Coaching Communication Flashcards
Advice to stop
Gives negative message
Conflicting
Nagging
Frustrating fir both doc and patient
3 elements to stopping successfully smoking
Wanting to stop
Good quality support
Evidence based treatment
Better advice to give VBA
Advice how to stop
Simple form to tell pt how to stop in 30nseconds
Ask
Advice
Act
Ask advice act
Ask:establish and record smoking status
Advice:on how to stop
Act:offer support and treatment
If not interested
Don’t push them
Make it clear that help is always available
Benefits of vba
Brief
Records smoking status as most relapse
Positive
Non confrontational
Opportunistic
Informative
Engaging
Evidence based
Why do ppl smoke
Nicotine addiction is more addictive than heroine or cocajne
Nicotine neurophysiology
Has highest affinity binding for alpha or beta in ventral tegimental area
Increases alpha and beta receptors over long term
Is a chronic relapsing organic brain disease
Behavioral support
Reduce motivation to smoke
Bolster commitment to abstain
Enhance ability to cope with cravings
Ensure effective use of pharmacotherapy’s
Licensed pharmacotherapy’s
Nicotine replacement therapy-skin patches gum lozenges inhalator oral spray nasal spray
Bupropion
Varenicline (most effective)
Bupropion
Non nicotine ores proton target
Modifies dopamine and noradrenergic activity
Varenecline
Partially stimulates and inhibits alpha 4 beta 2 eceptore to relieve craving and withdrawal symptoms and partly blocks pleasure from smoking to prevent risk of relapse
E cigarette
Less harmful in short term
Long term implications not known
Alcohol identification and brief advice
Identification-who’s at risk from alcohol use
Brief advice-about cutting down
Support-self help or referral to a specialized alcohol service
How to measure alcohol drunk
Audit
Audit c if you have cell time
Score from 0-12
