Behaviour Change Behaviour Change

Patients often either fail to make or sustain behavioural changes that could improve their health outcomes and quality of life. One way to overcome this is to be flexible so that the service caters for differing needs and preferences.

Generally, patients need assistance to take responsibility for their outcomes and learn to self-manage their conditions.

Tips in service delivery

  • One-on-one interactions – Allow time for establishing individual rapport in order to gain an understanding of the person’s needs and circumstances. Motivational interviewing is a useful technique and can give the patients time to build importance and confidence
  • Group interactions– Many people find a group environment daunting or will not like the idea of being ‘educated’ with other people. Some may not be able to make the sessions due to work or other commitments. Group education sessions should maximise participant involvement, be fun and enjoyable, and be offered at different timeslots for convenience
  • Telephone consultations – Telephone consultations may provide effective support to initiate and maintain changes over time. Communicating on the phone has its own peculiar dynamics and challenges. See Tips for telephone consultations

The barriers to patients decreasing their cardiac risk may be categorised into four groups, using the acronym BEST:[#gale-j.-2012]

  1. Behaviours — Ingrained habits, lifestyle behaviours and lack of planning
  2. Emotions — Moods and our emotional reactions to situations, e.g., getting angry or depressed about a diagnosis, or anxious about not achieving our planned goals
  3. Situations — Finances, medical conditions, cognitive and physical abilities, social supports, work and childcare commitments, access to services
  4. Thinking — Beliefs, attitudes, expectations, habitual thinking patterns, motivation and knowledge

Clinicians should explore all four categories to help patients identify barriers to adhering to clinical advice. This helps uncover subtle factors that might otherwise undermine attempts to change.

  • Gale J. A practical guide to health behaviour change using the HCA approach. Sydney, Australia: Health Change Australia. 2012.

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