11. Motivational Interviewing Flashcards
EBD
____
____
____
Dentist’s expertise
scientific evidence
patient needs & preferences
Interdependence
Evidence-based medicine, shared decision making and patient-centered communications skills are all the ____
same
What Do Dentists Need To Teach Their Patients
● ____:
Preventive Home Care, Causes of Dental Disease, Rationale for Dental Care
● ____:
Best Ways to Care for Mouth at Home, Oral Facial Self Examination
● ____:
Why is Dental Care and Oral Health Important for General Health,
Value of Frequent, Routine Dental Appointments
knowledge
performance
value
Teaching Knowledge: 6 Levels Bloom’s Taxonomy
\_\_\_\_ Comprehension \_\_\_\_ Analysis \_\_\_\_ Evaluation
* Knowledge is the beginning of understanding * Synthesis/evaluation > take initial stages and make a decision about specific cirucmstance
knowledge
application
synthesis
Focusing on Knowledge
● Content Area & Patient Specific: NEED TO KNOW
● Building on What Patient Knows & Can ____
● Evaluate Literacy & ____ Levels
● Small Steps in Sequence
● Talk Combined with Illustration
understand
comprehension
Performance - Coaching & Skill Training
● Clear Understanding of ____
● Specific Demonstration with Appropriate Products
● Practice with ____ Tips
● Continued Practice & Evaluation
● ____ Reinforcement
objective/rationale
coaching
periodic
Communicating Values ● Arrange the \_\_\_\_ Environment ● Set the Cultural Norms ● \_\_\_\_ the Change You Want To See ● Establish a Relationship ● “Make Health the \_\_\_\_ Choice”
physical
model
easy
Motivating Patients to Change
● ____ People Change:
Maslow’s Needs & Drives
Rosenstock & Becker Health Belief Model
● ____ People Change:
Prochaska’s Trans-theoretical Theory
● ____ Clinicians Help People Change: Motivational Interviewing
why
when
how
Maslow’s 5 Needs and Drives
Physiological survival needs > ____ > social & belonginess > ____ > creativity/self actualization
Can ____ this model!
physical safety & economic security
ego/esteem
argue
Maslow’s Theory Applied to Dental Care
● Physiologic Survival Need
○ Remove or Reduce ____
● Physical Safety & Economic Security
○ Halt current and prevent future damage to preserve ____ & save
____
● Social & Belongingness
○ ____ and fresh breath for ____
● Ego & Esteem
○ Use latest ____ to have best oral health
● Self Actualization & Creativity
○ ____ for its own sake, highest level
pain teeth money beauty social acceptance technology health
Rosenstock & Becker’s Health Belief Model
* Health seekin behvaior depends on al of these * \_\_\_\_ - think back as to why all teeth need to come out * \_\_\_\_ - may thingks things are abd, but not as bad * \_\_\_\_ - uncomfortable dentures, may think there's no benefit * \_\_\_\_ - won't be able to affod dentures, etc
susceptibility
severity
benefit
barrier
Stages of Change: Transtheoretical Model
Six Predictable Changes in a Spiral Pattern
- ____
- Contemplation
- ____
- Action
- ____ in Change
- Relapse
- Parchoskas
- Before stop smoking - ____; contemplation, maybe stop but aware of problem; ____ - asking for nicotine patch, and gearing up; ____ after action; then relapse and do it all over, etc, can go right into other stages
- Predictable way
precontemplation
preparation for change
maintenance
precontemplation
preparation
maintenance
Patient Centered Care
* Role of patient * \_\_\_\_ - keep child safe * \_\_\_\_ - providing srervice, keep customer happy; consumer * \_\_\_\_ - counsel someone who is more in charge * \_\_\_\_ - providing knowledge
Go for the ____ two!
parent-child hairstylist advisor-executive coach-player last
Patient Provider Partnerships
1. Health is determined by more than healthcare
2. Patients are active ____ in their own health 3. Healthcare providers are ____ who help
patients achieve their own health goals.
• Non-\_\_\_\_ model
agents
facilitators
- Goods are different than service
* Good is ____ from the consumer; service is not
independent
Rethinking Compliance
____ describes patient behavior that doesn’t align with the plan of care, for example, not taking medicines as prescribed.
compliance is a term that comes from the paternalistic model of care, where provider’s role is to decide on the plan of care and the patient’s role is to follow it.
When patients don’t follow a plan of care, it may be a sign that the health care system is ____in meeting patients’ needs or goals.
non-compliance
non-compliant
• Rather than saying what’s the ____, but what matters to ____
matter
you
Motivational Interviewing
● Ask in ____ Fashion
● Listen, Using Back ____ Cues (Head nodding, Umm)
● Allow Patient to Tell ____
● Show ____ to Bond with Patient
● Give ____
● Ask about Positives and Negatives of Change
● Follow Patient’s ____ about When and How to Change
non-judgmental channel story empathy information lead
Talking about money
* Different in med vs dent * Dentistry egts hit out of \_\_\_\_ than any other healtchare cost • Different from medical provider; different prices for dentistry
Talking about Money
MediCAID
MediCARE
* Medicaid = \_\_\_\_, given to poor people, meant to temp help * Medicare = \_\_\_\_, anyone over 65, disabled and kidney failure * For denstiry, \_\_\_\_ is better, than \_\_\_\_ (more benefits)
bandaid
elderly
medicaid
medicare
Case 1
• Maslow
• Mom is worried about ____
○ Health-belief - may not beliee perceived severity
Case 2
• Misconception
• Not perceiving as ____ or salient to healthcare
○ Dangerous - translocation of bacteria
Case 3
• Maslow - ____
• Clinical disease, may not see recurrent caries
economics
dangerous
social/esteem
