Quiz #2 Module 2 Part 1/2 Flashcards
list and describe Prochaska’s stages of the theoretical model of change
- pre-contemplation stage- person doesn’t see a health problem or no intention of modifying it in future
- contemplation stage- characterized by awareness of problem, person is thinking of change by lacks a commitment to take action
- preparation stage- person begins to take small tentative steps toward changing difficult health habits, but not fully committed to consistent action
- action stage- marked by a strong commitment to change and taking consistent definitive actions to make behavioural changes a reality
- maintenance stage-clients stabilize and consolidate gains achieved during the action stage follows, not easy to maintain behaviours once newness has worn off- clients can easily relapse
- termination stage- change is done, good and set. you wont go back to drinking ever
what is the theoretical model of change?
evidence-based model used to explore a person’s motivational readiness to intentionally change health habits
define self efficacy
personal belief in ones ability to execute the actions required to achieve a goal
how is self efficacy and motivation linked?
they are reciprocal processes: increased self efficacy strengthens motivation to compete desired task
who created the social learning theory?
Albert Bandura
what are bandura’s 3 sets of motivating factors that promote the learning necessary to achieve a predetermined goal?
- physical motivators
- social incentives
- cognitive motivators
examples of a physical motivator?
can be internal such as memory of previous discomfort or a symptom that the client can’t ignore (having broken leg and having to take care of it)
examples of social incentives?
praise and encouragement, increase self esteem, give client reason to continue learning (positive reinforcement)
example of cognitive motivators?
internal thought processes associated with change (taking med’s more regularly and feeling better so you continue to take the medication)
what is disease prevention?
concerned with identifying modifiable risk and protective factors associated with specific diseases and mental disorders
what are the 3 levels of disease prevention?
primary, secondary, and tertiary
what is the importance of patient education
patients need education so they can make informed decisions about their healthcare and lifestyle
define patient-centered approach
nurse helps patient to be active participants in their education and is better able to self manage their needs and care with health providers across health care settings
what are the essential domains of nursing education?
- knowledge
- critical inquiry
- communication and collaboration
- professionalism
- leadership
what are the 3 goals of patient education?
- maintaining and promoting health and preventing illness (ex. DBND)
- restoring health (teach about regaining health)
- optimizing quality of life with impaired functioning (help them to cope with permanent health issues)
what is the relationship between teaching and learning?
teaching is an interactive process that promotes learning
when is teaching most effective?
when it addresses the learners needs, learning style, and capacity
what are the 3 domains of learning?
- cognitive (understanding)
- affective (attitudes)
- psychomotor (motor skills)
what is cognitive learning?
- includes all intellectual behaviours and requires thinking
- most simplest behaviour is remembering, and most complex is creating
what is affective learning?
- concerns expressions of feelings and acceptance of attitudes, opinions, or values
- simplest behaviour is receiving, and most complex is characterizing
what is psychomotor learning?
- involves acquiring skills that require the integration of mental and muscular activity (walking, use an eating utensil)
- simplest behaviour is perception and most complex is origination
what does LEARNS stand for?
- Listen to patient needs
- Establish therapeutic relationships
- Adopt an intentional approach to every learning encounter
- Reinforce health literacy
- Name new knowledge via teach-back
- Strengthen self management skills
what is the telling approach?
- telling approach is useful when limited info must be taught (ex. Preparing patient for emergency diagnostic procedure)
- this provides no opportunity for feedback
list the 5 teaching approaches
telling, selling, participating, entrusting, reinforcing
what is the selling approach?
- entails two-way communication
- nurse needs to pace instruction according to patients response (ex. When patient learns step by step procedure for changing a dressing, first patient learns to remove old dressing, then to clean wound and finally to apply new dressing)
what is the participating approach?
- involves setting objectives and becoming involved in the learning process together
- opportunities are provided for discussion, feedback, and mutual goal setting, and revision of teaching plan
- together nurse and patient identify goals and learning strategies
what is the entrusting approach?
-provides patient with opportunity to manage self care
what is the reinforcing approach?
