Case study analysis
Motivation and determination play important roles in health behavior changes for protecting patients from harmful chronic and acute disorders. Often, it is seen that healthcare professionals advise patients with interventions which they are advised to follow. In some of the cases, the patients do not achieve quality outcomes of their health. On close analysis of the situations, it can be found that the patient might not remain motivated for the health behavior changes (Michie et al., 2014). Therefore, their apprehensive nature and lack of motivation make them miss interventions, not follow the routine procedures of care, not visiting doctors on time and many others. These aspects worsen the health condition. Hence, the professionals need to motivate the patients at first and ensure their emotional stability (Hollands et al., 2016). This will make them aligned to the set of medical interventions and make them more compliant. This assignment would mainly discuss the case study of a hypothetical client. It will also show the different ways that nurses might undertake to help the patient in developing motivation and emotional stability and ensure better quality lives.
A patient named John Green of 35 years of age had visited the clinic with symptoms of substance abuse disorder. His clothes were not ironed and his hair was in a messy situation. A strong smell of alcohol filled the room as soon as he entered the room. He was initially very reserved but after an informal communication, he opened up revealing his various issues. He stated that it was after his wife left, that he picked up the habit of drinking to overcome depression. He stated that it initially helped him to relieve him from depression and loneliness and gave him feelings of pleasure. However, in course of time, he experienced that although he had overcome his loneliness and he no more thinks about his wife, he felt still addicted to alcohol. This behavior is causing huge problems in his occupation and therefore, his friends had requested him to take the help of healthcare practitioners. However, he stated that he does not believe that his drinking of alcohol is any reason for issues in his professional life. He believes that it is a bad time, which is only creating the issues. He is also adamant that these issues will go away with time. He was not confident about the healthcare professional as he stated that no one understands his problems and he feels emotionally drained out. Therefore, the healthcare professional needed to analyze each aspect of the case in order to understand the various determinists of health that are affecting him. Accordingly, interventions would be devised for the patient.
Trans-theoretical model for behavior change
One of the most important aspects that had been identified in the case of the patient is the lack of his motivation. He seems to be unaware of the ill effects of alcohol dependence and therefore he does not feel the need for change of any form of his lifestyles. Researchers have stated that motivating people who are disinclined towards the engagement in healthy behaviors is indeed a significant challenge to the different public health practitioners (Ramseier & Suvar, 2015). Over the years, most of the psychosocial theories that had been applied for the different health behavior changes tend to assume a degree of motivation for changing and being focused on various attempts. These attempts mainly help in promoting the actions by converting motivation into the action. Different types of approaches are proposed by the healthcare researchers which include the significance of goals-settings, self-monitoring, action planning and implementation (Anderson et al., 2014). These approaches help in focusing on the harnessing of the motivation as well as promotion of the actions in those individuals who already are likely to be motivated for changing.
In the present situation, it is very important for the healthcare professionals to first identify the health behavior issue and analyse the issues in references to that of an appropriate health behavior theory. This would help in identifying the state of change that the patient is present and the different stages he would need to go through to overcome the unhealthy behavior. One of the theories that the nursing professional can apply in this stage is the trans-theoretical model (Chiuazzi et al., 2015). This theory mainly focuses on the decision making of the individual and it can be described as the model of intentional change. This model is seen to operate on the assumption that individuals cannot change behaviors quickly as well as decisively. The nursing professionals need to help the patients move through six important stages of change. When these stages are accomplished successfully, the nursing professionals can ensure that the patients are emotionally motivated and would not relapse back into the previous stages.
The first stage is called the pre-contemplation stage. In this step, the patient does not intend to take the actions in the fore-seeable future. People in this stage are seen to underestimate the pros and cons of the changing behaviors. The patient named John is found to be in the pre-contemplation stage. He is not at all motivated for change and he does not believe that there is any need of change as well (Martin & Pear, 2015). The next stage is called the contemplation stage where the individuals develop intentions to take action and thereby plan to achieve the goals in the near future. In this stage, the professionals will undertake interventions that would help the patient to understand the various ill effects that the habit of drinking is causing him. Accordingly, the nurse would motivate the individual in ways by which he can recognize the ill effects and want to develop the condition of his life by altering risky health behaviors (Yardley et al., 2015). The nurse can undertake motivational interviewing in this stage to ensure that the patient is motivated. In this stage, he can also counsel the patient about the actions that are making him emotionally drained out and the interventions that he can take up to overcome the barrier. The third step is called the preparation stage where the individuals are seen to have already developed the intention for taking action and hence they have adopted some steps already. The nurse needs to be in constant touch with the patient and acknowledge his actions. When individuals are acknowledged about their achievements, the patients feel encouraged and they tend to stick with the interventions. The nurse who would be treating John would follow the same approach.
