SDL PT 1 - Talking About Health Behaviour Change - (Smoking, Brushing, Overview) Flashcards
SDL LOs
Lecture LOs
- want to have an evidence-based structure to guide how to talk to patients about health behaviour change
- this lecture gives an overview of an approach on how to talk about health behaviour changes
1
What is health behaviour change
2
What does it include?
1
- any behaviour change that affects health
2
In dentistry, most relevant behaviours are things like:
- tooth brushing
- interdental cleaning
- diet
- tobacco use
- alcohol intake
- regular dental attendance
What are the 3 steps of talking to a patient about behaviour change?
1 - Ask
2 - Advice
3 - Act
- evidence based approach HENCE more effective than just telling the patient to change
- patient centred approach HENCE ensures patients perspective is taken into account and work together with them
STEP 1 - ASKING ABOUT THE BEHAVIOUR
DOs?
DON’Ts
- Deciding to talk about health behaviour change should be their choice
DO
- ask patient their permission to discuss
- if more than 1 health behaviour to talk about, ask the patient which one they’d like to talk about (providing choice, gloves the patient control)
= patient is most likely to want to talk about behaviour
they are mostly likely to change
- Use a mix of open and close ended questions
- engage in reflective listening
- provide affirmations (demonstrate appreciation for patients efforts)
DON’T
- just tell the patient that their will be a discussion
- go straight into telling patient advice
STEP 1 - ASKING ABOUT THE BEHAVIOUR
Why is it useful to ask the patient open and close ended questions?
CLOSE ENDED
- help you get specific info you need from the patient
OPEN ENDED
- explores how patient feels about a behaviour
- helps you understand their perspective
- helps you understand why the are behaving like that
STEP 1 - ASKING ABOUT THE BEHAVIOUR
1
What is reflective listening?
2
Why is useful?
3
Where do people go wrong with reflective listening?
1
involves making a summary statement/ paraphrasing in reply to what the patient has said
2
- can help the patient feel understood
- encourage the patient to elaborate + clarify what they meant
- ensures you have understood what they have said
- gives you time to process
- helps you maintain rapport with patient
3
- don’t paraphrase enough - give all the info back to patient
- can’t paraphrase or reflect back as weren’t listening to patient fully
STEP 1 - ASKING ABOUT THE BEHAVIOUR
Why is useful to provide affirmations?
- can help patient to believe they have ability to change and have change so they continue these behaviours
- importance as confidence + perceived confidence is a key factor in successful behaviour change
Extra
(- reinforce positive acts
- appreciate patients efforts)
STEP 1 - ASKING ABOUT THE BEHAVIOUR
What are the steps for asking about behaviour change?
1 - invite, rather than force a patient to discuss health behaviour change
= ask patient their permission to discuss
2 - encourage the patient to select the issue they feel most happy to talk about
= if more than 1 health behaviour to talk about, ask the patient which one they’d like to talk about (providing choice, gloves the patient control)
= patient is most likely to want to talk about behaviour
they are mostly likely to change
3 - Find out about health-related behaviour
- Use a mix of open and close ended questions
4 - engage in reflective listening
= paraphrase back what the patient has said
5 - provide affirmations
= demonstrate appreciation for patients efforts
STEP 1 - ASKING ABOUT THE BEHAVIOUR
EGs of Q’s you may ask during each step of asking about behaviour change
STEP 2 - ADVISE ABOUT CHANGING BEHAVIOUR
There are different ways of providing this advice
What can this advice include?
EG’s of what you may say
Advice about:
- how to change behaviour
- the benefits of changing . How a behaviour change may help
↳ (DON’T ASSUME that change in oral health will be a
motivating factor for change) - risks associated with behaviour
TIP
- Giving advice is a key step BUT the advice alone is unlikely to lead to behaviour change
STEP 2 - ADVISE ABOUT CHANGING BEHAVIOUR
When giving advice it’s important to use core communication skills to ensure effective communication
How would you give advice/ what are the steps (MAKE BETTER Q???) And EGs of what you may ask or say?
STEP 2 - ADVISE ABOUT CHANGING BEHAVIOUR
Why are these steps (from previous FC) useful for good communication?
- by assessing what a patient already knows
- contributing to their existing understanding
- and then establish what the patient sees as the personal implications from that information
- this means you’re exchanging info rather than just giving info
- exchanging info increases the likelihood of the patient taking the info on board
STEP 2 - ACT - check interest in changing + ACT on patient’s response
1
What should you do 1st during this stage?
2
Ask patient if they’re interested you can…
EXTRA
- giving advice = a key step BUT giving advice alone is unlikely to lead to behaviour change
- need to offer help + support to change
STEP 2 - ACT - check interest in changing + ACT on patient’s response
For patients interested in changing what do you do?