1. My topic is Multiple food allergies: IgE allergy to wheat, peanut and milk. just look at the sample and rubric2. The sample topic is Irritable Bowel Syndrome.
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My role-play should relate to my topic, which is Multiple food
allergies: IgE allergy to wheat, peanut and milk.
Part A: Role-play requirements:
1. Create a role-play situation where you (the dietitian) are obtaining information from a
patient prior to counseling on the diet that the person has been advised to follow by
their physician. Prepare a script for you and your partner, but practice several times so
that you don’t have to read off the script.
2. This is the patient’s first visit to you and the two of you are getting to know each other.
This is an opportunity for you to practice your listening and interviewing skills.
Consult Ch. 15 in the textbook, pgs. 329-336 for a review of Motivational Interviewing
and The Transtheoretical Model for Change
One person will be the interviewer (counselor), the other the client or patient. You
will gather information from the client about his or her history and current problem.
Use motivational interviewing techniques to interview and very briefly counsel.
The goal is to guide the patient around to deciding that he or she wants to make one
or two changes.
The techniques of a 24-hour recall (dinner only) and b) usual intake should be
used. The total session for both students should be kept to 5 minutes.
RD: Hello, Mrs. Smith how are your today?
Patient: Hi, I’m doing well, how are you?
RD: I’m great. My name is Xin, I’m a register dietitian for you today. So, I understand you
refer here because recently you diagnosed irritable bowel syndrome. Is that correcting?
Patient: Yes, it’s.
RD: How are you feeling about that?
Patient: I feel anxious because the abdominal pain and diarrhea. My life is threatening
but I don’t know what to do. And I don’t really understand the irritable bowel syndrome.
RD: Don’t worry, I’m here to help you and I will guide you to through the whole process
in right direction. The irritable bowel syndrome is a common disorder in large intestine.
In US, it’s more common among women. Some risk factors of IBS may be abnormal
movement of the colon (too slow or too fast), Gastroenteritis, or hormone imbalance.
The triggers of IBS could be stress or food. Let’ talk about what a normal day look like
Patient: I usually go to work at 8 am and sit in front of desk to contact my customers for
hours. At 1 pm, I will have a quick lunch then continue working. After coming back
home, I need to cook dinner for my family. The life is stressful for me.
RD: Your stress may trigger your symptoms of IBS. Well management of diet and stress
could reduce the symptoms. Therefore, let’s move to next step. In the past 24 hours, are
you able to remember some stuff you eat?
Patient: Yes, I remembered. In the morning, I had 1 piece whole wheat bread, 1 cup of
steam broccoli, one cup of coffee and one fried egg. During lunch, I had almost 2 cups
mixed vegetable salad it included cabbage, green peas and cucumber. Then I ate half
salmon sandwich and drunk 1 cup of orange juice. My afternoon snack was half cup
fresh raspberry, a small bag of chips and 1 cup of milk. I like to cook a huge dinner every
day. I ate beef potato stew with half cup of brown rice, 1 cup of roast cauliflower and
half cup of corn. Then I ate 3 pieces chocolate cookies as desserts.
RD: OH, it sounds great. I’m glad to hear that you cook for your dinner. And I noticed
that there is very high fiber amount in your diet, is that your normal diet?
Patient: yeah, I like to eat a lot of vegetable and I think it’s good for me.
RD: you are right about that; proper amount of fiber can help the food move through
your digestive tract quickly. Some people are not willing to eat vegetables or fruits and
that cause them constipation. But I also notice there is high amount of insoluble fiber
vegetable in your diet like broccoli and cauliflower. Insoluble fiber can help relieve
constipation but high amount of it may cause or worse diarrhea.
Patient: oh, I never know that. I always think more vegetables are good and I have
followed this diet for few years.
RD: Don’t worry about that. We can start to build up new diet for you. Have you ever
heard PodMap diet?
Patient: NO, what’s that?
RD: FODMAPs stands for
“Fermentable Oligosaccharides,Disaccharides, Monosaccharides And polyols. These are
a collection of short chain carbohydrates and sugar alcohols found in foods. The small
intestine does not absorb FODMAPs very well for sensitive individuals and it may result
in gas, pain and diarrhea. So the low fodmap diet comes out for people who have IBS. In
the low FODMAP DIET, we remove food that high in these fodmap dietary sugar type
food. You may eat less food such as cow’s milk, apple, cauliflower, asparagus and wheat.
So far, studies have shown that a low FODMAP diet improves IBS symptoms. A lot of
people who follow the low fodmap diet for two to four weeks relieve the symptoms. Is
this diet sound good for you?
Patient: Yes, I really want to relieve the symptoms it causes too much trouble in my life.
RD: Here are suggestion foods of FODMAP diet that you can look at. It recommends
lactose-free milk such as almond milk, fruit such as bananas, blueberries, vegetables
such as carrots, lettuce. How do you feel about this diet?
Patient: Ennnn, it sounds good and acceptable. I can try most of suggestions in this
diet. But I don’t want to change my eating habits so fast. Although now my diet is not
helpful for my condition, that’s all my favorite food.
RD: It’ good to hear you can accept this diet. You already put first step in changing your
diet. So, on the scale one to ten, one is lowest and ten is highest, how willing do you like
to try the fodmap diet?
Patient: I guess I’m on 7.
RD: it’ wonderful, it means you are willing to make change and that’s very helpful for
your condition. How do you think to write a food record for your next one week? It will
help yourself and me to tract your daily diet.
Patient: I would like to do that.
RD: Great! If you have any questions after coming home, write it down and I will help
you with that on our next meeting.
Patient: Ok, I will, thank you so much. See you.
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