Motivation and Learning

HAS 3190

Readiness

• Teachable moments

• Readiness to learn

• Time your teaching

Maslow

Health Belief Model

• Susceptibility

• Seriousness

• Threat

• Benefits

Health Belief Model

• Motivation to avoid illness or get well

• Desire for a level of health

• Belief that specific action will lead to health

Stages of Change

• Pre-contemplation

• Contemplation

• Preparation

• Action

• Maintenance

Source: alcohol.org.nz

Yes, and I do not intend to stop drinking 5 or more drinks in a row.

Yes, but I intend to stop drinking 5 or more drinks in a row during the next 6 months.

Yes, but I intend to stop drinking 5 or more drinks in a row during in the next 30 days.

No, but I have had 5 or more drinks in a row in the past 6 months.

No, and I have not had 5 or more drinks in a row in the past 6 months.

No, I have never had 5 or more drinks in a row.

Alcohol: Stages of Change (Short Form)

Alcohol Stage Item for non-dependent drinkers Males (females use 4 or more in a row)

In the last month have you had 5 or more drinks in a row?

1. Yes, and I do not intend to stop drinking 5 or more drinks in a row.

2. Yes, but I intend to stop drinking 5 or more drinks in a row during the next 6 months.

3. Yes, but I intend to stop drinking 5 or more drinks in a row during in the next 30 days.

4. No, but I have had 5 or more drinks in a row in the past 6 months.

5. No, and I have not had 5 or more drinks in a row in the past 6 months.

6. No, I have never had 5 or more drinks in a row.

Principles of motivation

• Use the environment to focus patient’s attention

• Internal motivation is best

• Individual must be ready

• Enhance with instructional material

• Success is best

Principles of motivation

• Some anxiety is good…too much is bad

• Set goals

• Affiliation and approval

• Behaviors are a combination of motives

An enormous gap exists between knowing that health behavior is motivated and identifying the specific motivational components on an particular act.

Issues with behavior

• Individual factors

• Social factors

• Environmental factors

• Medical regimen

What would you do…

• Poison

• Toilet bowl cleaner

• Drano or Liquid Plumber

Assessment

• Goal: to foster client self-assessment

Four steps…

• Select the areas to be assessed

• Gather data

• Sort and categorize data

• Summarize

Assessment

• Select the areas to be assessed– Physiologic– Psychosocial– Family system– Cultural issues– Environmental issues– Motivation

Assessment of motivation

10 20 30 40 50 60 70 80 90 100Quite Moderatelycertain certain

Certain

Can Do ConfidenceWalk one block _______ _______Walk two blocks _______ _______Walk one mile _______ _______Walk two miles _______ _______

Assessment

• Gather data– Objective (mostly)– Some subjective– Observation– Interview

Assessment

• Sort and categorize data

• Write the summary/plan

Readiness to LearnStudent Needs Assessment

Protective Factors Scale

SOAP

• S – (subjective data)

• O – (objective data)

• A – (assessment)

• P – (plan)

SOAP … Assessment

• Functional HA, neck and shoulder pain• Poor health habits, caffeine, skipping lunch, poor

fitness and body mechanics• Situational stress with moderate support system• Recent experience with stop smoking positive,

possible recidivism now

Soap …Plan

• Eat lunch daily away from desk. Include protein, carbo, veg or fruit.

• Review time management materials, consider class

• Increase water and non-caffeine beverages. No caffeine after 6 pm

Soap …Plan

• Keep headache journal including food, activity, feelings and headaches, discuss with husband to analyze

• Schedule 3 additional appointments over next 6 weeks. RTC 1 week.

• View headache film. Read headache article • Call PRN

The Four Habits

• Invest in the beginning

• Elicit the patient’s perspective

• Demonstrate empathy

• Invest in the end

Learning Styles

• Behavioral – Skinner– Positive reinforcement– Negative reinforcement– Punishment– Extinction– Shaping

Cognitive

• Piaget– Sensorimotor– Preoperational– Concrete Operational– Formal Operational

Bandura

• Social Cognitive

• Self efficacy

Locus of Control

Learning Sytles

• Active vs Reflective

• Sensing vs Intuitive

• Visual vs Verbal

• Sequential vs Global

Educational Factors

• Predisposing

• Enabling

• Reinforcing

Illiteracy stereotypes• Low socioeconomic status

• Poor grammar

• Unemployed

• Uneducated

Health Literacy

• Ability to read, understand and act

• AMA study (1999)

• Low literacy = 2 X likely to be hospitalized

• $73 billion in costs

Text…

• Empathy

• Trust

Combating Health Illiteracy

• Teach back

• Try it out

• Best method…

• Simple ways handout

SMOG

• 10 consecutive sentences each in– Beginning– Middle– End

• # of words with 3 or more syllables

SMOG

• 0-2 = 4th

• 3-6 = 5th

• 7-12 = 6th

• 13-20 = 7th

• 21-30 = 8th

• 31-42= 9th

• 43-56 = 10th

• 57-72 = 11th

• 73-90 = 12th

• 91-110 = 13th

• 111-132 = 14th

• 133-156 = 15th

• 157-182 = 16th

• 183-210 = 17th

• 211-240 = 18th

Coping Styles

• Denial• Compensatory• Blocking out idea• Retreat• Role modeling• Regression• Ascribing blame

• Self-blame• Rationalization• Hiding feelings• Redirecting emotions• Excess of activity• Diverting feelings