Behaviour change -smoking cessation

Question 1

When thinking about behaviour change, it is the patients task to say what?

Answer 1

To say how and when they should change You will never be able to make someone who doesn’t want to quit smoking quit

Question 2

The first step in a consultation is to create good ‘rapport’ with the patient. Why is this also important when considering behaviour change?

Answer 2

Research has show that good rapport directly correlated with patient behaviour change outcomes

Question 3

What are the 3 styles of consulting?

Answer 3

-Directing -Following -Guiding

Question 4

Describe the consultation style of directing.

Answer 4

-Delivery of expert advice -Traditionally dominant within healthcare -Best employed when there is a good rapport between patient and dentist -Should be well-times, personally relevant and delivered in such a way as to engage the patient

Question 5

Describe the consultation style of following.

Answer 5

-Utilising listening skills, and occurs in situation where sensitivity is required such as when patient is upset -goal of the clinician is not to solve patient’s problems immediately -aims to provide support and encouragement in difficult situations such as breaking bad news

Question 6

Describe the consultation style of guiding

Answer 6

-more complex than the other 2 -patient and clinician work together to help the patient identify his or her goals, and how they might be achieved -useful for those unsure about change (ambivalent)

Question 7

What are the 4 main communication skills for guiding?

Answer 7

OARS

Open questions (gives deeper understanding of patients view)

Affirmation (demonstrates appreciation for patients efforts e.g. i can see that))

Reflective listening (enables listener to check what has been said by speaker e.g. i understand that)

Summary Examples of each are in the powerpoint

Question 8

Describe the cycle of behaviour change.

Answer 8

ITs called a cycle because a smoker might go round and replase 7 times before they finally maage to quit

Question 9

To get started in the cycle of behaviour change with a patient, what do you have to do in able to come up with a plan of action?

Answer 9

Establish rapport

Set adgenda

Assess importance and confidence (readiness to change)

Question 10

How can you establish rapport with a patient?

Answer 10

Ask any question that might help you understand the patient better:

• Can you take me through a typical day of smoking/typical diet/alcohol intake
• Use smoking and diet diaries

Question 11

What info do you need to se an adgenda?

Answer 11

Is it a single or multiple behaviour that you want to change??
e.g. smoking AND alcohol (maybe a p at risk of oral cancer) or just smoking

Question 12

What 2 factors are required for a patient to be ready to change?

Answer 12

Patient needs to feel the change is important and have the confidence to do it (self efficacy)

e.g. it is too expensive and the p knows how they will change