What is the PES Statement?
The PES statement is a structured, clear, and concise sentence that describes a specific nutrition problem for a patient or client. It is the foundation of the diagnosis step within the Nutrition Care Process (NCP), enabling dietitians to articulate the core issue they are addressing. The statement is broken down into three key parts: Problem, Etiology, and Signs/Symptoms. Its standard format is:
[Problem/Nutrition Diagnosis] related to [Etiology] as evidenced by [Signs/Symptoms].
This format ensures that the dietitian’s reasoning is transparent and links the problem directly to its cause and observable data. It is a critical communication tool in clinical settings, private practice, and community nutrition programs.
The Components of a PES Statement
Each element of the PES statement provides crucial information for developing and justifying a nutrition care plan.
Problem (P): The Nutrition Diagnosis
The "P" represents the specific nutrition-related problem that a dietitian can resolve or improve. This is not a medical diagnosis, but rather a nutritional issue that can be addressed through dietary changes or counseling. The Academy of Nutrition and Dietetics provides a standardized terminology list (eNCPT) for these diagnostic terms, which fall into three main domains. The domains are related to intake, clinical, and behavioral-environmental issues.
Etiology (E): The Root Cause
The "E" describes the root cause or contributing factors of the identified problem. This is important because a dietitian's intervention aims to address this cause. The etiology should be specific and supported by assessment data.
Signs and Symptoms (S): The Evidence
The "S" represents the evidence for the nutrition problem and its etiology. This includes both objective data (signs) and subjective data (symptoms). These should be measurable to monitor the intervention's effectiveness.
PES vs. Medical Diagnosis: A Comparison
It is vital to understand the difference between a nutrition diagnosis, documented as a PES statement, and a medical diagnosis. The distinction is key to a dietitian’s role within the healthcare team.
| Aspect | Nutrition Diagnosis (PES) | Medical Diagnosis |
|---|---|---|
| Primary Focus | Nutritional problems that can be managed or resolved by a dietitian. | Diseases or pathological conditions a physician treats. |
| Example | Inconsistent carbohydrate intake. |
Type 2 Diabetes. |
| Responsibility | Dietitian | Physician |
| Changeability | Can change with patient status. | Remains the same until resolution. |
| Core Purpose | To create a tailored nutrition care plan. | To guide medical treatment. |
Putting it all together with examples
To see how the PES statement works in practice, consider examples such as excessive sodium intake related to frequent consumption of processed meals, or inadequate protein intake related to decreased appetite. More examples of PES statements can be found in resources like {Link: NutriAdmin Blog https://nutriadmin.com/blog/nutrition-diagnosis-and-pes-statements/}.
The Importance of the PES Statement in the Nutrition Care Process
The PES statement is a critical thinking framework that drives the subsequent steps of the NCP. It serves as the bridge between assessment and intervention, ensuring the dietitian's actions are focused, justified, and measurable.
- Guides the Intervention: The etiology component directly informs the nutrition intervention.
- Facilitates Monitoring: The signs and symptoms provide measurable indicators to track progress and evaluate the intervention's effectiveness.
- Enhances Communication: The standardized format allows for clear communication among healthcare providers.
Conclusion
The PES statement, encompassing the Problem, Etiology, and Signs/Symptoms, is essential to the nutrition diagnosis phase of the Nutrition Care Process. It is the standardized method for summarizing a patient's nutritional status and creating a targeted, evidence-based care plan. By clearly defining the problem, its root cause, and quantifying the evidence, the PES statement ensures that nutrition interventions are effective, efficient, and well-documented. A thorough understanding of this framework is essential for any nutrition professional providing high-quality, patient-centered care. The official electronic Nutrition Care Process Terminology (eNCPT) provides the comprehensive standardized language used by dietitians.
