Clinical Nutrition- Exam 1- Education and Counseling

What are examples of focused and intent to use while talking to patients

Your blood evaluation indicates that you a have cholesterol level of 330. Your diet year evaluation shows a high intake of saturated fat and sugar and low intake of fiber and vegetables

How did you handle the party last week

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Goals of nutritional counseling

Facilitate lifestyle awareness

Healthy lifestyle decision-making

Take appropriate action

What are common roadblocks in counseling

Ordering, directing

Warning

LECTURING

MORALIZING

Judging

Agreeing

Shaming

Interpreting

Sympathizing

Questioning

Withdrawing, changing subject

Empathy

Truly understanding another persons perspective or experience without judging, critiquing or blaming

NOT putting yourself in your patients shoes

Clinicians empathy is significantly correlated with

Likelihood to impact behavior change

What is the difference between directing and giving advice

Directing= telling them what needs to be done

Advice= provide possible solutions

Proper way to give advice

Give nonjudgmental

Identity problem

Explain need to change

Advocate plan of action with options

End with open ended question to elicit response

What factors impact a persons ability to change

Policy and systems

Settings

Interpersonal

Personal

Policy and systems factors that impact a persons ability to change

Healthy care system, food system

Government

Policy

Media

Settings factors that impact a persons ability to change

Institutional organization: work, school

Community environment: stores, parks, neighborhood, restaurants

Interpersonal factors that impact a persons ability to change

Social support, family social networks, friends pees

Personal factors that impact a persons ability ability to change

Biology, self efficacy, beliefs, agency, empowerment, knowledge, attitudes skills

Why is self efficacy important

Perception of efficacy is more important than actual skill

The convince to perform a specific behavior

Self efficacy

What is a major component in all behavior change theories and models

Self efficacy

What are the individual beliefs and actions in the health belief model

Perceived susceptibly and perceived severity= perceived threat

Perceived benefits

Perceived Barrie's

Perceived self efficacy

What are the stages of trans theoretical model of change (AKA stages of change)

Precontemplation

Contemplation

Preparation

Action

Maintenance

Precontemplation

No changes, not even thinking about changing

Contemplation

Weight pros and cons

Preparation

Planing but still no action

Action

Positive behavior is observed

Maintenance

Behavior change becomes habit (FOR AT LEAST 6 MONTHS)

What is the theory of planned behavior

Psychological theory that lines beliefs and behavior

What are the things that are part of behavior intention, therefore behavior

Attitude toward behavior

Subjective norm

Perceived behavioral control

What are the 4 steps of motivational interviewing

Engaging

Focusing

Evoking

Planning

Key intervention objectives of the Precontemplation stage

Increase awareness

Show empathy, use reflection

Clarify

Assess knowledge, attitudes and beliefs

Key intervention objectives for contemplation stage

Encourage self reevaluation, increase confidence

Validate lack of readiness

Small achievable steps

Give positive feedback

Key intervention objectives for preparation stage

Resolution of ambivalence (those and but phrases)

Help set SMART goals

Remove cues for undesirable behavior

Explore social support

What part of the motivational interviewing process do we use the OARS of motivational interviewing

During the evoking stage

Explain the OARS of motivational interviewing

Open ended questions

Affirmations

Reflective listening

Summaries

What is the heart of motivational interviewing

Reflective listening

When would reflection be used in motivational interviewing

During the evoking stage

How can you assess a patients readiness for change

VAS scale (1-10)

What can you do if they are not ready for change

Raise doubt, ONLY GIVE ADVICE AFTER AKISNG PERMISSION

-personalize benefits

-promote change talk

-resptvet automay

What can you do if they are unsure about change

Build confidence

-explore ambivalence, barriers

-imagine future

-encourage support

-explore successes

-summarize

What can you do if they are ready to change

Develop plan

-parasite positive behaviors

-explore options

-negotiate realistic short term goals

-develop action plan

Some of the biggest barriers

Lack of knowledge

Lack of skill

Lack of risk taking

Someone's readiness to change is VAS 1-3 then

Level 1 (AKA Precontemplation stage)

Someone's readiness to change is VAS 4-6

Level 2 (AKA contemplation stage)

Someone's readiness to change is 7-10

Level 3 (preparation phase)

What is the closing phase

Support self efficacy's

Summarize barriers and strengths

Arrange a follow up

How can you handle an ambivalent patient, what stage are they in?

Reflection both sides

Emphasizing change talk

They are in contemplation stage

Moving through ambivalence

DARN- preparing

CAT mobilizing

DARN (the preparing part) of the ambivalence stage

Desire

Abilities

Reason

Need

CAT (the mobilizing part) of the ambivalence stage

Commitment

Activation

Taking steps

Categories for the DARN (preparing part) of the ambivalence

Desire- preference for change

Ability- self perceived ability

Reasons- benefits of change

Need- imperative for change without reason

Category for the CAT (mobilizing part) of the ambivalence stage

Commitment- reflect intentions

Activation- signal move to change

Taking states- action already taken

What are components of SMART goals

Specific

Measurable

Achievable

Relevant

Time-Bound

How should you educate a patient

NO MORE THAN 2 CHANGES AT A TIME

Avoid jargon

Simplify things

Organized

How do we make behavior change last

Support networks

Stress management

Sleep recommendations

Mindful eating

What helps with stimulus control

Focus on antecedent part of behavior triggers

-identify triggers

-counteract cue

-set up reminders