Tottori J. Clin. Res. 8(1), 80-84, 2016

Multi-disciplinary discharge support initiatives for long-term psychiatric inpatients– Role for dietitians–Mayumi Nakamura1)*, Kazuo Kuramoto2), Toyoharu Tsutsumi3), Satoko Tanaka4), Akitaka Suzuki5),
Toshiyuki Ueda6)
1) Department of Nutrition Management, NHO Tottori Medical Center2) Department of Nursing, NHO Tottori Medical Center
3) Regional Medical Liaison Office, Department of Regional Cooperation Service,NHO Tottori Medical Center4) Department of Clinical Psychology, NHO Tottori Medical Center5) Department of Rehabilitation, NHO Tottori Medical Center6) Department of Psychiatry, NHO Tottori Medical Center*Correspondence: 876 Mitsu, Tottori 689-0203
Abstract
At our hospital, we provide multi-disciplinary discharge support for psychiatric inpatients. In this report, we
describe our experience with a patient with sigmoid volvulus accompanied by frequent ileus, for which dietary andnutritional care was required and a registered dietitian was requested to intervene. In the presence of the patient himself,
we held monthly conferences to identify possible problems associated with his discharge and discuss viable ways forimprovement. The registered dietitian started by having weekly interviews with the patient to build a relationship withhim and evaluate his dietary and nutritional status. By holding regular meetings for multi-disciplinary discussions, wewere able to review and re-evaluate dietary and nutritional challenges. We found an increase in the number of patient’s
utterances and variety of vocabulary by improving the way we listened to the patient during meetings with him. Hisfacial expressions changed as well, his nutritional status improved progressively, and we were also able to revise thecontent of his meals and to make a transition from his long-term thick liquid diet to full-thickness rice porridge. We werealso able to provide information regarding meals to the institution where he is to reside after being discharged, arrange
for his meals after admission to the institution, and hold discussions necessary for this purpose. By conducting dense
information exchange, we succeeded in unifying how staff members with different professions interacted with the patient.
Although the patient did not initiate talks at the beginning, he began to show interest in his diet and express his intentions
after we improved our listening techniques. We found that diet and nutrition guidance should cover topics of interest to
the patient, use visually appealing materials, and have “active silence” during conversations for effective improvement of
dietary and nutritional status as a part of discharge support. Tottori J. Clin. Res. 8(1), 80-84, 2016
Key Words: multi-disciplinary discharge support, registered dietitian, multi-disciplinary discussions, sigmoid volvulus
with ileus,	 schizophrenia, intervention by registered dietitians
I. Introduction
At our hospital, discharge support for a
psychiatric inpatient is provided by multiple staff
members with different professions. In this paper, we
present a case of sigmoid volvulus accompanied byfrequent ileus, for which dietary and nutritional care
was required and a registered dietitian was requested

to intervene, and discuss about the multi-disciplinarydischarge support initiatives and the role for registereddietitians in the support team.
II. Case profile
Age: In early 50’s.
Gender: Male