LMBR2: 2-Health and Behavior Change Flashcards
You are working with a patient on a goal and the patient’s confidence level in succeeding is 8/10. What should be your next steps with this patient?
A) This confidence level is associated with success, so no adjustment of the goal is needed.
B) This confidence level is unacceptable, and the goal should be avoided.
C) This confidence level is close to an ideal confidence level for success and may require some adjustment of the goal.
D) This confidence level is not an important predictor of behavior change.
A.
Confidence is an important predictor of behavior change. A moderate to high level of confidence > 7/10 is needed to succeed.
After meeting with your patient, you note that: change has been adopted, his confidence is high that he’ll continue to succeed, and the new behavior is part of the patient’s routine. Determine the transtheoretical model’s stage of change and the appropriate next steps.
A) Pre-contemplation; create strategies for pitfalls and high-risk times.
B) Contemplation; revisit motivation, values and purpose.
C) Preparation; revisit motivation, values and purpose.
D) Action; create strategies for pitfalls and high-risk times.
E) Maintenance; revisit motivation, values and purpose.
E.
The trans-theoretical model’s maintenance stage of change is characterized by: the change has been adopted, there’s a high confidence level to continue to succeed, and the new behavior is part of the patient’s routine. Once a patient reaches the maintenance phase, the next best steps would be to revisit motivation, values and purpose, and to create strategies for pitfalls and high-risk times.
Positive emotions:
A) Are much more fleeting than negative emotions.
B) Narrow thinking.
C) Decrease flexibility, creativity and open-mindedness.
D) Diminish emotional resources.
A. Positive emotions are much more fleeting than negative emotions.
Positive emotions broaden thinking by increasing flexibility, creativity and open-mindedness. Positive emotions build emotional resources.
You are coaching a patient for health behavior change to help build motivation. You should:
A) Provide detailed information about each stage of change that the patient will go through.
B) Assume what the patient already knows, and give them only supplemental information.
C) Avoid all or nothing thinking.
D) Start with the area in which the patient has the least confidence.
E) All the above.
C.
Coaching skills for building motivation include: avoiding information overload by providing only the amount of education needed for a patient’s stage of change; not assuming what a patient knows or doesn’t know; asking permission to share ideas; avoiding all or nothing thinking; and starting with the area in which the patient has confidence.
You are using reflection in your patient interaction and say to your patient, “I hear you saying that you need to exercise but that you have little to no time.” This is an example of what type of reflection?
A) Simple.
B) Double-sided.
C) Summarizing.
D) Empathy.
E) Amplified.
B.
Reflections create a connection, tap into emotions and help patients hear what they are saying in a new way. Reflections therefore can be more provocative and transformational than inquiry. Double-sided reflections reflect both a pro-change statement and a resistance statement that the patient has made.
The 5 transtheoretical stages of change in order are:
A) Precontemplation, contemplation, progress, action, maintenance.
B) Precontemplation, contemplation, action, maintenance, progress.
C) Contemplation, action, maintenance, progress, redo.
D) Precontemplation, contemplation, preparation, action, maintenance.
E) None of these are correct.
D.
Precontemplation, contemplation, preparation, action, maintenance.
Regarding cognitive behavior therapy (CBT) and processes to assist the patient, the “ABCD” method of behavior change involves all of these except:
A) What ACTION or event occurred?
B) What are the BELIEFS about the event that occurred?
C) What are the CONSTRAINTS around those beliefs?
D) How can the patient DISPUTE those beliefs that are unhealthy?
C.
“C” should be consequences. What are the consequences of those actions and beliefs; how do they make the patient feel. Cognitive behavioral therapy is about understanding the underlying beliefs that materialize in thoughts, which leads to emotions and finally to an action.
An action plan must include all of the following except:
A) It must be evidence-based, achievable and specific to the patient.
B) It must incorporate only the patient rather than the patient and her support system (i.e., family and friends).
C) It must be written down, and a copy must be provided to the patient as well as placed in the chart.
D) It will have more success if it’s written down as a prescription and given to the patient followed by an agreement-binding handshake or followed by the patient signing and dating the prescription.
B.
It must involve the patient’s immediate support system to provide accountability and support.
At a follow-up visit when reviewing the action plan from a prior visit, all of the following should be included except:
A) Review of the action plan that was agreed upon at the previous visit, including goals, expected barriers, planned routes around the barriers and problem solving skills.
B) If there were failures, review the triggers that caused the failures and ask about any problem solving skills that were attempted.
C) If there were successes, then congratulations should be offered along with a congratulatory sign if appropriate (i.e. handshake, hug or a high-five)
.
D) If there was a failure, the patient should be berated, unless the patient is Chuck Norris, in which case there are no failures and you should berate yourself for attempting to change perfection.
D.
If there was a failure, an in-depth evaluation of the failure should be reviewed while providing problem-solving skills and tools to avert failure in the future. And, in answer C, appropriate professional conduct must be implemented at all times.
Which of the following is incorrect?
A) Tools that are effective, sustainable and self-managing include: social support strategies; community and employee programs; and digital technology, such as a pedometer.
B) When reviewing the stage matched interventions, the appropriate stage (e.g., precontemplative, contemplative, etc.), should be matched with the appropriate importance scale and confidence scale. In other words, the maintenance in action stage should have a confidence of 10/10 and an importance of 10/10.
C) The 5 A’s used to improve motivation and the intention for behavior change are: ASSESS, ADDRESS, ASSIST, APPEAL, and ARRANGE.
D) The 5 A’s were created to help with all of the following: health behavior counseling, improving patient motivation, creating patient centeredness, motivational interviewing and using a patient-provider collaborative approach.
C.
ADDRESS and APPEAL are not part of the 5 A’s.
The 5 A’s of behavior change counseling are Assess, Advise, Agree, Assist, Arrange
and for tobacco or intervention counseling are Ask, Advise, Assess, Assist, and Arrange.
See table on page 295 as a reference.
