WK 4- LIFESTYLE DISEASE, RISK AND BEHAVIOURAL CHANGE

Question 1

What are the top 5 chronic diseases in Australia

Answer 1

1. Ischemic heart disease, 2. Stroke, 3. Depression, 4. Lung cancer, 5. Colorectal Cancer

Question 2

What are the 4 determinants of chronic illness and name examples within the groups

Answer 2

• Biological Factors→ genetics and ageing
• Social Factors→ Education, employment, income, wealth and housing
• Behavioural Factors→ SNAP
• Environmental Factors→ air quality, spread of pesticides and other chemicals

Question 3

What is SNAP

Answer 3

S-smoking
N-nutrition
A-alcohol
P-physical activity

Question 4

What are some determinants of behaviour

Answer 4

Meaning and function of behaviours, age and stage of life (ie. adolescence and risk taking behaviour), context of the person (situational, social, mental health, personality)

Question 5

According to Bandura- what does behaviour arise from

Answer 5

previous experience, anticipation of the future, learning, being able to set out own standards, reflecting and evaluating behaviour

Question 6

True or false- behaviour is strongly influenced by self-efficacy

Answer 6

True- self efficacy determined through past experience, perception of personal competencies, reaction to persuasion and response to a situation can affect how someone behaves

Question 7

What is self efficacy

Answer 7

Perceived ability to undertake an action

Question 8

What are the stages of the transtheoretical model of change

Answer 8

1. precontemplation- not considering change
2. contemplation-considering change
3. preparation- planning change
4. action- recent change
5. maintenance- change has been established

Question 9

What is the 5 A’s approach

Answer 9

Ask: identify patients with risk factors
Assess: level of risk factor and relevance to the individual, assess readiness to change
Advise: provide written information, brief advice and motivational interviewing
Assist: Pharmacotherapies, Support self monitoring
Arrange: Referral to special services; social support groups; phone information/ counselling services; follow-up appointments (show pt that you are walking beside them)

Question 10

When should intervention occur and how should it occur?

Answer 10

• Pre-contemplation stages- conscious raising (do you realise that..), including feedback and education
• Contemplation stages- self re-evaluation (what are the things happening in your life that may make it difficult/easy to make these changes), work towards supportive environments
• Planning stages- social re-evaluation, working with the appraisal outcomes

Question 11

What is the GRACE model in terms of motivational interviewing

Answer 11

• Generate a gap
– Between what patient wants and what is current situation, Roll with the resistance
– Ambivalence is normal, alter strategy if resistance occurs
• Avoid arguments
– Arguments only increase resistance – get the patient to voice the arguments against change (not you)- don’t get irritated
• Can do attitude
– Encourage self efficacy and hope
• Express empathy
– Listen, communicate acceptance and support, gently persuade while respecting personal views and choice of patient

Question 12

What is the structure of a motivational interview

Answer 12

• Brief interventions
-Provision of information and advice (in general practice settings -5As model fits here)
• Solution focused
–solution building rather than problem solving
•Strengths focus
– What does person already do well – build on their self-efficacy→ what things the person has done well previously