CNA250 Nursing Practice 2

The case exhibited here features the state of a 55 old patient, Alistair who has been admitted to the orthopedic ward. He needs to undergo a total knee management. He has been overweight for quite a while, due to which he is stressed over his wellbeing and furthermore the medical procedure as he feels being overweight is the fundamental explanation for his medical problem. Both MI and TTM approaches that have originated and have been used that can be implemented extensively with the treatment of the substance abuse and disorders of addiction along with the treatment of the disorders which forms a significant proportion of psychotherapy. The aim of the paper intends to feature that being a part of the nursing group of this patient, how it is conceivable to keep up him through the phases of progress cycle. It also states that this maintenance can be accomplished through the execution of Transtheoretical Model of Change and Motivational Interviewing methods, which will be additionally talked about in the paper.

Motivational interview (MI) is an intervention that is evidence based in nature and which is very strong and that has been utilized with the expectation to bring out characteristic inspiration to change practices. MI as a mediation assumes a job in concentrating on encouraging the development through the phases of the transtheoretical model of progress (Hoy, Natarajan& Petra, 2016). The phases of progress cycle involve pre-contemplation, trailed by examination, arrangement/assurance, activity or self-control, support and lastly backslide. Pre-contemplation recognizes that some issue is available in the conduct for which change is required. Thought recognizes that the issue is available yet there is no surety that change is needed. Planning or assurance gets readied for the change. The activity or self-discipline is the changing conduct and support helps in keeping up the conduct change. Lastly there is a relapse that is coming back to the more seasoned practices alongside abandonment the new changes (Laplante-Lévesque, Hickson& Worrall, 2013).

The transtheoretical model (TTM) of progress can clarify the difference in conduct that is purposeful and acts along a measurement which can use both execution based and psychological parts (Hardcastle et al., 2013). Scientists have advanced that through TMM people travel through a chain of stages comprising of precontemplation (PC), examination (C), planning (PR), activity (An), and upkeep (M), which in turns helps in the selection of sound practices and discontinuance of the ones that are less healthy.

Change mediations are particularly helpful in tending to way of life alteration for illness counteractive action, long term disease prevention and addictions. The ideas of “tolerant resistance” and inspiration regularly center on patient disappointment. Understanding patient preparation to bring about improvement, acknowledging hindrances to change and helping patients foresee backslide can enhance fulfillment and lower doctor dissatisfaction amid the change procedure. The Transtheoretical Model of Change otherwise called the Stages of Change show and talk about its application to the family work on setting (Lee, Park and Min, 2015). The Readiness to Change Ruler and the Agenda-Setting Chart are two basic devices that can be utilized in the workplace to advance discourse. It is required to help the patients in understanding their wellbeing and to enable them to roll out the improvements fundamental for wellbeing change. Exercise programs, stretch administration systems and dietary confinements speak to some normal mediations that require understanding inspiration. An adjustment in patient way of life is vital for fruitful administration of long termss disease, and backslide can frequently be ascribed to slips in solid conduct by the patient. Patients effectively comprehend way of life adjustments yet steady, deep rooted conduct changes are troublesome. Over and again instructing the patient isn’t constantly effective and can end up baffling for the doctor and patient. Moreover, encouraging patients an enhanced result does not ensure their inspiration for long haul change. Patients may see doctors who utilize an angry methodology as being basic instead of steady. Finally amid any treatment program is here and there seen as a disappointment by the patient and the doctor. A sentiment of disappointment, particularly when rehashed, may make patients surrender and keep away from contact with their doctor or evade treatment inside and out. After doctors put time and vitality in advancing change, patients who fall flat are regularly named “resistant” or “unmotivated” (Joo Yun Lee, Park & Min, 2015).

Thinking about the given state of the patient, in the main phase of pre examination, I would attempt to deal with this issue by expanding the attention to the patient in regards to his patient condition and in the following stage will enable him to endeavor to perceive the genuine issue so he can comprehend that his corpulence isn’t the main factor so he can quit censuring himself. The underlying thought of conduct change and data assembling about conceivable arrangements and activities will likewise be considered. In the following period of arrangement, I should set up the patient as far as the choice made with respect to wellbeing and contemplation about the choice is required. Activity incorporates execution of the practices required for fruitful conduct change pursued by solidification of the practices that is started amid the phase of activity. At long last in the last stage it is required to influence the patient to understand that the previous issue practices ought to be not any more saw as being alluring (Arkowitz, Miller & Rollnick, 2015). Being a part of the nursing group, it is likewise required to endeavor to actualize certain intercessions for the procedure of progress that should move from stage to arrange. These incorporate awareness raising, sensational help, ecological re-assessment, social freedom, self-reassessment. These are experimental in nature. While others incorporate conduct like upgrade control, helping relationship, counter molding, fortification administration and self-freedom (Noordman et al., 2013).

