NCP theories Flashcards
NCP 4 steps:
Nutrition Care process (ADIME)
1) Assessment
2) Intervention
3) Diagnoses
4) Monitoring and Evaluation
The client relationship with the RDN is ______ to the NCP model
Central (remember the NCP is a cycle)
Assessment:
- Collect and interpret data
Diagnoses:
- Identify Problem
- Determine Etiology
- State signs/symptoms
Intervention:
- determine intervention
- formulate goals and determine actions
- implement actions
Monitoring and Evaluation:
- identify and select quality indicators
- monitor and evaluate resolutions of diagnoses
RDN-level factors:
collaboration, skills and competencies, communication, evidence-based practice, critical thinking, documentation, code of ethics, nutrition and dietetics knowledge
Environment factors:
practice settings, health care systems, social systems, economics
Standards of practice (SOP) in NC for RDNs
Standard 1-4:
1) Nutrition assessment
2) Nutrition diagnoses
3) Nutrition intervention
4) Nutrition monitoring and evaluation
Standards of professional performance or RDNs
Standard 1-6:
1) quality in practice
2) competence and accountability
3) provisions of services
4) application of research
5) communication and application of knowledge
6) utilization and management of resources
? Model: cognition plays a significant and primary role in the development and maintenance of emotional and behavioral responses to life situations
Cognitive Model or Cognitive-Behavioral Therapy
? model: use of socratic questioning
CBT
? Model beneficial when targeting dietary habits, wt, cardiovascular or type 2 diabetes risk factors
CBT
?: developed in 1950s by scientists in US public health service in an effort to understand why individuals don’t adopt disease prevention strategies or undergo screening tests
Health Belief Model
? model: focused on individual’s belief about disease condition because beliefs help predict health-related behaviors
Health belief model
6 constructs in Health Belief model:
1) perceived susceptibility
2) perceived severity
3) perceived benefits
4) perceived barriers
5) cue to action
6) self-efficacy
? model: theoretical model of intentional health behavior change that describes a sequence of cognitive and behavioral steps people take in successful change
Transtheoretical Model
TTM 5 Stages of Change occur in an UPWARD SPIRAL:
- Precontemplation
- Contemplation
- Preparation
- Action
- Maintenance
TTM developed by who and when?
Prochaska and DiClemente in the 1980s
Precontemplation Description:
Pt unaware problem exists, no intention of changing behavior (unwilling/unable), not considering change, potentially in denial
Precontemplation RDN actions:
raise self awareness through education and pointing out cognitive dissonance, assess knowledge, cognitive restructuring, discuss risks and benefits
Contemplation Description:
Pt aware of the problem but no firm commitment to change behavior
AMBIVALENT, UNCERTAIN, plans to make changes within next 6 months
Contemplation RDN actions:
resolve ambivalence, provide education and instruction, help client choose change and gain confidence
Preparation Description:
intent on taking action to address problem, convinced change is good and that are able to to do it, committed but still deciding what to do in next 30 days
Preparation RDN actions:
help client identify appropriate strategies, help client gain confidence, listen, encourage, support
Action Description:
actively modifying behavior/problem, taking steps towards change but not yet stabilized as change has been occurring <6 months
Action RDN actions:
help implement strategies, anticipate to learn to eliminate relapses, encourage and support skills client has developed, listen to determine where client is at social support
Maintenance description:
sustained change with new behaviors replacing old behaviors, achieved goals and has maintained change for >/= 6 months
Maintenance RDN actions:
work on skills to maintain new behavior, listen/encourage/support relapse prevention
Low levels of readiness, RDN should:
instruct, advise, coach, and listen
Moderate levels of readiness, RDN should:
listen, encourage, and support
Social Cognitive theory by who and when?
Albert Bandura 1970s
?: learn through observation, mental state important to learning behaviors, learning does not necessarily lead to behavior change
Social Cognitive Theory
? model: provides a framework for understanding, predicting, and changing behavior
Social Cognitive theory
Social Cognitive theory factors
- Personal factors (knowledge, expectation, and attitudes/affective events/biological events)
- Behavioral factors (skills/practice/self-efficacy)
- Environmental factors (social norms/access in community/ability to change own environment)
Social cognitive theory has 4 mediating processes:
attention, retention, reproduction, and motivation.
?: collaboration not confrontation, evocation of ideas rather than imposition, autonomy rather than authority
Motivational Interviewing
MI is useful when client has ______ about change and ______
high ambivalence about change and low confidence/desire because MI targets ambivalence
4 Principles of MI:
- express empathy
- support self-efficacy
- rolling with resistance
- developing discrepancy
OARS
acronym for basic MI approaches:
- open ended questions
- affirmations
- reflections
- summaries
Change talk:
statements that a client makes when they are at different stages of changes
DARN:
preparatory change talk
D- desire ( i want to change)
A- ability (I can change)
R- reason (important to change)
N- need (I should change)
CAT:
implementing change talk
C: commitment (i will make changes)
A: activation (i am ready/willing to change)
T: taking steps (taking specific actions to change)
4 fundamental processes key to MI:
engaging, focusing, evoking, planning
