Dietitian perspective and experience: Implementation of telenutrition in Indonesia and the challenge of performing the nutrition-focused physical examination (NFPE)

Abstract

Background

Nutrition assessment is the first step of the nutrition care process (NCP), which includes investigating physical status and malnutrition signs. With the widespread digitalization of healthcare in Indonesia, including telehealth in dietetic practice (telenutrition), evidence is required to address the barriers and improve the current practice of conducting remote physical assessments.

Aim

This study aimed to explore the adaptation of nutrition-focused physical examination (NFPE) using telenutrition in Indonesia.

Methods

This qualitative study recruited Indonesian registered dietitians (RD) with experience in performing NCP using video conferences, phone calls, or other remote/online platforms. The search for participants was conducted until the information was considered sufficient. Data were collected using semistructured in-depth interviews. Thematic analysis was used to analyze the data.

Results

Eleven RDs were interviewed via video conference. Three themes emerged from the analysis: (1) feasibility and practicality, (2) barriers, and (3) adaptations and pre-requisites of remote physical assessment. Remote physical assessment was considered not practical by the majority. Barriers were categorized into technological challenges, lack of NFPE training and practice, and challenges in involving patients. Pre-appointment preparations, guiding the patients through video calls, or asking patients to send images of their bodies are adaptations needed for remote physical assessment.

Conclusion

Challenges in remote physical assessment could be minimized by establishing protocols to deliver standardized care and ensure session efficiency. Additionally, strengthening the implementation and training of NFPE for dietitians in Indonesia is of paramount importance.