BACKGROUND Lifestyle change can be influenced through effective interaction between care receiver and care provider. The physical environment where the interaction occurs can affect the dynamics of long-term therapeutic treatment. There have been no studies on the perception of the physical environment in nutritional treatment. OBJECTIVE Our aim was to ascertain the impact of the physical environment on the dynamics and communication between dietitian and patient based on perceptions of dietitians. DESIGN We conducted qualitative constructivist phenomenological research. PARTICIPANTS In-depth interviews (n=10) and eight focus groups (n=62) were held with dietitians who offer treatment in a physical environment designed according to the medical model and/or in a physical dynamic environmental design according to the dynamic model. RESULTS Most dietitians in Israel treat their patients in a physical environment arranged according to the medical model. The participants reported that the physical environment affects the interaction. However, the idea of transforming the physical environment according to the dynamic model raised reservations. Barriers include upsetting therapeutic boundaries, challenging professional authority, and lack of therapeutic tools suitable for the change. CONCLUSIONS Changes in the spatial design in which the therapeutic interaction occurs might support the dietitians' transformation from counseling into therapy. The barriers toward such change suggest that professional training is needed to enable dietitians to overcome them. We recommend conducting further research to evaluate the current physical environment, as well as raising dietitians' awareness and training them to work in the new environment, reflecting a counseling/therapeutic mindset. These changes should be followed by additional research among practitioners to report on their effects.

中文翻译：

---

营养师从咨询到治疗的转变是否也适用于物理和治疗环境？以色列实践案例研究

背景 生活方式的改变可以通过护理接受者和护理提供者之间的有效互动来影响。发生相互作用的物理环境会影响长期治疗的动态。目前尚无关于营养治疗中物理环境感知的研究。目标我们的目标是根据营养师的看法确定物理环境对营养师和患者之间的动态和交流的影响。设计 我们进行了定性建构主义现象学研究。参与者与营养师进行了深入访谈（n=10）和八个焦点小组（n=62），他们在根据医学模型设计的物理环境和/或根据动态模型设计的物理动态环境设计中提供治疗. 结果 以色列的大多数营养师在根据医学模型安排的物理环境中治疗他们的患者。参与者报告说，物理环境会影响交互。然而，根据动态模型改变物理环境的想法引起了保留。障碍包括打破治疗界限、挑战专业权威以及缺乏适合变革的治疗工具。结论 治疗相互作用发生的空间设计的变化可能支持营养师从咨询到治疗的转变。这种变化的障碍表明需要专业培训才能使营养师克服这些障碍。我们建议进行进一步研究以评估当前的物理环境，并提高营养师的 意识并培训他们在新环境中工作，反映咨询/治疗心态。这些变化之后应该在从业者中进行额外的研究，以报告其影响。