Motivational Interviewing (MI) depends on the comprehension of the current state of the patient. With a specific end goal to deal with the phases of changes that the patient experiences certain methodologies can be connected. In the main phase of pre-contemplation, I will attempt to accumulate data and will endeavor to tune in to the inconsistencies between the wellbeing objectives and the way of life decisions of the patient. At that point I will attempt to teach him about the conceivable wellbeing dangers concerning his condition and his way of life decisions. An essential advance will be to ingrain trust in him by giving data about the conceivable moderation of wellbeing dangers through way of life change. Amid the consideration arrange, it is expected to investigate both the positive and the negative parts of the decision of way of life (Miller and Rose, 2015). Amid this stage it is likewise required to keep up the parity towards the bearing of progress by reflecting back what patients have expressed. As far as arrangement, duty to change is required to be surveyed alongside ID of help and boundaries to change. In the following stage, the patient should be assisted for the execution of the change (Prochaska, 2013). This should be possible by distinguishing proof of the startling obstacles and help the patients characterize the adapting methodologies. Moreover there is a need to assist the patient with identifying new wellsprings of help alongside following advancement with him. At last for upkeep, I will execute ventures to keep on following additions that are related with a positive development. I will likewise need to recognize the general population, the spots, and things that could present triggers to backslide for the patient. I will likewise need to keep on assisting the patient form abilities with preventing backslide there is additionally a prerequisite to help the patients in effectively keeping up the progressions they have made in regards to their wellbeing (Mastellos et al., 2014). Persistent obstruction is proof that can be utilized in order to propel the patient in the change procedure as required, and a move back to sympathy and provocative inquiries when necessary. I also can draw in patients in the consideration procedure by creating and keeping up a constructive relationship, customizing hazard factors and offering conversation starters that incite musings about patient hazard factors and the apparent “primary concern.”

It can thus be concluded from the above discussion that the transtheoretical model of progress can portray the different stages that an individual needs to experience with a specific end goal to go finish the procedure of progress. MI is a proof based mediation that is very hearty in nature, which intends to lift the responsibility and the inspiration towards the procedure of progress. This thusly is educated trough the transtheoretical model of progress. Hence there is a probability that these can be adjusted for the intercessions where the general population or the patients are at high hazard identified with their medical problems like the patient portrayed here. Such adaptions frequently assume a job in offering utility alongside the appraisal of the hazard in a significant straightforward manner. This additionally summons the inspirations alongside the defensive variables which are essential during the time spent hazard evaluation.

References

Arkowitz, H., Miller, W. R., &Rollnick, S. (Eds.). (2015). Motivational interviewing in the treatment of psychological problems. Guilford Publications.

Hardcastle, S. J., Taylor, A. H., Bailey, M. P., Harley, R. A., &Hagger, M. S. (2013). Effectiveness of a motivational interviewing intervention on weight loss, physical activity and cardiovascular disease risk factors: a randomised controlled trial with a 12-month post-intervention follow-up. International journal of behavioral nutrition and physical activity, 10(1), 40.

Hoy, J., Natarajan, A., & Petra, M. M. (2016). Motivational interviewing and the Transtheoretical Model of change: Under-explored resources for suicide intervention. Community mental health journal, 52(5), 559-567.

Laplante-Lévesque, A., Hickson, L., & Worrall, L. (2013). Stages of change in adults with acquired hearing impairment seeking help for the first time: application of the transtheoretical model in audiologic rehabilitation. Ear and hearing, 34(4), 447-457.

Mastellos, N., Gunn, L. H., Felix, L. M., Car, J., &Majeed, A. (2014). Transtheoretical model stages of change for dietary and physical exercise modification in weight loss management for overweight and obese adults. Cochrane Database Syst Rev, 2(2), CD008066.

Miller, W. R., & Rose, G. S. (2015). Motivational interviewing and decisional balance: contrasting responses to client ambivalence. Behavioural and cognitive psychotherapy, 43(2), 129-141.

Noordman, J., de Vet, E., van der Weijden, T., & van Dulmen, S. (2013). Motivational interviewing within the different stages of change: An analysis of practice nurse-patient consultations aimed at promoting a healthier lifestyle. Social Science & Medicine, 87, 60-67.

Prochaska, J. O. (2013). Transtheoretical model of behavior change. In Encyclopedia of behavioral medicine (pp. 1997-2000). Springer, New York, NY.

Lee, J.Y., Park, H.A. and Min, Y.H., 2015. Transtheoretical model-based nursing intervention on lifestyle change: a review focused on intervention delivery methods. Asian nursing research, 9(2), pp.158-167.

Joo Yun Lee, R. N., Park, H. A., & Min, Y. H. (2015). Transtheoretical Model-based Nursing Intervention on Lifestyle Change&58; A Review Focused on Intervention Delivery Methods. Asian Nursing Research, 9(2), 158-167.