Lecture 7: Motivational Interviewing Flashcards
What are the 5 A’s of intervention?
Ask
Advise
Assess
Assist
Arrange
What is the main purpose of Ask of intervention?
Identifying the documenting the current behavior you want to change.
EX: How much alcohol do you drink per day?
What is the main purpose of Advise of intervention?
Give info about health risks if not changed.
Give info about health benefits to reinforce change.
What is the main purpose of Assess of intervention?
Determining if the patient is willing to change their behavior.
What is the main purpose of Assist of intervention?
If PATIENT IS WILLING, use interventions to help make change.
What is the main purpose of Arrange of intervention?
Schedule short-interval follow-up with patient.
What are the 5 stages of change?
Precontemplation
Contemplation
Preparation
Action
Maintenance
What is the precontemplation stage?
Not even considering change.
Either due to denial/disbelief OR failed so many times they’ve lost hope ):
What is the contemplation stage?
Ambivalent about changing.
Giving up their behavior causes them to feel a sense of loss.
What is the preparation stage?
Preparing to make a specific change, often experimenting with small changes.
What is the action stage?
Actively pursuing a change.
Need encouragement, support, and praise still.
What is the maintenance stage?
RELAPSE PREVENTION.
Incorporating the new behavior for the long term.
Some patients may recycle a few times before their changes are fully established.
How often does the preparation stage last?
0-3mo
How often does the action stage last?
3-6mo
How often does the maintenance stage last?
6+ mo
What is adherence?
The extent to which a patient’s behavior corresponds with the agreed-upon recommendations from a healthcare provider.
How good is adherence for chronic diseases among developed countries?
50% only ):
If a patient didn’t agree to a care plan, what is a change we can make?
Shared decision making.
If a patient says they’re unable to afford care, what is a change we can make?
Change to a more affordable one.
Look for patient assistance to help cover cost.
If a patient says they’re unable to access treatment, what is a change we can make?
Alternative treatment.
Look for ways to improve patient access.
If a patient says they do not like the SE of a treatment plan, which is a change we can make?
Explain risks vs benefits.
Look for alternative treatments.
If a patient says they think they are better and no longer need treatment, what is a change we can make?
Educate patients on the course of their disease.
What are some major causes of non-adherence?
Healthcare team and system-related factors
Condition-related factors
Therapy characteristics
Patient-related factors
