behaviour modification for CV and respiratory health Flashcards
what is the biopsychosocial approach?
- how psychological and social factors are involved in disease processes
- psychological consists of: behavioural factors, cognitive factors
what is the IMB model?
- simplest summary of 3 key elements needed for behaviour change (information, motivation, behavioural skills)
- components may be multifaceted
what are the components of health promotion?
- information/knowledge
- beliefs
- motivation and persistence
- skills
- plans
- opportunities
- habits (healthy and unhealthy)
- feedback and rewards
- support
- environmental context
what are the 3 factors that facilitate healthier choices?
- smack
- shove
- nudge
what are smack, shove and nudge?
- smack: eliminate choice (legislation)
- shove: restrict choice (eg: sugar tax)
- nudge: guide and enable healthier choices (effective way to change diet)
what are the 3 individual cognitive factors?
- contemplation and planning
- action and maintenance
- multi component interventions
what is contemplation and planning in terms of cognitive factors?
- identify important cognitive and affective factors
- develop required skills for imitation and maintenance
- information/knowledge
- perceived susceptibility
- perceived severity
- perceived benefits
- perceived barriers and actual barriers
- attitudes
- normative beliefs - descriptive/injunctive
- self-efficacy
- motivation and maintaining motivation
- behavioural skills
what is action and maintenance in terms of cognitive factors?
- cues to action: but NOT just shocking images, boundary conditions/habit
- monitoring progress: rewards for accomplishments (material, psychological)
- managing relapse: learning from relapse, strengthening skills and motivation
what are multi-component interventions in terms of cognitive factors?
- one-to-one
- group interventions
- pharmacotherapy
- provide: information, motivation, skill development, peer support
what did the NHS smoking cessation show?
- effective for supporting smokers to quit in the short and longer-term
- group intervention may be more effective than 1:1
- buddy systems may increase effectiveness of 1:1
- intensity of intervention appears to be integral to efficacy
what is relapse and recovery?
- relapse is very common among smokers who make a quit attempt
- systemic review of relapse prevention programs found support for programs overall, but little evidence to support the use of any specific behavioural interventions
- evidence is strongest for interventions focused on identifying and managing tempting situations and strategies
- combining behaviour therapy and nicotine replacement may be most effective
what symptoms are more likely in people diagnosed with CVD?
- depression
- anxiety
- PTSD
when is psychological distress in patients more likely?
- perceive more serious consequence of CVD
- have less coherent understanding of their condition
- have stronger initial emotion response to MI or stroke
what does poorer psychological well-being predict?
- poorer adherence to medication or behaviour change
- poorer prognosis
when are patients more likely to attend rehab?
- less chest pain or other symptoms
- less understanding of condition
- less belief that their condition is controllable
- lower income
- living alone
- perceive health professionals to downplay important of exercise
- believe medication is more important for promoting health
what is the aim of rehab?
- plan to minimise the risk of relapse
- note that relapse is common: plan how to manage triggers/temptations, plan alternative responses
- important of managing relapse: framing of relapse, learning from relapse
what can cardiac rehabilitation involve?
- health promotion/health education
- behaviour change
- stress management
- psychotherapy for depression/anxiety
- support groups
- choices should be tailored to needs and preferences of patients
to be ready for SMART goals what does the patient need to believe?
- their current behaviour is bad for them
- they will be better off if they change
- they have a good chance of succeeding if they try to change
what does SMART stand for?
Specific Measurable Achievable Relevant Time-limited
what is motivational interviewing
a 1:1 approach that helps people:
- overcome ambivalence about behaviour change
- enhance commitment to change
- enhance motivation to change
- address barriers to change
what do patient centred interventions do in asthma?
- educate and develop skills: monitoring lung function and triggers
- develop action plan
- modify unhelpful illness beliefs
- less hospitalisation or other use of healthcare
- less school/work absenteeism
why are patient centred interventions good?
- can be delivered in various ways
- useful for people who find it difficult to engage face to face
- effective and cost effective