- the use of stimulus that increase the probability of a response
- three types of reinforcement
- most nurses use social reinforcers (encouraging words)
- material reinforcers are food, toys, music (work best for children)
- activity reinforcers are based on the principle that people are motivated to engage in an activity, if, after its completion, they are able to engage in more desired activity (works when patient is self motivated)
define self awareness
-process of understanding one’s own belief’s thoughts, motivations, biases, and limitations and recognizing how they affect others
what are the two types of communication?
verbal and non verbal. they are the building blocks to all successful relationships
what is verbal communication?
spoken words
what is non verbal communication?
gestures, expressions, body language
what are empathetic linkages?
direct communication of feelings
how are therapeutic and social relationships different?
Therapeutic- nurse focusses on client and client-based issues, even when engaging in social activities with that client (ex. Going shopping- there should still be a purpose behind the social aspect of hanging out and it should revolve around the client)
what are essential self-management skills?
problem solving, decision making, goal setting, utilization of resources
what is coaching?
- dynamic interactive and context-based teaching strategy
- builds on clients strengths instead of attempting to “fix” weaknesses
- emphasizing on patients autonomy because patient is always in charge of pace and direction of learning
what is an example of coaching?
coaching can help clients distinguish between which symptoms require immediate attention and which ones can be handled by self-management strategies
how are transitional cues important?
-transitional cues link purpose with action
what is motivational interviewing?
-clinical method designed to facilitate change in client behaviour by engaging a client’s own autonomous decision making ability
how does motivational interviewing help?
MI encourages clients to make his or her own decisions through directed counselling that addresses and involves at least two processes: increasing preferred behaviours and decreasing non preferred behaviours
what are two critical components that are assessed for patient’s influence?
- Conviction (importance)
2. Confidence
what is conviction?
Includes asking patient the importance of changing behaviour, examining the risks and benefits of the particular behaviour and of changing, exploring concerns about behaviour and exploring possible next steps
what is confidence?
also includes brainstorming solutions, focusing on successful past efforts, and serial reassessment and repetition of the process
what are the signs of successful MI?
• Nurse is speaking slowly
• Patient doing more of the talking
• Patient is actively talking about behaviour change
-Nurse is listening very carefully and gently directing the interview at appropriate moments
what does FRAMES stand for? and what is it?
feedback, responsibility, advice, menu, empathy, self efficacy. these are used to summarize elements of brief interventions with patients using MI
what are the factors that need to be effective in order for desired MI results?
-self awareness, empathetic linkages, active listening, and avoidance of defence mechanisms
what are the principles of motivational enhancement?
- Avoid arguing
- Express empathy
- Develop discrepancy
- Roll with resistance
- Support self efficacy
what is health education/teaching?
-a set of planned things to teach a client. Changing knowledge for someone who’s receiving the knowledge. Improve the quality of their life
how is teaching and learning most effective?
when it addresses the learners needs, their learning style, and capacity that they can lear
what are 3 things a nurse must do to be a good teacher?
- Listen empathetically
- Observe astutely
- Speak clearly
what are the four steps that have to happen in the learning process?
attention, retention, reproduction, and motivation
what are blooms three domains of learning?
- cognitive
- affective
- psychomotor
what are 6 intellectual skills? (blooms taxonomy)
knowledge- remembering comprehension- understanding application- applying analysis- analyzing evaluation- evaluating synthesis- creating
what are the three constructs of piaget and blooms learning theory?
behaviourism, cognitivism, humanism
what is behaviourism?
a. Based on learners behaviour
b. Stimulus and response
c. Conditioning
d. Pos. reinforcement
e. Observational learning and instruction (modeling-demonstration by the nurse; client imitation)
what is cognitivism?
a. Learning is a complex cognitive activity
b. Learners structures and processes information
c. Perception chosen by the learner
d. Personal characteristics impact perceptions- characteristics impact learning (some people can focus better during certain times of day)
what is humanism?
a. Focus on cognitive and affective qualities of learner
b. Learning is self motivated, self-initiated, and self evaluated
c. Learning is best when relevant to the learner
describe the term biorhythm
how you best learn. You wanna teach the patient at the right time for them so they can learn best
