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?
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?
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
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
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
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