Discussing Lifestyle changes Flashcards
What is Resistance to change?
Communication and risk of nonadherence
Poor communicator vs. Good communicator
The moral issue?
Patient choice
Difficult to discuss during a consultation
Patient do not want to be morally judged by their provider
Readiness to change
What are the stages of change?
Pre-comtemplation Comtemplation Planning Action Maintenance Relapse
Lastly, Reluctance/
Worst adherence rates with behavioral changes, physicians: promote confidence
What is Motivational Interviewing
- Patient Centered
- Build Motivation and confidence
- Better than traditional advice and education
What is the providers role in MI?
Collaborate
Encourage “change talk”
Reflective listening
Make patient comfortable
What are the techniques used in MI?
Show empathy
Cultivate discrepancy
Explore resistance
Encourage self-eficacy
How does it work?
Readiness, willingness, and ability to change
Key guiding principles: deeper issue and how to drive change
Time of process
How can we use it?
Lifestyle modifications such as alcohol consumption, poor diet and exercise and smoking
What is involved in alcohol use behavior?
Fetal alcohol syndrome (FAS)
- Alcohol induced prenatal abnormalities
- Risk of FAS increases with age and socioeconomic status
What are the patient challenges in alcohol use behavior?
openness regarding consumption, high school diploma, willingness to initiate conversation.
What are the provider challenges in alcohol use behavior?
Avoidance
Redirect the conversation
Focus on other health probelms
What was the impact of MI on alcohol use behavior?
Statistically significant outcomes favor MI
MI had greater impact within the first three months
No loss of impact when extended for more than three months
What is MI compared to other treatments for alcohol?
Superiority of MI
Cannot compare
What are the risk factors?
There are a lot of risk factors associated with diabetes
What is involved in diabetes self management?
Knowledge of diabetes Skills to manage diabetes Internal motivation Confidence in one's abilities Coping with complications
What are the patient challenges?
Time
Family
Cost
Stress
What are the provider challenges?
Providing check ups
Monitoring lifestyle
Addressing concerns
What are the four themes
- Framing the topic in terms of “being healthy”
- Motivating the patient
- cognitive restructuring
- Partnering with the patient to achieve weight loss
- Handle challenges that arise as a part of weight loss
What is the role of the provider?
Meal planning
Physical activity planning
Short term, realistic goals
What are the benefits to lifestyle modifications
Increased physical activity
Reduced caloric intake
Decreased BMI
Increased self-efficacy
What are the effects of smoking behaviors?
Increases blood pressure
Decreases exercise tolerance
Increases tendency for blood to clot
Decreases HDL cholesterol levels
What are the patient challenges in smoking behavior?
Difficult to focus on long term consequences
Stress in present lifestyle
Determining readiness to quit
What are the provider challenges?
Create presuppositions
Judge patient on lifestyle behaviors
Build a rapport
