Class 8 - Supporting Wellness in Illness Flashcards
What are some negative effects of patient education?
-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
Non-adherence can cause frequent ____________ for the same concern
hospitalizations
Factors that affect adherence level:
-developmental level
-level of understanding
-beliefs of treatment
-perceived barriers
-self-efficacy
-treatment difficulty
-meaning of the condition
-emotional readiness
What does the transtheortetical model of change focus on?
readiness for change before change is made
What are characteristics of the pre-contemplation phase?
-not considering change
-denial
-problem isn’t considered serious
-may have given up on previous attempts
Strategies to move forward the pre-contemplation phase:
-education
-assistance with identifying risks v. benefits
-assess readiness for change
-“might” questions to visualize potential benefits
-remain flexible
-revisit
What are the characteristics about the contemplation phase?
person is ambivalent about changing
What are strategies to move forward the contemplation phase?
-identify barriers and misconceptions
-pros and cons of new behaviour
-DARN questions
-address concerns
-identify support systems
-assess readiness
-establish a time frame
DARN Questions
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?”
Characteristics of the preparation stage?
person is prepared to experiment with small changes
What are strategies for the preparation phase?
-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
Characteristics of the action phase:
person takes definitive action to change
What are strategies during the action phase?
-positive reinforcement
-follow-ups
What are strategies for maintenance and relapse prevention?
-encouragement and support
-contingency plans for handling setbacks
-follow-ups
What are some factors that influence behaviour?
-default to zero
-illogical thinking
-media, family, peers
-windows of opportunity
What are some barriers to change?
-lack of info/skill
-lack of confidence
-misconceptions
-personal cost
-environmental/logistical barriers
-salience
Motivational interviewing is an assessment strategy and an ______________
intervention
What does motivational interviewing address?
ambivalence - mixed feelings
What is the focus of motivational interviewing?
exploring meaning and self-efficacy
What is the key component of motivational interviewing?
active listening
Motivational Interviewing - READS
Roll with resistance
Express empathy
Avoid argumentation
Develop discrepancy
Support self-efficacy
What is resistant behaviour?
negating, blaming, excusing, etc.
How do you “roll with resistance”?
provide info and alternative and explore possible solutions
Elicit, provide, elicit strategy
-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
What is the goal of developing discrepancy?
change persons perceptions without creating a sense of being pressured
