Module 3 Flashcards
Language matters, why?
- Role of healthcare professionals
- a way to encourages and motivates
- focus on postitivity
- has an impact on motivation, behaviour and outcomes
- reduce negativity in language which can affect psychosocial well-being
Use these words - people with DM I/O diabetic people
- non- compliant/ compliant XXX I/O adherent/ non-adherent
- perfect diabetic XXX
Patient empowerment focuses on four main points.
AADE and the American Diabetes Association convened to develop these guidelines using four guiding principles:
1]Diabetes is a complex and challenging disease involving many factors and variables.
2]Every member of the healthcare team can serve people with diabetes more effectively through a respectful, inclusive, and person-centred approach.
3]The stigma that has historically been attached to a diagnosis of diabetes can contribute to stress and feeling of shame and judgement.
4]Person-first, strengths-based, empowering language can improve communication and enhance motivation, health and well-being of people with diabetes.
How to change these words? -diabetic people -Disease -Normal, healthy blood glucose levels -Obese, normal weight he or she is … poorly controlled, cooperative, uncooperative -Poor control, good control, well controlled -Control -Should, should not, have to, can’t, must, must not -Failed, failing to -Compliance, compliant; non-compliance, non-compliant; adherence, adherent, nonadherent
-people with DM
-Condition
-People without
diabetes; target,
optimal blood
glucose
-Unhealthy, healthy
weight
-‘his or
her blood glucose
is high’
-Stable / optimal
blood glucose levels,
within the optimal
range, or within
the target range;
suboptimal, high/low
-Manage, influence
-You could
consider…, you
could try…, consider
the following
options…, you could
choose to…
-Did not, has not,
does not.
-Words that describe
collaborative
goal-setting
Patient empowerment focuses on four main points.
- they need to understand their role in care
- need to know enough to take care of themselves and work with HCP
- need skills
- environment need to be supportive
Definition of Patient Empowerment
A process in which patients understand their role, are given the knowledge and skills by their health-care provider to perform a task in an environment that recognizes community and cultural differences and encourages patient participation.
Behaviours influence outcome
family eating patterns to the design of neighbourhoods to workplace and national health policies
motivational interviewing
self-management education: problem solving therapy , cognitive behavioural and related psychotherapeutic approaches, family approaches, and group interventions
Ecological model of health behaviour
goverment, policies, large system > organization, communities, culture > family, friends small group > individual biological psychological
EPF campaign
- person-center choices
What is Health Literacy?
a measure of patients’ ability to read, comprehend, and act on medical instructions
[Source: Schillinger et al.]
Outlets for Health Literacy promotion?
health and edu sys media marketplace home work place community policy making
Ophelia approach ?
consist of ?
a system that supports the identification of community health
literacy needs, and the development and testing of potential solutions. It allows easy
application of evidence-based health promotion approaches to the field of health literacy
Ophelia means Optimizing Health Literacy and Access to health information and services
Psychology and Behavioral Challenge that patient face?
1]changing their behaviour is difficult - approach - motivational interviewing
2]range of factors can influence - approach - organisational approaches
Behavioural Changes
eating, exe, smoking, alcohol, taking tablets, taking insulin, self care ( feet, eyes)
But why do some patients not want to change their behaviour?
quantity and quality of life
- not aware of the seriousness of the situation
- don’t like a new habit
- refuse to accept the situation
The burden of DM?
- chronicity
- self-management
- complex
- lifestyle changes
- complications
- multiple treatments
- additional health problems
- lack of reward
- progressive
- loss of freedom
- lack of support
- social barriers
- treatment is aversive
- fear of complications ( blindness, amputation)
- self-blame
5 C intervention for a behavioural approach
Constructing a problem definition
Collaborative goal setting
Collaborative problem solving
Contracting for change
Continuing support
Barriers for behavioural change ?
cognitions, e.g., beliefs that treatments are not effective
emotions, e.g., lack of self-efficacy
social networks, e.g., lack of support
resources, e.g., lack of time or money
physical environment, e.g., lack of facilities
def of Self-efficacy?
confidence in one’s ability to perform health behaviors—increases the performance of those behaviors
emotional problems
Identify patients who are suffering from diabetes-related distress.
Apply effective treatments to relieve diabetes-related distress.
Identify patients who are suffering from psychiatric disorders.
Refer patients for specialized mental health care when appropriate.
how to identify diabetes distressed patient?
Are you having trouble accepting your diabetes?
Do you feel overwhelmed or burned out by the demands of diabetes management?
Do you get the support you need from your family for diabetes management?
Do you worry about getting diabetes complications?
20 item PAID ( problem areas in diabetes) questionnaire
enhance= emotion-focused coping cognitive behavioural therapy (CBT).
help people identify the negative, usually unrealistic, thoughts that lead to distress, diminished motivation, and less-active self-care (e.g., “I’ll never be able to do anything right.”
helps patients find more positive realistic perspectives
encouraging more active self- care
DSM-IV diagnostic criteria for depression
PHQ-9 (9-item Patient Health Questionnaire)
cardinal diagnostic criteria mood and anhedonia)
Rx In depressed patients who are not in good control of their diabetes?
- counselling ( CBT) alone (or) with medication
Vulnerable groups in behavioural change?
- elder age group
- literacy
- less amount of time to learn disease
- mental illness
- adolescent
