Class 8 - Supporting Wellness in Illness

Question 1

What are some negative effects of patient education?

Answer 1

-assumes lack of knowledge is primary cause of unhealthy behaviour
-can cause blaming
-can curate a defensive response
-doesn’t consider motivation or state of change

Question 2

Non-adherence can cause frequent ____________ for the same concern

Answer 2

hospitalizations

Question 3

Factors that affect adherence level:

Answer 3

-developmental level
-level of understanding
-beliefs of treatment
-perceived barriers
-self-efficacy
-treatment difficulty
-meaning of the condition
-emotional readiness

Question 4

What does the transtheortetical model of change focus on?

Answer 4

readiness for change before change is made

Question 5

What are characteristics of the pre-contemplation phase?

Answer 5

-not considering change
-denial
-problem isn’t considered serious
-may have given up on previous attempts

Question 6

Strategies to move forward the pre-contemplation phase:

Answer 6

-education
-assistance with identifying risks v. benefits
-assess readiness for change
-“might” questions to visualize potential benefits
-remain flexible
-revisit

Question 7

What are the characteristics about the contemplation phase?

Answer 7

person is ambivalent about changing

Question 8

What are strategies to move forward the contemplation phase?

Answer 8

-identify barriers and misconceptions
-pros and cons of new behaviour
-DARN questions
-address concerns
-identify support systems
-assess readiness
-establish a time frame

Question 9

DARN Questions

Answer 9

D - desire “why do you want to make the change”
A - ability “do you have to tools to make the change?”
R - reason “what is motivating you to make the change”
N - need “on a scale of 1-10 how important is this to you?”

Question 10

Characteristics of the preparation stage?

Answer 10

person is prepared to experiment with small changes

Question 11

What are strategies for the preparation phase?

Answer 11

-let patient create plan
-keep it simple
-realistic goals and timeline
-clear and positive info
-social connections
-stack the deck
-pros and cons
-readiness
-time frame

Question 12

Characteristics of the action phase:

Answer 12

person takes definitive action to change

Question 13

What are strategies during the action phase?

Answer 13

-positive reinforcement
-follow-ups

Question 14

What are strategies for maintenance and relapse prevention?

Answer 14

-encouragement and support
-contingency plans for handling setbacks
-follow-ups

Question 15

What are some factors that influence behaviour?

Answer 15

-default to zero
-illogical thinking
-media, family, peers
-windows of opportunity

Question 16

What are some barriers to change?

Answer 16

-lack of info/skill
-lack of confidence
-misconceptions
-personal cost
-environmental/logistical barriers
-salience

Question 17

Motivational interviewing is an assessment strategy and an ______________

Answer 17

intervention

Question 18

What does motivational interviewing address?

Answer 18

ambivalence - mixed feelings

Question 19

What is the focus of motivational interviewing?

Answer 19

exploring meaning and self-efficacy

Question 20

What is the key component of motivational interviewing?

Answer 20

active listening

Question 21

Motivational Interviewing - READS

Answer 21

Roll with resistance
Express empathy
Avoid argumentation
Develop discrepancy
Support self-efficacy

Question 22

What is resistant behaviour?

Answer 22

negating, blaming, excusing, etc.

Question 23

How do you “roll with resistance”?

Answer 23

provide info and alternative and explore possible solutions

Question 24

Elicit, provide, elicit strategy

Answer 24

-Elicit information from the person to understand values and readiness
-Provide information to address knowledge gaps
-Elicit information on the persons understanding and their feelings about it

Question 25

What is the goal of developing discrepancy?

Answer 25

change persons perceptions without creating a sense of being pressured