WK9 - Promoting Self-Managed PA in PWD Flashcards
What are some evidence-based BCS - disability context?
- goal setting
- self-monitoring
- +ve reinforcement
- self-efficacy (personal mastery, modelling success, persuasion/support)
- time management
- graded tasks (perceived effort)
- barrier identification (pre-participation personal/environment Ax )
- enjoyment/reward
- social support
- attitude of primary care giver
- physician support
- previous successes
- knowledge of benefits
- prompting practice/follow-up
What did McEwan et al, 2016 find between goal setting and PWD?
Signficant effects were found regardless of goal specificity.
Goall setting interventions had min. effect on targeted behaviour… even when goal was vaguely defined (e.g. to be more active)
How did moderators vs mediators affect goal setting?
Moderators:
* ability
* task
* complexity
* commitment
* feedback
* resources
Mediators:
* choice to take action
* stimulate effort
* cue existing strategies
* display persistence
Specific, challenging, performance goal = greater performance
What is the difference between open and SMART goals?
Open:
* non-specific
* exploratory
* self-referenced
e.g. “ see how many steps you can reach today”
SMART
* specific, measureable, attainable, relevant, timely
What is the difference between learning and performance goals?
Learning
* identify strategies used to implement activity
* high focus on process of activity, instead of fiving a set target to achieve
* benefits: reduce pressure/stress related to goals
Performance
1. Does pt have basic skill set of activity aiming to complete?
2. Is activity complexity within scope of improvement?
3. are they intrinsically committed to goal?
4. Does pt have channels to soruce relevant feedback when required?
5. Does pt have resources to complete activity?
What considerations are made for what type of goal might work best initially?
- new to complex task?
- ability, commitment, resources, feedback?
- currently sufficiently active?
- ever been sufficiently/highly active?
- what is most important to pt: experience or outcome?
- found any goal types useful in past?
- do they have preferences?
Why is Tailored Motivation important for PWD?
PWD receive more encouragement/info regarding PA benefits
* media campaigns, info seminars, promotional material etc
* increased exposure to health practitioners through outpatient clinics and ongoing health concerns
Despite this, 79% of all PWD are not compelting required PA levels for health benefits
–> indicates this message is ineffective at increasing PA in PWD
What to consider about motivation as an EP?
- increased no.s of Ct being referred rather than voluntarily attending EP’s (medicare, DVA and workcover)
- individuals have lifelong Hx of being P inactive
- EPs need to implement evidence-based strategies to increase motivation
What is the relationship between motivational interviewing and the stages of change?
Changing Ct demographic results in more individuals presenting in 1st 3 stages of change
1. pre-contemplation
2. comtemplation
3. preparation
MI is effective in transitioning individuals through these stages
Define Motivational Interviewing.
Key concept = ambivalence
Client-centred, directive method for enhancing intrinsic motivation ot change by exploring and resolving ambivalence - Miller 1996
What is intrinsic motivation?
MI focuses on Ct as facilitator of change.
It is not the role of the therapist to ‘inform’ or ‘education’ Ct of benefits of change
Define ambivalence.
Feeling two ways about a behaviour - Pros vs cons
MI demonstrates that unless change is in the person’s inherent interests, it will not happen
What are the 4 principles of MI?
- expressing empathy
- developing discrepancy
- rolling with resistance
- supporting self-efficacy
How to facilitate change through exploring and resolving ambivalence? How does it work?
PA benefits (cons of P inactivity) vs PA cons (benefits of inactivity)
- explore/resolve ambivalence
- change ocurs as result of resolving ambivalence - therapist aids Ct in shifting balance towards change based on the 4 principles.
What does the 1st principle “expressing empathy” mean?
- conveys true acceptance of Ct’s perspetive w/o judging/criticising
- essential to building/maintaining strong therapeutic relationship
- builds non-judgemental and supportive environment