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  • Internal Code :
  • Subject Code : HLSC111
  • University :
  • Subject Name : Nursing

The Person, Health and Wellbeing

Trans-Theoretical Model of Change is important to understand the changing behaviour of the individual concerning the different stage. There are five stages which include pre-contemplation, contemplation, preparation, action and maintenance (Hashemzadeh et al., 2019). Motivational interviewing is important to support the changing behaviour of the individual to improve the behaviour that is important to improve health status. Motivational interviewing help the individual to empower that is necessary for a better health outcome (Frost et al., 2018). The case discusses that patient is worried about her eating pattern that can increase her complication due to obesity and she is in the preparation stage which increases the need for motivational interviewing to shift to the action stage. The essay will discuss how motivational interviewing can help Rebecca to improve her lifestyle and different technique will be included that need to be avoided for the negative result over Rebecca.

Motivational interview is considered to be the method that utilizes the client-centred approach for the resolution of the issue that has changed the behaviour of the patient. There are the different factor that leads to the behavioural change like drinking, smoking, exercise and diet. The technique that is utilized for the motivational interviewing will be concerning the specific case so that patient-centric principle can be utilized (Cooper, 2017). Four techniques can be utilized for motivational interviewing and one of them that are suitable for the case study is a partnership. The study presented Laws et al. (2018) discussed that partnership with the client is important to improve the care process and in the motivational interview, it shows better results. Partnerships help both the individual to understand their perspective so that a common goal can be established for better health outcome.

The motivational interviewing for Rebecca will be framed to improve her understanding concerning her diet pattern and how it increases complication concerning the obesity which is the leading cause of diabetes, heart disorder or another functional issue. The motivational interviewing will be conducted my maintaining the empathy and discrepancy that are important to support the individual behaviour change. The therapists are considered to encourage and empower the patient by using reflective listening to improve the session (Mutschler et al., 2018). Rebecca will be informed during the motivational session concerning the slow changes she can incorporate in the lifestyle to improve the health status which is required to decrease the complication associated with obesity. According to Amiri et al. (2018), Motivational interviewing follows the four-step process to assist the patient in the care and improve the motivation to manage the issue. The steps start with the engagement with the patient that is followed by focusing over the issue. The third step is evoking the motivational aspect to improve the health outcome and the last step is planning the strategies that are important for the patient. The motivational session with Rebecca will include the open-ended question, affirmation and summarizing the main point that is important to improve patient understanding concerning the change.

Different aspects need to be improved concerning the behaviour to improve the health status which I necessary to reduce complication associated with obesity. Behavioural change at the dietary level is important to maintain the balance of the demand and supply of the calories to decrease overconsumption that is unhealthy for the patient. One of the studies presented by Park et al. (2018) discussed how nutritional management is important for weight management and reducing issue related to obesity. The dietary interventions help to improve the intake of calories concerning the health status which improves the demand and supply. The physical activity incorporation in the daily routine is another behavioural change that is important to improve the metabolisms which improve the health status. According to Schröder et al. (2018), there are different set of physical activity that can be utilized to improve the body metabolism that is important for weight management. Walking, jogging and aerobic exercise are suggested to the patient in daily routine concerning the individual capacity to improve the health status.

One of the changes that need to be incorporated is the weight control programs that help to reduce complication associated with overweight. One of the studies presented by Soeliman & Azadbakht (2014) discussed that the weight management program is necessary to improve the weight loss that is important to maintain body composition. The weekly monitoring of the weight is important to track the impact of the different strategies over the individual. The weight control program helps the individual to sustain the strategies considering their impact covers the body which is necessary to improve body composition. The Rebecca should also improve her behavioural aspect concerning the unhealthy foods that are important to decrease the calories intake which adds a complication for the patient. The article presented by Zhang et al. (2014) discussed that patient suffering from obesity should follow the food policy that is important for avoiding unhealthy food. The food policy helps the individual to understand and bifurcate the healthy and unhealthy food to maintain the diet plan.

