• terminology
• Habermas

Acknowledgements

We would like to thank Professor Alan Warde and Professor Christina Fjellström for valuable advices and comments regarding the manuscript. We thank all dietitians contributing to this study through participating in the focus groups. We also thank dietitian and PhD student Åsa von Berens for observing the focus groups. All authors have participated in conception and design, analysis and interpretation of data. First author Elin Lövestam was responsible for drafting the manuscript; all other authors contributed with critical revisions and supervision.

Disclosure statement

No potential conflict of interest was reported by the authors.