Giving information and behaviour change Flashcards
Practical use of Transtheoretical model
Precontemplation - create doubt, increase awareness of risks and benefits
Contemplation - help weigh up risks and benefits, strengthen patient’s self-efficacy
Preparation - help pt determine what they might do
Action - help pt determine clear course of action
Maintenance - Help pt identify and use strategies to prevent relapse
Termination - give encouragement
Relapse - help pt renew process of change
How can you start to help a patient through pre-contemplation to contemplation?
State diagnosis/problem
Personalise message
Offer support
Assess problem awareness
Assess and clarify knowledge
Assess and attend to feelings
Assess readiness to change and build commitment
(Use reflective statements to clarify what patient says/means)
How can you help a patient move from contemplation to action?
Explain options and alternatives provide specific recommendations
Ask for a decision and start negotiating a plan for a trial
Assess and reinforce skills and resources
Anticipate problems
Identify and mobilise support
How can you help a patient move from action to maintenance?
Offer support
Arrange a follow-up
Check an reaffirm agreed plan
Role of SMART Targets in consultation
Specific
Measureable
Attainable
Relevant
Time related
Helps with goal setting for patients, particularly in action>maintenance stages
Strategies for supporting a patient in relapse
Offer support
Normalise
Assess how patient is thinking/feeling (cognitive/emotional),
attitude to future action (behavioural),
commitment to re-attempt (stage),
how this will be acheived (envisioning)
What are the main difficulties in providing information?
Doctors underestimate the time spent giving information, give to much information
Use of technical language to provide information
Factors that affect how involved a patient is in descision making
Patient age
Gender
Severity of illness
Length of illness (acute/chronic)
Objectives of giving information
To gauge the correct amount and type of information
To provide explanations that the patient can remember and understand
To use an interactive approach to ensure a shared understanding
To involve the patient and plan collaboratively to the level that the patient wishes
offering an opinion and discussing significance of problems
discussing investigations and procedures
Health belief model applied to taking medicine
Can be affected by:
Percived susceptibility to illness/adverse outcome
The perceived efficacy of the medicine
Percieved Barriers:
The danger of becoming “immune over time”
The danger of addiction and dependence
The unnaturalness of manufactured medicines
The anti drug attitude
Balancing risks and benefits
Managing everyday life
Health belief model applied to communication about medication
Risks not worth benefits
Discrepancy between the doctor’s and patient’s perception of risk
Doctor is unclear about advice
Patient has not understood/accepted information
Does not fit patient’s beliefs
Patient may disagree with advice
May understand/agree but too difficult (Impractical/ Expensive)
May have secondary gains from illness
Things to consider when promoting behvaiour change
Cognitive level: information - assess awareness, knowledge, explain facts, provide information
Attitude: beliefs, intentions, motivation
Instrumental level: assess cues, conditions, consequences. Practice necessary skills
Planning and coping: assess coping skils, plan reminders, teach behavioural skills
Social: assess support and resources.
