Motivation and Terminology
the extent to which the patient's behavior coincides with the clinical advice.
True or False. The Health Belief model was developed in the 1950s by a group of psychologists that wanted to know why so few people were participating in a free chest x-ray program to screen for tuberculosis.
True
True or False. The transtheoretical model is also referred to as the stages of change model.
True or false: the social-ecological model works under the assumption that a change in behavior and health status at one level will produce change at other levels of the community system.
True! healthy individuals = healthy community is the basic logic of this system.
What is the proper nursing intervention for a patient in the preparation stage of the transtheoretical model of change?
What is an alternative term for compliance that is more patient-centered and prevents blaming behavior towards patients?
Adherence
What are the 6 key components of the health belief model?
perceived susceptibility
perceived severity
perceived benefits
perceived barriers
cues to action
self-efficacy
Precontemplation
Contemplation
Preparation
Action
Maintenance
Termination
What are the 5 levels of influence on health behaviors that make up the ecological model of health promotion?
Intrapersonal/Individual Factors
Interpersonal/Relationship Factors
Organizational and Institutional Factors
Community Factors
Societal/Public Policy Factors
False. Not every patient reaches the termination stage. Relapses happen all the time and many patients need ongoing support and remain in the maintenance stage for their whole lives.
Give an example of a statement someone with an internal vs. an external locus of control might make regarding their genetic predisposition to diabetes.
Internal: Even though diabetes runs in my family, I will follow a low-glucose diet and exercise to manage my insulin levels and stay healthy.
External: Both of my parents have diabetes, it will catch up to me anyway. I might as well eat whatever I want and not exercise.
Give an example of what a perceived barrier might be for a patient considering getting a routine colonoscopy.
fear of the pain, lack of insurance, not being able to get time off work...
What stage of the transtheoretical model is a patient in if they state: "I don't really smoke that many cigarettes, so I don't have to worry about lung cancer or anything like that."
Precontemplation
List some of the factors that are classified under "Intrapersonal/individual factors", the first level of the ecological model of health promotion.
Age, family history, education, behavior, attitude, beliefs, religion, mental health status...
A new piece of legislation that makes 4 hours of gym class mandatory for all public school students would be an example of what level of influence on health behaviors? (according to the ecological model of health promotion)
Societal/Public factors, aka the 5th and largest level of influence in this model.
True or False: Motivational interviewing is a patient-centered, directive counseling method that aims to strengthen the individual's motivation to make a change for the better.
True.
What is one way that a nurse can help promote self-efficacy in a patient who is managing their diabetes?
What stage of the trans theoretical model is a patient in if they state "I know I should stop eating gluten because I have celiac disease, but I am just really busy right now and don't have time to figure out how to change my diet."
Contemplation
Give an example of a nursing intervention that operates under the intrapersonal level of the ecological health model.
Something about changing the individual rather than changing the environment. ie: convincing one teenager that smoking is uncool so that they can resist peer pressure.
Case studies sneak peak: Jimmy wants to get a routine colonoscopy, but he lives on a farm and the nearest health clinic is a one hour drive away from him. Which the 6 concepts from the health belief model is demonstrated in this scenario?
perceived barriers.
What does the READS acronym for motivational interviewing stand for?
Roll with resistance (acknowledge)
Express empathy (understood)
Avoid argumentation (less defensive)
Develop discrepancy (acceptance)
Support self efficacy (build confidence)
How could a nurse help a patient who might not think that smoking is really that big of a risk to their health?
Provide statistics and education on the consequences of smoking, show them a video like the one we saw last week in lab, and recommend actions that they could take to reduce their risk of lung cancer and smoking-related diseases.
What is the proper nursing intervention for someone in the contemplation stage?
Helping the patient identify barriers and provide support.
religious organizations, workplace organizations, schools, colleges, and universities...
Lisa signed up for a yoga class at the community center and plans to go twice a week to reduce her risk for osteoporosis. In which stage of the trans theoretical model is Lisa at?
Preparation. She has not started yet, but she is ready to get into it.