The Metaparadigm of Clinical Dietetics

What is a Metaparadigm?

A metaparadigm is a concept naming one of the levels of knowledge. Metaparadigms encompass paradigms. Paradigms encompass theories. Theories encompass science or facts. A metaparadigm is the most abstract level of knowledge. Science is the most concrete level of knowledge.

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

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

This can also be described as a hierarchy or as a continuum of knowledge. This is a theory, or statement, of how the knowledge utilized by the discipline of Clinical Dietetics can be organized. The Metaparadigm of Clinical Dietetics is the most abstract statement of the organizational structure of the body of knowledge.

 Body of Knowledge of Clinical Dietetics

The Global:  The Defining Concerns: The Metaparadigm

The Unmeasurable: Paradigms,  Conceptual  Models, World Views

The Measurable:  Theories, Hypotheses

The Measured:  Data, Observations, Descriptions

The seven concepts/domains of The Metaparadigm of Clinical Dietetics:

The definition of each domain, or concept of concern, is one way to define that discipline or profession and differentiate it from other groups. These other groups may be other health professions or nutritional scientists.

Human Condition:

For clinical dietitians 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 clients. Such assessment gives direction to the practitioner providing nutritional care to clients.

Practitioner Actions / Attitudes:

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

Attitude refers to intrapersonally based thoughts and feelings about aspects of the clinical dietitian’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 attitude includes, but is not limited to ability, aptitude, beliefs, decisions, emotions, ethics, ideas, knowledge, morals, opinions, preferences, thoughts, values, will and world view.

Practitioner Environment:

Practitioner environment refers to the complex social and physical circumstances in which clinical dietetics is practiced. 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 Actions / Attitudes:

Client refers to any individual or groups that present to a clinical dietitian for nutritional services.

Attitudes:

refers to intrapersonal characteristics and processes of a client. Attitudes may be explicit and willfully affect client 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, beliefs, decisions, desires, emotions, ethics, ideas, knowledge, morals, opinions, preferences, thoughts, values, will and world view.

Client Environment:

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

Reference Person:

Reference Person refers to the theoretical, statistically derived individual representative of the reference population, for example the reference “infant 0.5-1.0 years old” referred to in the Recommended Dietary Allowances. It includes the assumption of 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.

Nutraceuticals:

Nutraceuticals refers to any substance that can be considered to be a food or a component of a food that affects health, including the 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 and pharmafoods.

Suggested reference:

Leyse, RL, Perceptions of the Metaparadigm of Clinical Dietetics. 1998. UMI Dissertation Services, Ann Arbor Michigan.

Leyse-Wallace, Ruth, The Metaparadigm of Clinical Dietetics: Derivation and Applications. 2007. iUniverse, Inc., New York.

* Mary Ann Kight, PhD, NIES, Professor Emeritus,The University of Arizona, Tucson comments “Dr. Leyse-Wallace is a meta-theoretical pioneer in differentiating clinical dietetics from clinical nutrition, the nutritional sciences and other health-medical professions.”

* Jacqueline Fawcett, PhD, RN, FAAN, Professor, The University of Massachusetts, Boston, and originator of The Metaparadigm of Nursing comments Articulation of the metaparadigm of clinical dietetics lays the foundation for advancement of knowledge in the discipline. Leyse-Wallace’s work represents a hallmark of success for knowledge development in clinical dietetics.”