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Motivation and Learning
HAS 3190
Readiness
• Teachable moments
• Readiness to learn
• Time your teaching
Maslow
Health Belief Model
• Susceptibility
• Seriousness
• Threat
• Benefits
Health Belief Model
• Motivation to avoid illness or get well
• Desire for a level of health
• Belief that specific action will lead to health
Stages of Change
• Pre-contemplation
• Contemplation
• Preparation
• Action
• Maintenance
Source: alcohol.org.nz
Yes, and I do not intend to stop drinking 5 or more drinks in a row.
Yes, but I intend to stop drinking 5 or more drinks in a row during the next 6 months.
Yes, but I intend to stop drinking 5 or more drinks in a row during in the next 30 days.
No, but I have had 5 or more drinks in a row in the past 6 months.
No, and I have not had 5 or more drinks in a row in the past 6 months.
No, I have never had 5 or more drinks in a row.
Alcohol: Stages of Change (Short Form)
Alcohol Stage Item for non-dependent drinkers Males (females use 4 or more in a row)
In the last month have you had 5 or more drinks in a row?
1. Yes, and I do not intend to stop drinking 5 or more drinks in a row.
2. Yes, but I intend to stop drinking 5 or more drinks in a row during the next 6 months.
3. Yes, but I intend to stop drinking 5 or more drinks in a row during in the next 30 days.
4. No, but I have had 5 or more drinks in a row in the past 6 months.
5. No, and I have not had 5 or more drinks in a row in the past 6 months.
6. No, I have never had 5 or more drinks in a row.
Principles of motivation
• Use the environment to focus patient’s attention
• Internal motivation is best
• Individual must be ready
• Enhance with instructional material
• Success is best
Principles of motivation
• Some anxiety is good…too much is bad
• Set goals
• Affiliation and approval
• Behaviors are a combination of motives
An enormous gap exists between knowing that health behavior is motivated and identifying the specific motivational components on an particular act.
Issues with behavior
• Individual factors
• Social factors
• Environmental factors
• Medical regimen
What would you do…
• Poison
• Toilet bowl cleaner
• Drano or Liquid Plumber
Assessment
• Goal: to foster client self-assessment
Four steps…
• Select the areas to be assessed
• Gather data
• Sort and categorize data
• Summarize
Assessment
• Select the areas to be assessed– Physiologic– Psychosocial– Family system– Cultural issues– Environmental issues– Motivation
Assessment of motivation
10 20 30 40 50 60 70 80 90 100Quite Moderatelycertain certain
Certain
Can Do ConfidenceWalk one block _______ _______Walk two blocks _______ _______Walk one mile _______ _______Walk two miles _______ _______
Assessment
• Gather data– Objective (mostly)– Some subjective– Observation– Interview
Assessment
• Sort and categorize data
• Write the summary/plan
Readiness to LearnStudent Needs Assessment
Protective Factors Scale
SOAP
• S – (subjective data)
• O – (objective data)
• A – (assessment)
• P – (plan)
SOAP … Assessment
• Functional HA, neck and shoulder pain• Poor health habits, caffeine, skipping lunch, poor
fitness and body mechanics• Situational stress with moderate support system• Recent experience with stop smoking positive,
possible recidivism now
Soap …Plan
• Eat lunch daily away from desk. Include protein, carbo, veg or fruit.
• Review time management materials, consider class
• Increase water and non-caffeine beverages. No caffeine after 6 pm
Soap …Plan
• Keep headache journal including food, activity, feelings and headaches, discuss with husband to analyze
• Schedule 3 additional appointments over next 6 weeks. RTC 1 week.
• View headache film. Read headache article • Call PRN
The Four Habits
• Invest in the beginning
• Elicit the patient’s perspective
• Demonstrate empathy
• Invest in the end
Learning Styles
• Behavioral – Skinner– Positive reinforcement– Negative reinforcement– Punishment– Extinction– Shaping
Cognitive
• Piaget– Sensorimotor– Preoperational– Concrete Operational– Formal Operational
Bandura
• Social Cognitive
• Self efficacy
Locus of Control
Learning Sytles
• Active vs Reflective
• Sensing vs Intuitive
• Visual vs Verbal
• Sequential vs Global
Educational Factors
• Predisposing
• Enabling
• Reinforcing
Illiteracy stereotypes• Low socioeconomic status
• Poor grammar
• Unemployed
• Uneducated
Health Literacy
• Ability to read, understand and act
• AMA study (1999)
• Low literacy = 2 X likely to be hospitalized
• $73 billion in costs
Text…
• Empathy
• Trust
Combating Health Illiteracy
• Teach back
• Try it out
• Best method…
• Simple ways handout
SMOG
• 10 consecutive sentences each in– Beginning– Middle– End
• # of words with 3 or more syllables
SMOG
• 0-2 = 4th
• 3-6 = 5th
• 7-12 = 6th
• 13-20 = 7th
• 21-30 = 8th
• 31-42= 9th
• 43-56 = 10th
• 57-72 = 11th
• 73-90 = 12th
• 91-110 = 13th
• 111-132 = 14th
• 133-156 = 15th
• 157-182 = 16th
• 183-210 = 17th
• 211-240 = 18th
Coping Styles
• Denial• Compensatory• Blocking out idea• Retreat• Role modeling• Regression• Ascribing blame
• Self-blame• Rationalization• Hiding feelings• Redirecting emotions• Excess of activity• Diverting feelings