One of the aspects that can negatively impact the Rebecca is judging the individual concerning her health status and idea. The judging has the negative impact over the individual mind as the well emotional aspect that directly deteriorate the outcome of the patient One of the article presented by Van den Hooff & Buijsen (2014) discussed that health care judgmental behaviour concerning the patient health negatively impacts over the individual which can lead to the decreased outcome. The negligence toward patient perspective is also one of the issues that can negatively impact the patient outcome. The article presented by Chew-Graham (2018) described that patient perspective is important in the care as it helps to improve the care that leads to a better health outcome. The negligence toward the patient perspective can lead to less personalized care which leads to a decreased health outcome.

The discharge planning is important to transfer the necessary information concerning the care to eh patient and the family to improve the health status. Different aspects are needed to be considered includes health data, personal data, environmental data and important client information. The discharge plans also include the precautions and future practise that are important to sustain the health lifestyle (Flink & Ekstedt, 2017).

The Rebecca discharge plan for the on-going support will include the information concerning the referrals and these referrals can be utilized if she needs any assistant concerning the health status. The study presented by Hegarty et al. (2016) discussed that referrals are important to improve the understanding of the patient considering the different organization from where she can avail assistances. The referrals are necessary for the discharge plan so that during any issue the patient can refer to the expert to get the best assistance.

The information about the on-going intervention will also be included in the discharge plan so that Rebecca can refer the document if she forgets any point. The study presented by Emes et al. (2018) described that on-going intervention information is important for the patient during the discharge plan to understand and remember the important point concerning the intervention. The on-going intervention information is necessary so that the health care professional can refer to it during any other appointment.

The progress report is also important in discharge planning so that patient can understand and achieve the goals that are necessary for a better health outcome. One of the studies presented by Asmirajanti et al. (2019) discussed that progress report is important in the discharge planning as it helps the patient to keep a track of the health status which is necessary to attain the goal for better health outcome. The progress report is also important to identify the effectiveness of the intervention concerning patient health status. 

The discharge will be framed concerning the patient current health status and intervention to improve the self-management skills that are necessary for better health status. The discharge plan will include all different healthcare professionals involved in the care like nurse, doctor, therapist, family and the patient.

The essay can be concluded by stating that the motivational interview is been a great asset to assist the behavioural change in the patient. In the case study, Rebecca is facing issue due to unhealthy eating habits and obesity that are needed to be urgently addressed to improve the health status. The motivational interviewing with the patient will include the empathy and discrepancy that are important for the empowerment of the patient. The therapist will utilize the partnership approach of the motivational interviewing for the process to improve the participation. The judgmental and negligence toward the patient perspective can negatively impact the health outcome that is not suitable for the health status of the patient. The discharge plans of the patient will include different aspect to improve patient understanding which includes referrals, on-going intervention information and progress report. The patient will be informed about different aspect to improve her self-management capability. 

References for Trans-Theoretical Model of Change

Ådnanes, M., Cresswell-Smith, J., Melby, L., Westerlund, H., Šprah, L., Sfetcu, R. & Donisi, V. (2019). Discharge planning, self-management, and community support: Strategies to avoid psychiatric rehospitalisation from a service user perspective. Patient Education and Counseling. 103(5):1033-1040. DOI: 10.1016/j.pec.2019.12.002

Amiri, P., Kazemian, E., Mansouri-Tehrani, M. M., Khalili, A. & Amouzegar, A. (2018). Does motivational interviewing improve the weight management process in adolescents? Protocol for a Systematic Review and Meta-Analysis. Systematic Reviews, 7(1). DOI: 10.1186/s13643-018-0814-6 

Asmirajanti, M., Hamid, A.Y. S. & Hariyati, R.T. S. (2019). Nursing care activities based on documentation. BMC Nursing 18(32), 1-5. DOI: 10.1186/s12912-019-0352-0

