MP

BC lecture - week 5

  • Transtheoretical model

  • Therapeutic adherence

  • Selye’s general adaptation syndrome (stress)

  • Acceptance and commitment therapy

Behavior change

what can we expect in patients with low back pain?

Despite the different variables that we need to keep in mind, in the end we need action to change behavior

Variable

  • perceived susceptibility → how much the patient is susceptible to the complaint

  • perceived severity → how much does the patient think about the severity of the problem

  • Perceived benefits → What are the benefits of resolving the problem

  • Perceived barrier → What do I need to know as a healthcare provider in terms of barriers (ex: cultural)

Is the patient sticking to the plan?

therapeutic adherence definition

  • 60% of patients do not adhere

  • 45% - 70% do not adhere to prescribed exercises and recommendations of physical activity

  • 20 % of patients adhere to therapy after 1 year

Important ti understand the patient

are the exercises too long? are they too difficult, are they busy?

how do we solve this?

How can I ask about adherence without scaring the patient off or judging?

A - B -C

  • can you show me the exercise? lol

keep in mind the factors that could make the patient not to the exercise correctly

ambivalence = unsure

I am trying to change their behavior but their patient is unsure, do they understand the benefits? Understand the ambivalence

make this exercise

How to apply therapy adherence

health literacy → are they educated about health?

  • motivate and don’t over-explain

  • assist the patient don’t talk down to them

  • incorporate the psychosocial components

do this at the practical exam

  • please they don’t have to have feelings for you, treat them without judgment and listen to them, you are not a psychologist but they show a vulnerable side

Acceptance

  • shift our view to be open to unwanted emotions, we let them come and go

  • clean the dirty pain = pain alongside emotions

  • eliminate the experiences that provoke those emotions

IT'S JUST A THOUGHT

  • thoughts are just thoughts, and they don’t define me

  • work through pain with awareness and tolerance

shift the focus to what they want to achieve