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NURS 3520 - Patient Education > Week 5 > Flashcards

Week 5 Flashcards

1
Q

what is compliance

A
  • extent to which the pts behavior coincides w clinical advice
  • includes an authoritarian undertone
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2
Q

what are 2 concepts that affect compliance

A
  • locus of control

- noncompliance

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3
Q

what is locus of control

A
  • the extent to which an individual believes they have control over their life experiences & health
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4
Q

what is an internal locus of control

A
  • belief that one has control over their health outcomes

- belief that health is a consequence of one’s actions

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5
Q

what is external locus of control

A
  • belief that health is controlled by factors outside of one’s control
  • unrelated to behavior
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6
Q

what can impact one’s locus of control (2)

A
  • can change based off individual conditions

- may “give up” their locus of control if interventions are failing

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7
Q

what is noncompliance

A
  • the resistance of the pt to follow the treatment plan
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8
Q

what is often associated w noncompliance (2)

A
  • blaming

- labelling of the pt

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9
Q

what is adherence

A
  • the extent to which a person’s behavior corresponds w agree recommendations from a HCP
  • pt follows a care plan that was established in partnership w the HCP
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10
Q

what does adherence include

A
  • reciprocity of responsibility & action
  • plan agreed upon by pt and HCP
  • commitment on part of the pt
  • patient-centered and supports the pts right to choose to follow, or not, the treatment recommendations
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11
Q

what is nonadherence

A
  • occurs when the pt doesnt follow treatment recommendations that have been mutually agreed upon
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12
Q

nonadherence can be…

A
  • intentional

- nonintenional

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13
Q

what factors play a role in adherence (5)

A
  • socioeconomics
  • pt related
  • condition related
  • therapy related
  • healthcare team and system related
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14
Q

what is motivation

A
  • an internal state that arouses, directs, and sustains human behavior
  • a willingness of the learner to embrace learning w readiness as evidence of motivation
  • movement in a direction to meet a goal
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15
Q

what is motivation affected by

A
  • internal & external factors
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16
Q

factors that influence motivation can serve as either…

A
  • incentives or obstacles to achieving desired behaviors

- a motivational incentive for one, can be an obstacle for another

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17
Q

facilitating or blocking factors that shape motivation to learn be classified into 3 categories:

A
  • personal attributes –> physical, developmental, and psychological components of the learner
  • enviro influences –> surroundings and attitudes of others
  • learner relationship systems –> so, family, community, teacher-learner interaction
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18
Q

what personal attributes can impact motivation (10)

A
  • developmental stage
  • age
  • gender
  • emotional readiness
  • values & beliefs
  • sensory functioning
  • cognitive ability
  • educational level
  • actual/perceived state of health
  • severity of illness
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19
Q

what environmental influences can impact motivation (4)

A
  • can promote or detact ability to learn
  • physical characteristics of enviro
  • accessibility and availability of human & material resources (both physical and psychological)
  • different types of behavioral rewards (internal & external)
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20
Q

what are axioms

A
  • rules that set the stage for motivation

- an unprovable rule or first principle accepted as true bc it is self-evident or particularly useful

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21
Q

what are 5 axioms r/t motivation & goal setting

A
  • state of optimal anxiety
  • learner readiness
  • realistic goal setting
  • learner satisfaction/success
  • uncertainty reducing or uncertainty maintaining dialogue
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22
Q

describe a state of optimal anxiety r/t motivation: what is the optimal amt, what does too high or too low cause

A
  • learning occurs best w mod lvl of anxiety
  • at high lvls –> become self absorbed and ability to perceive enviro, conc, and learn is reduced
  • low lvls = not driven to act
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23
Q

how can we help reduce anxiety of pts (3)

A
  • guided imagery
  • use of humor
  • words of reassurance
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24
Q

descrbie the impact nurses have on learner readiness

A
  • desire cant be imposed on learner, but can be influenced by external forces & promoted by nurse –> make info relevant & stimulating
  • incentives are specific to learner*
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25
Q

what are considered realistic goals

A
  • goals within the pts grasp & possible to achieve
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26
Q

why is it imp to have realistic goals

A
  • goals beyond reach can cause frustration and discouragement
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27
Q

what is important to consider when setting goals

A
  • set realistic goals by determining what the learner wants to change –> motivating factors
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28
Q

describe the impact that learner satisfaction/success has on motivation

A
  • learner is motivated by success
  • focusing on success as means of positive reinforcements = learner satisfaction and instills sense of accomplishment
  • affirm the small steps
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29
Q

describe the impact of uncertainty on motivation

A
  • can be motivating factor
  • many people are unsure what is going on in healthcare enviro
  • less motivated if they are not sure if the strategy will work
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30
Q

what are the comprehensive parameters for motivational assessment of the learner (6)

