ENHANCING PATIENT MOTIVATION TO CHANGE

Maybelline Aguilar

DQ1

Patient compliance does not solely rely on the patient's ability to follow medical advice/directions, but also includes a holistic approach to developing a plan of care based on patient-specific physical, mental, and cultural/spiritual needs (Rothenberg, 2003). Alma is awaiting to have an invasive procedure done and this can be a frightening process from the beginning of scheduling the appointment. I believe that Alma wants to trust the medical professionals that are going to perform the procedure, but how can she if they cannot pronounce her name correctly? This may be interpreted as impersonal service and she may believe that she is not going to receive the best care. 

I believe the first step in approaching Alma is to issue an apology for the mispronunciation of her name and the tone in which she was spoken to. Secondly, it is important to ask Alma for the correct pronunciation of her name and what she prefers to be addressed as from the medical staff. I believe these steps could potentially help build rapport between patient and medical staff. After establishing rapport, medical staff should identify patient strengths and barriers for adherence of plan of care. Identifying barriers such as social and educational factors, patient perceptions of healthcare system, and support systems are important in ensuring the patient's needs can be met. 

Patient education is extremely important when providing medical care and ensuring adherence to plan of care. The approach I would take in this case is to first identify Alma's learning needs. Assessing Alma's knowledge on her current health condition and procedure is important. If further education is needed it is important to ask: What is her preferred learning style: written, visual, auditory, or hands-on? I would tailor educational resources suited to her needs. If able to, I would also provide education to family to ensure everyone is on the same page. Prior to the procedure, I would have Alma relay the information back and fill in what is missing. 

Reference

Rothenberg, G. M. (2003, June). How To Facilitate Better Patient Compliance. Retrieved February 9, 2022, from https://www.hmpgloballearningnetwork.com/site/podiatry/article/1612 

Katrin Lindsay

DQ1

Mrs. Faulkenberger would like to be addressed respectfully, with her full name. The healthcare professional assumed calling her by her first name is sufficient but it should be the other way around. It is best practice to start addressing the patient with the correct full name and if the patient offers to address her differently that can be done after. First, the relationship has to be build carefully to gain trust and rapport with the patient. In this scenario the trust will be harder to gain since the patient already had an unpleasant first impression of the health care professional.

A plan to turn the situation around and have Mrs. Faulkenberger be compliant with her procedure and medication would be as followed: A thorough apology with a personal touch, explain why the mishap happened and share something with the patient that can help decompress the situation.

 The next step would be to get to know the patient a little better such as assessing her feelings about being hospitalized, if she has a support system like family and friends and if she has any significant financial worries. We want to identify what motivates the patient and if the patients motivation comes from intrinsic or extrinsic nature. Extrinsic motivation comes from the outside like social encouragement, from friends and family for example (Cohen et al., 1997). It can help build trust and rapport and suggests things that the health care professional need to address rather sooner than later. Next would be to assess what the patient already knows about the procedure and her feelings about it. Is she stressed and anxious about it or does she fully understand why it is necessary and is looking forward to getting it done so she can have an improved life? It is imperative to identify if the patient understands and supports the idea of the procedure and if she doesn’t, she needs to be educated on this first. If she understands why the procedure is necessary it is more likely that she complies with the medication regimen. Mrs. Faulkenberger’s basic needs, need to be addressed and covered first before we educate on the procedure and medication. If the patient is worried about financial aspects for example, the education on the medication regimen will not be effective because she will not be able to afford the medication and other resources have to be provided. When we as health care professionals educate on resources, connecting with social worker etc. we ensure a greater chance of compliance with the medication regimen.

Cohen, S., Doyle, W., Skoner, D. P., Rabin, B. S., & Gwaltney, J.M. (1997). Social ties and susceptibility to the common cold. Journal of the American Medical Association, 277, 1940–1944.

Quinetta Petite

DQ2

How would you use collaboration to assist in compliance with a patient as difficult as Alma?

           When we talk about patient compliance, I think there is a general misguided view of this concept. I know that when I first hear that a patient is noncompliant my immediate reaction is negative. However, something that I am working to change is this reaction. Noncompliance can be frustrating for nurses and other providers but ultimately when we see non-compliance this can be a good sign that a patient wants to be engaged with their healthcare in a more active and participatory way (Falvo, 2011). In Alma’s situation collaboration would be a valuable avenue for improving her compliance with the procedure and post-procedure recovery. This collaboration should occur between Alma, the physician overseeing/ performing the procedure, the nurse(s) assisting with her care, as well as any other members of the care team who will be involved in her care. Ideally, this collaboration would incorporate a lot of communication between the providers and Alma to better understand her medical history, her lifestyle behaviors, and her hesitations/ issues with the care being provided (Rothenberg, 2003). By collaborating directly with Alma the providers then have the opportunity to create a patient-based plan to engage Alma in her care. This can include education, asking the patient questions about her lifestyle and trying to adapt post-procedure recovery to her needs and preferences as is possible or other ways to empower Alma to be an active participant in her healthcare experience rather than feeling like she is just getting a procedure because she was told to get it.

References

Falvo, D. R. (2011). Effective patient education. Jones and Bartlett Publishers.

Rothenberg, G. M. (2003). How to facilitate better patient compliance. Podiatry Today. How would you use collaboration to assist in compliance with a patient as difficult as Alma?

ackie Engelsma

DQ2

A collaborative approach to healthcare involves using health care professionals from varying disciplines to coordinate care for a patient (Morgan, Bayly, Kosteniuk, & Elliot, 2019). This approach is focused on the patient, and is efficient, and cost-effective. The team-based approach uses individual roles and brings their expertise together, shares information and makes decisions together which result in the best care for a patient. This interdisciplinary approach shares the common goal of the best outcome possible for a patient. 

Team collaboration could be useful with Alma to help her feel more comfortable and compliant with her procedure and treatment. The male staff member could communicate with the other health care members the importance of respecting Alma’s name, so the same mistake is not made again. He could also ask another team member, who is a female, to talk with Alma to determine her preferences. Through effective communication, and team collaboration to ensure everyone is working towards the same goals, Alma will develop a sense of trust and will become more compliant with her care. Open relationships between a health provider and a patient are a key factor in compliance (Falvo, 2010). 

References

Falvo, D. (2010). Effective Patient Education. Retrieved from Jones and Bartlett Publishers: https://bibliu.com/app/#/view/books/9780763796181/epub/OPS/xhtml/frontmatter01.html#page_i

Morgan, D., Bayly, M., Kosteniuk, J., & Elliot, V. (2019). Collaborative approaches to team-based primary health care for individuals with dementia in Rural/Remote settings. Canadian Journal on Aging, 38(3), 367-383. doi:http://dx.doi.org/10.1017/S0714980818000727