Class Notes - Lecture 21 motivating patients Flashcards
3 most important health concerns
(1) smoking (reduces life time by 15 years), (2) eat and drink in moderation, (3) physical exercise
How many people go back to smoking after having lung cancer?
About 20% of people who have been treated for lung cancer because of smoking go back to smoking (it is an addiction).
Dr Ross sent a letter to his patients to quit smoking. He had 5000 patients, what were the results.
Only 3 of his patients contacted him and told him to remove their file (would not quit).
30 patients contacted and said they wanted to quit smoking.
How many of Dr. Ross’ patients smoked?
20-25% of people in Canada smoke.
Problem with Dr. Ross’ study
only his 10% patients smoked, where the national average was 20-25%. So perhaps patients who smoked didnt want to be with him in the first place.
Doctor patient motivation is important
for getting patients to listen to Dr orders
Two key motivational concepts in healthcare
o Autonomous motivation – feeling a sense of volition and choice in one’s behaviour
o Autonomy Support – (involves how they make eye contact, how they listen, how they ask questions etc.) Usually involves taking and acknowledging the patients perspective, providing choices (must be careful not to offer too many, they must be aware of what a patient can handle), providing meaningful rationale
♣ Sometimes you cant provide choices – if you have type 1 diabetes there is really only one kind of medication and thus doctor must provide a rationale as to why.
The Specifics of Autonomy Support
Look for behaviours that lead to another person feeling understood and heard.
o Does the doctor make eye contact, ask open ended questions, listen carefully, interrupt, encourage initiation and involvement, provide a rationale for your suggestions.
o Find that doctor waits 18 seconds before they interrupt patient and then doctor takes control of the interaction (patient never has another opportunity to freely voice thoughts/concerns).
