Sentidos e significados atribuídos por nutricionistas para utilização de abordagens não prescritivas no cuidado nutricional

Abstract

In an attempt to address issues that the hegemonic model of care in Nutrition has not achieved, there is a movement towards the reconfiguration of nutritional care, which takes place through the use of non-prescriptive approaches by nutritionists. Such approaches are presented as an alternative capable of building comprehensive care, promoting concrete changes in the long term, self-acceptance, autonomy and a balanced relationship with the body and food. Although studies point to the use of these practices by nutritionists, the process that leads these professionals to use such approaches in association with nutritional prescription or even as a substitute for it is still unclear. Since professional practice is built through mediations between the professional and society, the present work proposes to understand this process from the perspective of subjectivity, through the investigation of the senses and meanings that mediate this use. Aiming to carry out an analysis that was not limited to description only, the starting point was the theoretical-methodological framework of socio-historical psychology. Therefore, an interface was established between the field of Food and Nutrition and the Human and Social Sciences, in order to denaturalize the phenomenon observed here without isolating it from reality, apprehending its subjective and social dimensions without dichotomizing them. This is a qualitative, descriptive study to be carried out with male and female nutritionists. The investigation took place in two stages: in the first, information on training, professional performance and use of non-prescriptive approaches by nutritionists was obtained. In the second stage, participants were interviewed using a semi-structured script with questions related to the thinking, feeling and acting of these professionals in relation to non-prescriptive approaches. The results obtained are presented in the articles “Understanding of nutritionists on non-prescriptive approaches in nutritional care” and “Professional practice of nutritionists – meanings of care based on non-prescriptive approaches”. The nutritionists' speeches evidenced the use of non-prescriptive approaches by nutritionists from different areas of activity, in an attempt to counterpoint the idea of prescription associated with hegemonic nutrition and to build a care practice that is expanded, promoting autonomy and empowerment, and that has long-lasting results. In this process, the role of education, identity and professional practice as mediators is highlighted, articulating the search of nutritionists for an approach that corresponds to their vision of ideal care. It was observed that there is progress towards recovering the human aspect in the practice of care. However, factors such as complexity, autonomy and dialogue do not always materialize in the practice of these professionals, which can lead to the reproduction of weaknesses that were associated with prescriptive care. Thus, it cannot be said that the use of non-prescriptive approaches by nutritionists is a direct indication of the construction of a transforming praxis.