Chew-Graham C. A. (2018). Seeking the patient perspective. Health Expectations: An International Journal of Public Participation in Health Care and Health Policy21(3), 561–562. DOI: 10.1111/hex.12801

Cooper, L. (2017). Motivational interviewing: An evidence-based treatment for older adults. Innovation in Aging, 1(suppl_1), 18. DOI: 10.1093/geroni/igx004.067 

Emes, M., Smith, S., Ward, S., & Smith, A. (2018). Improving the patient discharge process: implementing actions derived from a soft systems methodology study. Health systems (Basingstoke, England)8(2), 117–133. DOI: 10.1080/20476965.2018.1524405

Flink, M., & Ekstedt, M. (2017). Planning for the discharge, not for patient self-management at home - an observational and interview study of hospital discharge. International Journal of Integrated Care17(6), 1-20. DOI: 10.5334/ijic.3003

Frost, H., Campbell, P., Maxwell, M., O’Carroll, R. E., Dombrowski, S. U., Williams, B. & Pollock, A. (2018). Effectiveness of Motivational Interviewing on adult behaviour change in health and social care settings: A systematic review of reviews. PLOS ONE, 13(10), 1-39. DOI:10.1371/journal.pone.0204890 

Hashemzadeh, M., Rahimi, A., Zare-Farashbandi, F., Alavi-Naeini, A. M., & Daei, A. (2019). Transtheoretical model of health behavioral change: A systematic review. Iranian Journal of Nursing and Midwifery Research24(2), 83–90. DOI: 10.4103/ijnmr.IJNMR_94_17

Hegarty, C., Buckley, C., Forrest, R. & Marshall, B. (2016). Discharge planning: screening older patients for multidisciplinary team referral. International Journal of Integrated Care16(4), 1. DOI: 10.5334/ijic.2252

Laws, M. B., Magill, M., Mastroleo, N. R., Gamarel, K. E., Howe, C. J., Walthers, J., Monti, P. M., Souza, T., Wilson, I. B., Rose, G. S. & Kahler, C. W. (2018). A sequential analysis of motivational interviewing technical skills and client responses. Journal of Substance Abuse Treatment92, 27–34. DOI: 10.1016/j.jsat.2018.06.006

Mutschler, C., Naccarato, E., Rouse, J., Davey, C., & McShane, K. (2018). Realist-informed review of motivational interviewing for adolescent health behaviors. Systematic Reviews, 7(1). DOI: 10.1186/s13643-018-0767-9 

Park, S., Woo, M. H., Lim, H. J., Chon, S., & Woo, J. T. (2018). A nutrition intervention focused on weight management through lifestyle improvements in prediabetic subjects. Clinical Nutrition Research7(1), 69–79. DOI: 10.7762/cnr.2018.7.1.69

Schröder, H., Cárdenas-Fuentes, G., Martínez-González, M. A., Corella, D., Vioque, J. & Salas-Salvadó, J. (2018). Effectiveness of the physical activity intervention program in the PREDIMED-Plus study: a randomized controlled trial. International Journal of Behavioral Nutrition and Physical Activity, 15(110), 1-13. DOI: 10.1186/s12966-018-0741-x 

Soeliman, F. A. & Azadbakht, L. (2014). Weight loss maintenance: A review on dietary related strategies. Journal of Research in Medical Sciences: The Official Journal of Isfahan University of Medical Sciences19(3), 268–275.

Van den Hooff, S. & Buijsen, M. (2014). Healthcare professionals’ dilemmas: judging patient’s decision making competence in day-to-day care of patients suffering from Korsakoff’s syndrome. Medicine, Health Care and Philosophy, 17(4), 633–640. DOI: 10.1007/s11019-014-9564-y 

Zhang, Q., Liu, S., Liu, R., Xue, H. & Wang, Y. (2014). Food policy approaches to obesity prevention: an international perspective. Current Obesity Reports3(2), 171–182. DOI: 10.1007/s13679-014-0099-6

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