A
  • cognitive variables
  • affective variables
  • physiological variables
  • experiental variables
  • enviro variables
  • educator-learner relationship system
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31
Q

what cognitive variables should be considered during motivational assessment (3)

A
  • capacity to learn
  • readiness to learn (expressed self-determination, constructive attitude, expressed desire)
  • facilitating beliefs
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32
Q

what affective variables should be considered during motivational assessment (2)

A
  • expressions of constructive emotional state

- mod lvl of anxiety

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33
Q

what physiological variable should be considered during motivational assessment

A
  • capacity to perform required behavior
34
Q

what should be considered regarding experiental variables in motivational assessment

A
  • previous successful experiences
35
Q

what enviro variables should be considered during motivational assessment (2)

A
  • approp enviro

- social support systems (family, group, work, community)

36
Q

what should be considered regarding educator-learner relationship in motivational assessment

A
  • prediction of positive relationship
37
Q

what are some motivational strategies for nurses as the teacher

A
  • assess pt motivation
  • decide what behavior, timeline, outcome, etc. is desirable for the pt
  • reduce or eliminate barriers to achieve goals to help instill or maintain motivation
  • consider hierarchy of needs
  • when teaching occurs, clearly communicate directions and expectations
  • make info meaningful to learner
  • maniuplate enviro to make it conductive to learning
  • provide positive verbal and nonverbal feedback
  • provide opportunities for success
38
Q

what is motivational interviewing (MI)

A
  • caring, respectful tool used to promote behavior change
  • an assessment strategy & intervention that support client self-esteem and self-efficacy thru emphasis on clients own reasons and values for change
  • collaberative event where positive atmosphere is created thru partner-like relationship
  • strategy that tries to enhance intrinsic motivation
  • pt has more autonomy and nurse has less authority
  • form of pt empowerment w goal of helpin pt gain control over most imp lifestyle management decisions affecting well-being
39
Q

what are the 2 phases of MI

A
  1. nurse helps pt enhance internal motivation for change
  2. commitment to change is strengthened
  • avoid telling the pt what to do, instead ask them what they think the benefits are of changing a behavior*
40
Q

what acronym is used to represent the 5 general principles of MI

A 
Roll w resistance
Express empathy
Avoid argumentation
Develop discrepancy
Support self-efficacy
41
Q

describe what is meant by roll w resistance during MI

A
  • refers to strategy of acknowledging that resistance to change is natural
  • rather than oppose resistance, roll w it
  • when pt displays resistance, nurse should activelt involve pt in process of problem solving and attempt to explore reasons behind resistance
42
Q

why is it imp to express empathy during MI

A
  • communicates to pt that they are understood and accepted –> helps facilitate change
  • dont judge pt!
43
Q

why should you avoid argumentation during MI

A
  • decrease instances of confrontations, which makes pt feel defensive
  • defensiveness = further resistance
  • when urge to argue arises, nurse should change strategies to help pt self-identify imp. issues and problem areas
44
Q

why is it imp to develop discrepancy during MI

A
  • involves helping pts understand how current behavior is inconsistent w their goals & values
  • the objective is set for pts to identify why change is necessary after seeing inconsistencies between behaviors and gals
45
Q

what does supporting self efficacy involve

A
  • building pts confidence that change is possible
46
Q

what acryonym outlines specific strategies for MI

A

Open ended questions
Affirmations
Reflective statements
Summary statements

47
Q

what is the importance of open ended questions in MI (2)

A
  • facilitates discussion

- encourages pt to do most of talking about why change is necessary or desirable

48
Q

what are affirmations r/t MI

A
  • involves nurse making statements that support & encourage the pt, particularly in areas where pt may only see failure
  • compliment efforts made
  • acknowledge small successes
49
Q

why are affirmations imp during MI (2)

A
  • promotes self-efficacy

- reinforces the efforts the pt is making towards change

50
Q

what does reflective statements during MI involve

A
  • restating pts own comments in concise manner = demonstrates nurse understands what the pt is saying
51
Q

what is the goal of reflective statements in MI

A
  • keep convo going forwards so pt can see need for change and begin to move in that direction
52
Q

what do summary statements in MI do

A
  • link and reinforce info that has been discussed

- emphasized signif parts of discussion and reviews plan of action

53
Q

what is a theory (4)

A
  • set of concepts, definitions, and propositions
  • systematic view of events or situations
  • allows explanantions of events or situation
  • explains and/or predicts
54
Q

what are the models/theories for health behaviors of the learner (7)

A
  • health belief model
  • health promotion model
  • self-efficacy theory
  • protection motivation theory
  • stages of change model
  • theory of reasoned action
  • therapeutic alliance model
55
Q

what is the health belief model

A
  • predicts preventative health behaviors based on pts belief about the health problem and behavior
56
Q

what 3 components are involved in the health belief model

A
  • individual perceptions
  • modifying factors
  • likelihood of action
57
Q

what is included in individual perceptions in the health belief model (2)

