Supporting Wellness In Illness

Question 1

Non adherence

Answer 1

Widely prevalent and can cause frequent hospitalizations for the same concern

Question 2

Adherence can be affected by

Answer 2

-developmental level
-lack of understanding
-doubt about the benefit of treatment
-barriers to treatment
-lack of self efficacy
-difficulty of treatment
-meaning of condition
-emotional readiness for change

Question 3

Porch ask a and diclementes trasntheoretical model of change

Answer 3

Precontemplation, contemplation, preparation, action, maintenance, relapse

Question 4

Pre contemplation

Answer 4

-not considering change
-denial
-does not consider problem to be serious
-may have tried before unsuccessfully and given up

Question 5

Strategies of precontemplation

Answer 5

Education, identity risks of current behaviour, flexible, ask why questions, revisit in future

Question 6

Contemplation

Answer 6

Person is ambivalent about changing

Question 7

Strategies for contemplation

Answer 7

Explore pro and cons, ask DARN questions, address concerns, establish a time frame

Question 8

Preparation

Answer 8

Person is prepared to experiment with small change

Question 9

DARN questions

Answer 9

D- desire eg why do you want to make this change
A-ability eg do you have the necessary tools to make this change
R- reason eg what is motivating you to want to make this change
N- need eg on a scale of 1-10 how important is this change to you

Question 10

Strategies for preparation

Answer 10

Let patient create the plan, keep it simple and realistic, provide positive reinforcement, stack the deck

Question 11

Action

Answer 11

Person takes definitive action to change behaviour

Question 12

Strategies of action

Answer 12

Provide positive reinforcement and schedule a follow up

Question 13

Maintenance and relapse prevention

Answer 13

The person strives to maintain the new behaviour over the long term

Question 14

Strategies for Maintenance and relapse prevention

Answer 14

Encouragement, support, develop plans for potential lapses and setbacks, follow up visits

Question 15

Factors that influence behaviour

Answer 15

-default to zero (something is too much work)
-illogical thinking (correlation vs causation)
-media, family, peers
-window of opportunity

Question 16

What are some barriers to change

Answer 16

-lack of information, skill, confidence
-misconceptions
-personal cost
-logistical barriers

Question 17

Motivational learning

Answer 17

Assessment strategy and an intervention

Question 18

Motivational learning is a process of

Answer 18

Asking, listening and informing to address ambivalence

Question 19

Five principles of motivational interviewing (READS)

Answer 19

1. Roll with resistance
2. Express empathy
3. Avoid argumentation
4. Develop discrepancy
5. Support self efficacy

Question 20

Do not oppose resistance but…

Answer 20

Flow with it

Question 21

Resistant behaviour includes

Answer 21

Negating, blaming, excusing, minimizing, rationalizing

Question 22

The person is the primary source of

Answer 22

Solutions for their own health problems

Question 23

elicit information from the person so you can

Answer 23

Better understand their attitudes, beliefs, values and readiness to change

Question 24

Provide information to address …

Answer 24

Any knowledge gaps identified

Question 25

Elicit information on the persons understanding to the…

Answer 25

New information and their feelings about it

Question 26

Goal of MI is to

Answer 26

Enhance confidence to overcome barriers and succeed in change

Question 27

How does a nurse suppport self efficacy

Answer 27

-provide recognition and support for small steps
-assist person to set reasonable achievable goals
-believe yourself that the person can be successful

Question 28

Goal is to change persons perceptions of discrepancy without

Answer 28

Creating a sense of being pressured or coerced

Question 29

Good things form the vide in class

Answer 29

-asked permission to progressively talk about personal things
-empathetic responses
-encouraged her to talk more

Question 30

What is a good strategy when asking N-need questions (as shown in video)

Answer 30

When asking a scale question for example—> how important is this change on 1-10, once you receive your answer ask “why not lower?” To encourage confirmation of why this is important to the patient

-asking as well why not higher might encourage patient to disclose barriers to change and create an easier way to form interventions