Motivational interviewing for promoting change
The next step in the model is the action stage where the individuals have changed their behavior for a short period. This, in turn, is followed by the maintenance stage where the behaviors in the patients have changed and continues to be maintained for the long-term (Enander et al., 2016). These two stages are very important stages where there remains a high chance that the patient might fall back into the old health behaviors if determination is lost or do not remain enough motivated. Therefore, throughout these stages, the nurse needs to be a constant companion with John and encourage him to visit the follow up sessions successfully (Sawesi et al., 2016). John should be motivated to stick to his new planning and goals to achieve a new life that would be free from alcohol dependence.
One of the best approaches to develop motivation of change among the patient and to ensure emotional stability in the patient is motivational interviewing. Motivational interviewing can be explained as a collaborative counseling strategy. This strategy is designed for elicitation and strengthening the motivation for the behavioral changes (Culzak et al., 2015). The professionals can take up a motivational interviewing style of the communication into the care of the patient named John. This form of treatment can be applied to substance abuse disorder patients to discuss behaviors by which they can overcome their dependence on alcohol and undertake self-management strategies (Morton et al., 2015). The professionals need to assist the patients in their motivation as well as confidence for making different types of changes that would improve their control over their urge to drink alcohol. The nursing professionals need to ensure that she undertakes this counseling strategy with John to ensure development of the motivation in the patient and help in change his drinking habits.
Researchers are of the opinion that motivational interviewing is indeed one of the counseling strategies that would encourage the healthcare professionals to engage in patient-centered communication. The nurse who would be attending the patient named John should ask John different open-ended questions as well as probes. She would need to affirm John when she shares the information and thereby reflect on what the patient is saying (Ekberg et al., 2016). She should be then summarizing the nature of the discussion to the patient. Studies are also of the opinion that motivational interviewing also recommends assessment of the confidence of the patient and determine the ability and commitment of the patient to achieve the agreed goals (Fumagill et al., 2015).
Conclusion
In order to ensure that the patient is well motivated and the outcomes of the motivational interviewing become successful, the nurse needs to maintain four important components. The nurse need to ensure that collaboration is successfully done by collaborating with the patient. The next important aspect that nurses need to follow is evocation. This mainly involves the elicitation of the desires of the patient and handles his emotions successfully. Reasons for the change should be discussed clearly. The next is the aspect of autonomy where the nurses need to respect and honor the autonomy of the patient. John should be allowed to be in control of his own decisions (Preswitch et al., 2015). Another important aspect is called compassion where the individuals need to actively promote the welfare of the patient. When the nurses maintain such principles of motivational interviewing, the patients will feel comfortable, emotionally stable and will be able to discuss different concerns successfully.
Another approach that the nurse can also undertake is the cognitive behavioral therapy. This is an approach which was initially developed to treat depression but is used nowadays in treatment of addiction, anxiety and many others. As John is addicted to alcohol, this therapy can be used for hiss treatment. The cognitive behavioral therapy helps on addressing the harmful thought patterns of the patients and helps the patients to recognize their ability to practices different alternative ways of thinking. This therapy also helps in regulation of the distressing emotions as well as different harmful behaviors (Giles et al., 2014). Studies have provided different evidences that support the application of CBT in the treatment of addiction issues. Firstly, this therapy helps in exploring the patterns of behaviors of the client and leads to self-destructive actions and beliefs, which are seen to control the thoughts. Secondly, this therapy would be also allowing the patient and the clients to work together in a therapeutic relationship with the patient, thereby identify the harmful thought patterns, and actively seek alternate thinking. Thirdly, this therapy is extremely useful, practical and provides helpful strategies that can be incorporated into the everyday life of the patient (Sinnott et al., 2015). Fourth, this therapy is also helpful as it helps clients for formulating different coping strategies for handling potential stressors and difficulties following addiction treatment. Therefore, the nursing professional who would be attending john would be providing this therapy helping him to overcome substance abuse disorder.
From the above discussion, it becomes clear that motivation and emotional stability are two important aspects that every patient needs to develop to ensure successful health behavior change. Motivation interviewing can be considered as one of the most important counseling strategy by which the nurses can help the individuals to identify their risky lifestyle and help them to know how the lifestyles can create health risks. This process of interviewing makes the patients develop motivation to modify the health behaviors for betterment. Another important therapy that also needs to be introduced is the cognitive behavioral therapy. It helps in identifying the risky behaviors, helping in modifying the thought procedures of the patients and thereby regulates distressing behaviors and the harmful behaviors. This process would help in modifying the behaviors of the patient towards better habits. One of the health behavior therapy that nurses can also use is the trans-theoretical model of care. They can use this model of care as guidance to them analyzing the systematic changes in the behaviors of the patient and helping to assess the outcomes of the intervention in the stages.
References:
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