A
  • perceived susceptibility (persons subjective perception of risk of acquring illness or disease)
  • perceived severity of disease (feelings on seriousness of contracting illness or disease –> medical and social consequences)
58
Q

what modifying factors are considered in the health belief model (3)

A
  • demographic variables
  • sociophyschological variables
  • structural variables

which influence the subcomponents of perceived threat of a specific disease

59
Q

what is considered w likelihood of action r/t health belief model (2)

A
  • perceived benefits of preventative action (perception of effectiveness of actions to reduce threat of illness or disease)
  • perceived barriers to preventative action (
60
Q

what is the health promotion model

A
  • helps to provide an understanding of whether or not people choose to engage in health-promoting behaviors
  • helps people reach health goals thru approach behaviors rather than avoidance-of disease behaviors
  • Health-promoting behavior is the desired behavioral outcome
61
Q

what are the major components of the health promotion model (3)

A
  • individual characteristics and experiences –> each persons unique charfacteristics and experiences affect their actions
  • behavior-specific cognitions and affect
  • behavioral outcome = health promoting behavior
62
Q

what does the health promotion model support

A
  • a collaborative partner relationship between the HCP and pt
63
Q

what is the difference between health belief model and the health promotion model

A

HBM = targets likelihood of engaging in preventative health behaviors

HPM = targets likelihood of engaging in health promotion activities that lead to positive outcomes

64
Q

what is an important determinant of participation in health-promoting behavior

A
  • self-efficacy
65
Q

what is the self-efficacy theroy based on

A
  • person’s expectations relative to a specific course of action
  • deals w belief that one is competent and capable of accomplishing a specific behavior
  • individuals belief that they can execute a certain behavior
66
Q

self efficacy is derived from 4 sources of info:

A
  • performance accomplishments –> self-mastery of similar behaviors
  • vicarious experiences –> observing successful expected behavior thru modeling of others and comparing it
  • verbal persuasions –> by others who present realistic beliefs that the indiv is capable of the expected beavior, encouragement and discouragement
  • emotional arousal –> ex. depression or anxiety may = less self efficacy
67
Q

what is the most influential source of efficacy info

A
  • previous performance accomplishments
68
Q

what is the protection motivation theory

A
  • threat to health is a stimulus to protection motivation –> leads to intent and action
69
Q

who is the protection motivation theory approp for

A
  • programs that target high-risk individuals or groups
70
Q

the stages of change model was developed around…

A
  • addictive and problem behaviors
71
Q

what are the 6 distinct time-related stages of change

A
  • precontemplation
  • contemplation
  • preparation
  • action
  • maintenance
  • termination
72
Q

what is the precontemplation stage of the stages of change model

A
  • individuals have no current intention of change in the foreseeable future (within next 6 mo)
  • may be unaware that their behavior is problematic or produces negative consequences
  • underestimate pros of change behavior and place too much emphasis on the cons
73
Q

what is the contemplation stage of the stages of change model

A
  • individuals accept/realize that they have a problem and begin to seriously think about changing it
  • may still feel ambivalent abt changing their behavior
74
Q

what is the prep stage of the stages of change model

A
  • plan to take action within 1 month
  • have concrete plan
  • start to taken small steps towards behavior change
  • believe changing their behavior will lead to healthier life
75
Q

describe the action stage of the stages of change model

A
  • there is visible improvement of behaviors and committment to longterm change
  • people have recently change their behavior and intend to keep moving forward w that behavior change
76
Q

describe the maintenance stage of the stages of change model

A
  • difficult stage to achieve
  • adherence to an established behavior over the longterm (more than 6 months)
  • work to prevent relapse to earlier stages
77
Q

what are some common challenges to the maintenance stage of the stages of change model

A
  • overconfidence
  • daily temptation
  • relapse
78
Q

describe the termination stage of the stages of change model

A
  • does not always occur
  • occurs when the problem no longer presents an temptation
  • no desire to return to their unhealthy behaviors
  • when a pt quits a behavior
79
Q

what is the theory of reasoned action & theory of planned behavior

A
  • focuses on prediction and understanding of human behavior within a social context
  • based on the idea that humans behave in a rational way that is consistent w their beliefs
80
Q

what are the predictors of behavior in the theory of reasoned action (5)

A
  • beliefs
  • attitudes towards the behavior
  • motivation to comply w subjective norms, influrential persons
  • perceived behavioral control
  • intention
81
Q

what is the therapeutic alliance model

A
  • addresses a shift in power from the provider to a learning partnership in which collaboration and negotiation w the pt is key
  • based on the theory that a therapeutic alliance must be formed
  • each viewed as having equal power
82
Q

what are the components of the therapeutic alliance lvl (3)

A
  • compliance
  • adherence
  • therapeutic alliance

NURS 3520 - Patient Education (5 decks)

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