Grief, Loss, Behavior Change Flashcards
- Pre-contemplative-
definition
- dont see a prob
- denial
- dont want to change in next 6 mo
Pre-contemplative - how to assess if pt at this level
- no knowledge of prob
- surprised about prob
- possibly resistant
Pre-contemplative - what to do w/ this pt
Tell me about __
Educate, address denial
Don’t push to action
Contemplation - definition
- knows there is a prob but ambivalent
- no plan to change in near future
Contemplation - signs a pt is at this level
I know I should but ___
Concerned but prefers status quo
Contemplation - what to do w this pt
Focus on benefits+ barriers
Explore fears
Still no push for action
Preparation - definition
Plan to do something in next 6 mo
Preparation - how to assess if pt at this level
“I can(must) do it”
Preparation - what to do with this pt
Tips, techniques, referral to groups/programs
Action - definition
Taking steps to change
Action - how to tell if pt at this level
They have made some changes already
Action - what to do with this patient
Praise
Encourage self-efficacy
Measurable results
Role-play
Maintenance - definition
Sustaining change
Maintenance - how to tell if pt at this level
Behaviors routine
Maintenance - what to do with this pt
Check-in
ID any barriers
Want to be a role model?
Relapse - definition
Pt demoralized, shame, decreased self-efficacy
Relapse - what to say
Re-energize
“those who try the most are more sucessful than those who dont”
3 tenants of motivational interviewing
collaborative
evocative (evoke strengths they have)
honor (choice not to change)
Principles of MI
- avoid righting reflex
- ID pt motivation
- listen > inform
- empower (pt is expert on their behavior)
Complicated grief “persistent complex bereavement d/o”
-death of someone close to you
For 12mo (6mo kids) has 1/4: -long for deceased -emotional pain -preocc w deceased -preocc w circumstnce of death
and
For 12mo (6mo kids) has 6 - diff accepting death - disbelief/emo numb - can't (+)ly reminisce - bitter/angry - self-blame -avoid loss-reminders -want to die (w them) -diff trusting -feel detached -life's meaningless -what my role in life? -can't plan for future **causes impairment/ distress**
Grief stages (list) 5 (DABDA)
Denial Anger Bargaining Depression Acceptance
Denial
refuse to admit its true
- be specific and have pt report back
- ask fam to verify truth
Anger
Place blame (act out physically or emotionally)
- ensure pt knows about big picture
- ID anger root cause
Bargaining
Postpone/distance oneself from reality by negotiating w/ God, PA
- be firm and don’t negotiate
Depression
Loss of control/helplessness
- Screen for dpn
- Remind pt they have control
Acceptance
Stability/resignation “pt becomes active participant in their life”
- Support them in time of adjustment
Factors improving adjustment
- give time
- social support
- optimistic personality
- self image
- coping strategies that enforce self-worth
