Week 9: Communicating Behaviour Change Flashcards
What is ‘Personality’?
Individual differences in characteristic patterns of thinking, feeling and behaving
Personality Types: Impact on health?
Openness/Agreeableness – smoking more common among experimenters in high school, positive association with BMI and obesity
Neuroticism – Higher risk of mental health conditions, substance use disorders, higher food consumption/obesity, higher use of emergency department services
Conscientiousness – associated with longevity, provide self-protection from health disorders
* Has implications for HCPs and policy makers
How do you identify your patients’ individual learning styles?
- Understanding their responses
- Asking open ended questions to identify their preferred style
Why do HCPs need to lead behaviour change?
- Health behaviours are a key determinant of health outcomes
- Poor health is often a consequence of poor health behaviours
- Improving health behaviours improves health outcomes
Role of HCPs
- The communication skills of the HCP when recommending lifestyle/behaviour changes can significantly impact patient motivation and the likelihood of positive outcome
- Guide patient to understand the importance of making a change & provide ongoing support
To facilitate behaviour change…
- Use a person-centred, non-judgemental therapeutic approach that respects autonomy
- Form a behavioural goal intention
- Convert the intention into action and maintenance
What are The Stages of Change and briefly describe
Pre-contemplation: Not currently considering to change
Contemplation: Ambivalent about change (mixed feelings)
“sitting on the fence” not considering change within the next month
Preparation: Some experience with change and are trying to change
“Testing the waters”
Action: Practicing new behaviour for 3 – 6months
Maintenance: Continued commitment to sustaining new behaviour (post 6 months – 5 years)
Relapse: Resumption of old behaviours
What is the Dynamic Process?
- Upward spiral
- Relapse returning to start of the process – very common
- Progress through a series of stages until reaching ‘lasting exit’ (sustained change)
What is motivational interviewing?
A way to strengthen patient motivation for change, with a focus on the patient’s attitude to change
The HCP assists the patient identify…
- Importance of change for the patient (willingness)
- Their confidence and ability to change (ability)
- Their priority for change (readiness)
The overall Spirit of MI is:
- Collaboration
- When presenting health interventions requiring a patient to change behaviours, confrontation & resistance can be avoided by - Evocation
- HCP role is to help the patient discover their own motivation & reasons to change, based on the things the patient cares about
- Lasting change is more likely to occur when the patient discovers their own reasons and determination to change - Patient Autonomy
- Choice is ultimately up to the patient to follow through with behaviour change
- Empowers the patient, but also give them responsibility
There are 4 distinct principles that guide the practice of MI…
- Express empathy
- Adopt an empathic style of communication
- Show that you have heard & understood them
- Use of reflective listening skills & accurate empathy - Support self-efficacy
- A patient’s belief that change is possible is an important motivator to making the change
- HCPs can influence a patient’s belief that they can change - Roll with resistance
- Approach resistance without judgement
- Avoid negative interactions
- Respect your patients’ views - Develop discrepancies
- Assist people to identify discrepancies between their current behaviour and future goals, values or situation
- Guide them towards their self-identified goals
- Help by exploring the pros and cons of change
Techniques & Strategies to Increase Motivation
- HCP Communication skills: OARS
a) Ask Open-ended questions
b) Provide Affirmations
c) Reflect patient statements
d) Summarise patient comments - Strengthening commitment to change: Change talk
a) Preparatory change talk
b) Implementing change talk
c) Evoking change talk
Describe Preparatory change talk
- Desire (I want to change)
- Ability (I can change)
- Reason (It’s important to change)
- Need (I should change)
Describe Implementing change talk
- Commitment (I will make changes)
- Activation (I am ready, prepared, willing to change)
- Taking steps (I am taking specific actions to change)
