UNIT 10 Motivating Patients Flashcards
Dr. Koestner opened the lecture with a story of a doctor who posed an ultimatum to his smoking patients. According to Dr. Koestner what was the issue with this doctor’s approach?
His approach is not autonomy supportive nor autonomously motivating to his patients
Those who did quit were extrinsically motivated to do so –> which is not sustainable in the long term
What might introjected motivation look like in this context?
Quitting smoking because you want to gain the doctors approval
Who was Dr. Geoff Williams and what was his main insight?
Doctor whose patients did not take his recommendations
Realized that:
–> Patient motivation is a part of the doctor’s job.
–>How I interact with the patient will have a major
impact on their motivation.
What are the three key aspects of autonomy support?
–> take and acknowledging patient’s perspectives,
–> provide choices
–> providing meaningful rationale
What specific behaviours should one engage in when providing autonomy support?
Basic listening skills
–> make eye contact
–> ask open-ended questions;
–> listen carefully,
–> do not interrupt;
–> encourage initiation and involvement;
–>provide a rationale for your suggestions
What did Dr. Williams look at? What was his mediation model?
(1) Smoking Cessation
(2) Medication Adherence -> for blood pressure
(3) Diabetes Control
Found that doctor autonomy support leads to patient autonomous motivation which will lead to greater adherence to the prescribed medical regimen
What is motivational interviewing?
Interview to assess how motivated someone is (I.e. 5a’s for smoking cessation)
What are the 5 A’s of the National Cancer Association protocol for smoking interventions?
- Ask - about their tobacco usage
- Advise -every tobacco user to quit.
- Assess - If they are willing to change
- Assist - him or her quit through medication + counselling
- Arrange - follow-up contact
What did the clip from Something’s Gotta Give illustrate?
That doctor’s should
– encourages questions and initiation by patient
– takes the patient’s perspective
– provides choices
What were Dr. Williams’ main findings?
Autonomy support + autonomous motivation = positive health outcomes
What kind of interpersonal behaviour fosters autonomous motivation?
As a health care professional, its important how you talk with patients
–> Should calm their fears
–> not scold them for making mistakes
–> freely answer their questions
