Supporting Wellness In Illness Flashcards
Non adherence
Widely prevalent and can cause frequent hospitalizations for the same concern
Adherence can be affected by
-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
Porch ask a and diclementes trasntheoretical model of change
Precontemplation, contemplation, preparation, action, maintenance, relapse
Pre contemplation
-not considering change
-denial
-does not consider problem to be serious
-may have tried before unsuccessfully and given up
Strategies of precontemplation
Education, identity risks of current behaviour, flexible, ask why questions, revisit in future
Contemplation
Person is ambivalent about changing
Strategies for contemplation
Explore pro and cons, ask DARN questions, address concerns, establish a time frame
Preparation
Person is prepared to experiment with small change
DARN questions
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
Strategies for preparation
Let patient create the plan, keep it simple and realistic, provide positive reinforcement, stack the deck
Action
Person takes definitive action to change behaviour
Strategies of action
Provide positive reinforcement and schedule a follow up
Maintenance and relapse prevention
The person strives to maintain the new behaviour over the long term
Strategies for Maintenance and relapse prevention
Encouragement, support, develop plans for potential lapses and setbacks, follow up visits
Factors that influence behaviour
-default to zero (something is too much work)
-illogical thinking (correlation vs causation)
-media, family, peers
-window of opportunity
What are some barriers to change
-lack of information, skill, confidence
-misconceptions
-personal cost
-logistical barriers
Motivational learning
Assessment strategy and an intervention
Motivational learning is a process of
Asking, listening and informing to address ambivalence
Five principles of motivational interviewing (READS)
- Roll with resistance
- Express empathy
- Avoid argumentation
- Develop discrepancy
- Support self efficacy
Do not oppose resistance but…
Flow with it
Resistant behaviour includes
Negating, blaming, excusing, minimizing, rationalizing
The person is the primary source of
Solutions for their own health problems
elicit information from the person so you can
Better understand their attitudes, beliefs, values and readiness to change
Provide information to address …
Any knowledge gaps identified
