Motivation, Education, Families

Question 1

Motivation

Answer 1

• The reason or reasons one has for acting or behaving in a particular way.
• The general desire or willingness of someone to do something

Question 2

Social Cognitive Theory

Answer 2

• Social Cognitive Theory (SCT):
  
  • “Human motivation and action are regulated by forethought”.
• SCT theory is based upon two types of expectations:
  
  • 1) The individuals beliefs and their capabilities in performing a course of action to attain the desired outcome
  • 2) The individuals belief that a certain consequence will be produced by personal action.

***A belief system that is founded upon the idea that exercise may increase pain has the potential to actually decrease the motivation to exercise. As a therapist you must deal directly with the individuals beliefs and provide clarity.

PAIN DOES NOT NECESSARILY EQUAL HARM!!! (Red vs yellow light)

• ex. beliefs that arthritis might be exacerbated by exercise*
• NEED INDIVIDUALIZED CARE (continue to re-evalute)*
• -Let them know exactly what you want to perform (written HEP or meds)*

Question 3

Components of motivation

Answer 3

• beliefs
• unpleasent physical sensations (pain, fear)
• individualized care
• social support
• goal identification

Question 4

Positive influential factors

Answer 4

• kindness
• humor
• gentle persuasion
• positive reinforcement
• clear expectations and communication
• teaching to their specific learning style
• music as motivation

Question 5

Patient education/Learning theories: Behaviorist orientation

Answer 5

• Behaviorist orientation=
  
  • stimulus/response. PTs role is to design an environment (stimulus) that produces a desired outcome (response) This a very basic approach however does not encourage creativity or problem solving.
    
    • stimulus and response and association between the two
    • environment most important here
    • ex teacher create environment to elicit desired behavior
    • as PT, teach and focus on correct technique (car transfer and stair climbing)
    • Less appropriate for higher order thinking, such as problem solving

Question 6

Patient education/Learning theories: Cognitive orientation

Answer 6

• Cognitive orientation=
  
  • involvement thinking, problem-solving articulation and formation of concepts.
  • Designing your program and or treatment session from the simple to complex.
    
    • ex PT organize therapy session with goal of instructing patient how to weight shift prior to ambulation. Move from supine wt shift to standing wt shift. Bipedal wt shift to unilateral wt shift to advancing foot forward

Question 7

Patient education/Learning theories: Humanist orientation

Answer 7

• Humanist orientation=
  
  • based on the human potential for growth.
  • Emphasis is placed the individuals freedom and responsibility as well as experiential perceptions which enable improvement.
    
    • perceptions centered on “experience”
    • as well as freedom and responsibility to become what one is capable of
      
      • ​self directedness and experience in learning process

Question 8

Social Learning theory:

Answer 8

• Social learning theory:
  
  • A system of thought based on imitation for modeling.

Question 9

Adult learning orientation:

Answer 9

• Based on 4 primary assumptions:
  
  • 1) Changes in self concept are a function of growth & maturity. move to total dependency as we age
  • 2) Role of experience in the older adult provides a substantial foundation upon which to build new learning experiences lifetime experiences/maturity
  • 3) Readiness to learn is based on the concept of transitioning from external to internal stimulus
  • 4) Orientation to learning refers to the older adults purpose for learning. Real life circumstances require immediately applicable interventions.

Question 10

Trans-theoretical Model:

Answer 10

• Trans-theoretical Model:
  
  • Based on the premise that receptivity is dependent upon 5 stages of readiness:
    
    • 1) pre-contemplation (not engaged in target activity, no intention to)
    • 2) contemplation (intend to engage in activity in next 6 months)
    • 3) preparation (intent to engage in next 30 days)
    • 4) action (begins targeted activity at least 1 day up to 6 months)
    • 5) maintenance (emgaged in activity for at least 6 months)

Question 11

Patient participation in goal setting

Answer 11

• PATIENT PARTICIPATION IN GOAL SETTING IS A NON-NEGOTIABLE
• Functional goals must be personalized
• Must be specific, measurable, functional, & time bound!!!
• ***To achieve the highest level of patient’s participation, the clinician should ask open ended questions to arrive at realistic and functionally measurable patient centered goals***

• ***walking to bus stop (400 feet) in 4 mins using uneven city sidewalk without assistive device (functional)*
• Having their participation improves clinical outcomes and patient satisfaction*

Question 12

Health Literacy

Answer 12

• The educational level of the older population is increasing. Between 1970 and 2008, the percentage of older persons who had completed high school rose from 28% to 77.4%. About 20.5% in 2008 had a bachelors degree or higher.
• In spite of the fact that the educational level of older adults has risen, only 12% of US adults are health literate”.

Question 13

Age changes in motivation (3)

Answer 13

• self regulation: greater capacity to self regulate secondary to life exerience
  
  • stronger adherence to behavior change
  • initiation of new changes often slower/delayed
  • new approaches to exercise and activities may actually be more motivating
  • positibe self concept
    
    • self monitoring, reinforcements, goal setting, self reactions gets better over life from experience
• social support: older adults often involved in caregiving with spouse and child. (important motivation)
• information seeking behavior: geriatric population tends to require less info when making a decision than do their ounger counterparts
  
  • older adults seek less info to make decision