Knowledge

One of the characteristics of a profession is the body of knowledge utilized by members while practicing the profession.

Knowledge can be understood and used more productively if it is organized.

This web site provides information concerning the organization of the body of knowledge used in the provision of clinical dietetics care, research enlarging this body of knowledge, and the education of dietetic practitioners.

The Metaparadigm of Clinical Dietetics: Derivation and Applications

Available at www.Amazon.com and www.iuniverse.com

Metaparadigm refers to seven global, abstract, defining concepts that 1) describe the phenomena of concern to professionals who diagnose, perform interventions and evaluate the process of providing nutrition care and 2) are guiding concepts which encompass the less abstract levels of professional knowledge.

Levels of Knowledge in the Body of Knowledge used by Clinical Dietetics:

Metaparadigm

 Seven, abstract, global, defining, domains of professional concern

Paradigms

Conceptual Models / World View / Philosophy

Unmeasurable

Theories*

Hypotheses

Measurable

Science

Measureable

Measured Data, Observations, Facts, Descriptions

Levels are indicators of degree of abstract-ness or concrete-ness rather than levels of truth or value.  Abstract concepts or constructs cannot be measured.  When a hypothesis is stated, the type and unit of measure is part of the content of the hypothesis.

When situations, circumstances, frequencies, occurrences, observations are measured, counted, described, etc.  the practitioner is gathering information. 

Information can be used to create knowledge by forming a hypothesis/theory and testing the theory. 

This type of scientific knowledge-building can be accomplished in the environment of clinical practice as well as in a nutritional, pharmaceutical or medical laboratory. 

Knowledge built from observation, built on theory, tested and confirmed by other practitioners is evidence-based knowledge.

Knowledge from practice can be valuable to other practitioners and their patients.

*Theory:

a) A scheme or system of ideas or statements held as an explanation or account of a group of facts or phenomena;  a hypothesis that has been confirmed or established by observation or experiment and is propounded or accepted as accounting for the known facts; a statement of what are held to be the general laws, principles or causes of something known or observed.

 b) that department or an art or technical subject which consists in the knowledge (or theory of knowledge), statement of the facts on which it depends, or its principles or methods, as distinguished from the practice of it.

[from the introduction to Dictionary of Theories by J. Bothamley,  2^o to The Shorter Oxford English Dictionary]; 

The Seven Domains of the Metaparadigm of Clinical Dietetics:

Definitions and Characterizations

Reference Person refers to the theoretical, statistically derived individual representative of a reference population, referred to in Arroyave’s model of stages of nutritional injury.  It includes the assumption of a defined criteria of selection and assumes the user is informed regarding the essential details of the derivation.  When reference values are used in evaluation or interpretation, it is acknowledged that health and disease are relative, not absolute states.

Human Condition  refers to the nutritional status of individuals in a state of health or with nutritional problems. The scientifically derived reference status is compared with observed departures from “Normal” status to assess the human condition of individual clients.  Such assessment gives direction to the practitioner providing nutritional care to clients.  Human Condition includes the Nutriologic Person, Psycho-Nutriologic Person and Nutrio-Genetic Person.

Practitioner Actions / Attitudes

Practitioner Actions refers to behaviors engaged in or purposefully refrained from, relative to the practice of the profession or to professional development.

Practitioner Attitude refers to intrapersonally based thoughts and feelings about aspects of the diagnostic nutritionist’s professional role enactment that are elicited by situational cues.  They may be explicit and willfully affect professional behavior, or implicit (unstated, unknown, subconscious or unconscious) and involuntarily affect behavior, not being under the influence of the will.  In this instrument attitudes includes, but is not limited to ability, aptitude, beliefs, decisions, emotions, ethics, ideas,  knowledge, morals,  opinions, preferences, thoughts, values will and world view.

Client Actions / Attitudes

Client refers to any individual or groups that present to a diagnostic nutritionist for nutritional care.

Client Actions refers to behaviors engaged in or purposefully refrained from relative to maintaining desired nutritional status or preventing nutrition- related departures from health, including but now limited to eating habits, food selection, procurement, intake, and use of nutraceuticals, as well as the utilization of recommendations.

Client Attitude refers to intrapersonal characteristics and processes of a client.  Attitudes may be explicit and willfully affect behavior or implicit (unstated, unknown, subconscious or unconscious) and involuntarily affect behavior, not being under the influence of the will.  In this instrument attitude includes, but is not limited to, ability, aptitude, belief, desires, emotions, ethics, ideas, knowledge, morals, opinions, preferences, thoughts, values, will and world view.

Practitioner Environment refers to the complex social and physical circumstances surrounding diagnostic nutrition practice.  It includes relationships with other professionals, the local and national organization, the prevailing political and social milieu, the scientific knowledge, the state of technology available and profession-specific tools.

Client Environment refers to the complex social and physical circumstances surrounding a client who receives nutritional interventions from a nutritional diagnostician.  It includes influences of health status and medications, family and associates, food available, work, finances, cultural influences, the marketplace and self care skills. 

Nutraceuticals refers to any substance that can be considered to be a food or a component of a food that affects health, including prevention and treatment of disease. Such products range from all natural, processed, created / engineered, manufactured foods, designer  food, functional foods, phytochemicals, isolated nutrients, supplements, chemopreventive agents, pharmafoods and probiotics.

Research survey using ninety-three descriptive knowledge topics characterizing each domain demonstrated the following results as perceived by 136 Clinical Dietitians respondents to the survey:

77 of 94 knowledge topics were considered relevant to clinical dietetics (82%).

27 of 94 knowledge topics were perceived as unique to clinical dietetics (29%).

49 of 94 knowledge topics were perceived as relevant and shared (52%).

            26 of these 49 were shared with both other health professionals and nutrition scientists (28% of total knowledge topics).

            16 of these 49 were shared with nutritional scientists (17% of total knowledge topics).

            7 of these 49 were shared with other health professionals (7% of total knowledge topics).

(Interested in validating this survey with additional groups? Contact Ruth Leyse-Wallace at RthLys@cox.net)

Applications of The Metaparadigm of Clinical Dietetics include:

            * Case studies

            * Organizing a private practice

            * Building knowledge in clinical dietetics

            * A conceptual model for education research

These and other applications illustrating how the Metaparadigm of Clinical Dietetics may be used in practice, education and research are fully described in The Metaparadigm of Clinical Dietetics:  Derivation and Applications by Ruth Leyse-Wallace PhD, RD.

Available at www.Amazon.com and www.iuniverse.com

Book Citation :  Leyse-Wallace, Ruth. The Metaparadigm of Clinical Dietetics: Derivation and Applications.  iUniverse, Inc. Lincoln, NE,  2007.  http://www.RuthLeyseWallace.com

Dissertation Citation  : Leyse, Ruth L.  Perceptions of the Metaparadigm of Clinical Dietetics: Conceptual Delineation of Phenomena Relevant to the Discipline. UMI Dissertation Services. Ann Arbor, Michigan, 1998.