Health Coaching Flashcards
Describe and explain the smoker’s pathway
70% of people who try to stop using meds and support eventually relapse!
How many VBAs lead to one long term quitter?
51
what is the health coaching framework to tackle alcohol abuse
IBA
- Identification – find out who’s at risk
-
Brief advice- about cutting down
- use Motivation interviewing
- Use Implementation intention (what when how and where)- prompt pt to come up with this
- Support- Self-help or referral to specialised alcohol service (if audit is more than 20)
what screening tool is used for identification for the IBA framework
- How often do you have drink containing alcohol
- How many units of alcohol do you drink on a typical day when you are drinking
- How often have you had 6 or more unit- male (8) on a single occasion in the last year
Apart from AUDIT-C what are the other screening tools for alcohol.
Give the features of this!
SADQ (Severity of Alcohol Dependence Questionnaire)-
- checks severity of dependency.
- used to check whether someone requires assisted alcohol withdrawal and what setting is ideal for it.
CIWA-Ar (Clinical Institute Withdrawal Assessment- Alcohol revised)-
- checks severity of acute, unplanned alcohol withdrawal (lead to death/seizures).
- used in A&E and inpatient wards to assess whether a pt with known dependency is experiencing acute withdrawal.
what are the other screening tools for physical activity and Nutrition
what’s the difference between them!
- Physical activity- GPPAQ (General Practice physical activity questionnaire)
- Nutrition- MUST (Malnutrition Universal Screening tool).
They have varying sensitivity and specificity
what are the demographic differences/inequalities in physical activities
- Men more likely to be active
- Rich people are more likely to be active
- Those with a disability and long-term conditions LESS likely to be active
- Some ethnic groups less likely to be active
What is the framework for Brief intervention for physical activity?
- Ask- ask for permission to discuss it and then screen activity levels using Scot PAS-Q
- Advice
- Assist - SIGNPOST
What is the Scot-PASQ screening tools for physical activity?
where can you signpost pt with physical activity problems
- NHS
- Sports England
- Couch to 5k
- Parkrun
- BBC sport
N.B: People who try to exercise need to be checked up at least yearly (prob 6 months) because there are many barriers to participation in physical activity.
what are the contents of a cigarette?
It has 4k chemicals and 60 known carcinogens and metabolic poisons!
it contains:
- Tar
- Nicotine
- Butane
- Naphthalene
- Ammonia
- Arsenic
What are the reasons people keep smoking?
- Nicotine addiction
- Habit
- Stress
- Weight control
- Social
what is the physiology of smoking addiction
i.e. how does nicotine cause addiction
- Nicotine has the highest binding affinity for alpha 4 beta 2 nicotinic receptors. These receptors are mediators of addiction. This occurs in the VTA of the midbrain.
- Inhaled nicotine reaches these receptors in 7-10 seconds. This then triggers release of dopamine into the nucleus accumbens
- Regular smoking upregulates the a4b2 receptors by 3-4 times. These receptors are long term.
- Smoking is a chronic relapsing organic brain disease; not a lifestyle choice.
what are the keys to stopping smoking effectively?
- Good quality support AND
- Evidence-based treatment- NRT , vareniciline etc
- Wanting to stop- not very successful alone
This improves quit rate up to 4 times greater than any one alone
Explain the features of NHS stop smoking service
They are stop smoking adviser which could be:
- practice nurses
- Hospital nurses
- Healthcare assistants
- pharmacists.
Standard support regime is: 4-6 face to face appointments over 6-12 weeks