26/04/23.

 

The lessen started with a recap and followed with a discussion regarding the assignment. We looked at the learning outcomes:

To understand the rationale behind helping individuals make healthy lifestyles choices.

To gain some knowledge of the definitions of behavioral change and how models help explain it.

To gain an understanding of how as nurses can influence behavior change using motivational interviewing techniques.

We discuss the NMC requirements as a future nurse: standard of proficiency for registered nursing associates (NMC, 2018). This explain and demonstrate the use of up-to-date approaches to behavior change to enable people to use their strength and expertise and make informed choices when managing their own health and making lifestyle adjustments. To assess motivation and capacity for behavior change and clearly explain cause and effect relationships related to common health risk behavior like smoking, obesity, sexual practice, alcohol and substance use, and communication and relationship management skills.

Looking at the healthy and unhealthy behaviors, government publications become confusing as to eating 5 portions of fruits and vegetables in a day, taking enough exercise, eating less sugar, practicing safer sex, eating less fat, (particularly saturated), give up smoking, having a social life, and to drink sensible amount of alcohol.

I learnt that there is a need, as a nursing associate to have an overall understanding in order not to only guide patients when they are ill, but also to answer questions from patients about healthy lifestyle in general, and to keep up with research and understand the evidence behind the guidelines to maintain the credibility with patients.

Looking at the cultural differences – race, ethnic and cultural differences exist in the occurrence of physical and mental illnesses.  Some of thee may be related to the adoption of behaviors related to health, possibly relating to values inherent in their culture. There may be some groups that has become vulnerable to illnesses. Groups may also differ with their help-seeking behaviors. Behaviors that are consider unusual in western cultures, are not seen in this same manner in other cultures.

 

We looked at the gender differences, it is thought that the behavior of females tends to be more variable. The treatment that suits one gender might not produce outcome in the other. Generally, women pay more attention to health behaviors- being more willing to have annual checks and attending education classes. Males and females also differ in their coping mechanisms. Social support is sought more readily by females -but they experience more frequent and variable stressors.

Looking at the behavioural models:

cognition -focusing on the thinking of the individual, so beliefs, values and attitudes are most influential (as a nursing associates work on those beliefs to change them). This model only works by making people think of suitable changes. This does not empower people to make the changes.

The social cognition model- introduces the influence of other individuals on a person’s behaviour, so that they worry about not being ‘normal’.  Sometimes the fear here is quite strong. There is an assumption that many factors act together in the failure to adopt health behaviour.

Empowerment model – this considers; how difficult it is to make a behaviour change. People need to become empowered through their own previous actions or they need to become empowered by others (the nurse and the patient). Empowerment is not just about gaining the knowledge; it is being able to weigh up the information and decide for yourself and boosting the belief that you can make the change. For a nursing associate, there is need to listen to the patient, value their opinions and give them space.

I learnt about the alternatives to behavioural change:

The educational approach – it does not set out to persuade or motivate change in a particular direction. It assumes that by increasing knowledge, there will be a change in attitude which may result in a change in behaviour. The goal of the client might be agreed upon bur this approach does not acknowledge the real socioeconomic constraints that might affect behaviour change. The education should come from a credible individual, and should be simple, brief and to the point, with emphasis on the consequences of not engaging.

The behavioural techniques: Open questions, brief interventions of 5-10 minutes, establish rapport, assessing the patient’s readiness to change, and develop an action plan.

The following are the qualities needed for motivational interviewing:

Unconditional positive regard and acceptance of others irrespective of their age, gender, culture, ethnicity, setting aside your personal values, and being non-judgemental.

Genuineness, being oneself, true, sincere, and non-defensive.

Empathic – understanding the world of another and appreciate meaning.

 

 

 

KSB ADDRESSED. KNOWLEDGE:

K1: Understand the code: Professional standards of practice and behaviour for nurses, midwives, and nursing associates (NMC 2018), and how to fulfil all registration requirements.

 

K2: Understand the demands of professional practice and demonstrate how to recognise signs of vulnerability in themselves or their colleagues and the action required to minimise risks to health.

K3: Understand the professional responsibility to adopt a healthy lifestyle to maintain the level of personal fitness and well-being required to meet people’s needs for mental and physical care.

K4: Understand the principles of research and how research findings are used to inform evidence-based practice.

K5: Understand the meaning of resilience and emotional intelligence, and their influence on an individual’s ability to provide care.

K6: Understand and apply relevant legal, regulatory and governance requirements, policies, and ethical frameworks, including any mandatory reporting duties, to all areas of practice.

K7: Understand the importance of courage and transparency and apply the Duty of Candour

K8: Understand how discriminatory behaviour is exhibited.

K9: Understand the aims and principles of health promotion, protection and improvement and the prevention of ill health when engaging with people.

 

K10: Understand the principles of epidemiology, demography, and genomics and how these may influence health and well-being outcomes.

 

K11: Understand the factors that may lead to inequalities in health outcomes.

 

K12: Understand the importance of early years and childhood experiences and the possible impact on life choices, mental, physical, and behavioural health, and well-being.

 

K13: Understand the contribution of social influences, health literacy, individual circumstances, behaviours, and lifestyle choices to mental, physical, and behavioural health outcomes.

K14: Understand the importance of health screening.

K15: Understand human development from conception to death, to enable delivery of person-centred safe and effective care.

K16: Understand body systems and homeostasis, human anatomy and physiology, biology, genomics, pharmacology, social and behavioural sciences as applied to delivery of care.

K17: Understand commonly encountered mental, physical, behavioural, and cognitive health conditions as applied to delivery of care.

K18: Understand and apply the principles and processes for making reasonable adjustments.

K19: Know how and when to escalate to the appropriate professional for expert help and advice.

K20: Know how people’s needs for safety, dignity, privacy, comfort, and sleep can be met.

K24: Know how to support people with commonly encountered symptoms including anxiety, confusion, discomfort, and pain.

K30: Understand the principles of health and safety legislation and regulations and maintain safe work and care environments.

K33: Understand when to seek appropriate advice to manage a risk and avoid compromising quality of care and health outcomes.

K36: Understand the roles of the different providers of health and care.

K39: Understand the principles and processes involved in supporting people and families with a range of care needs to maintain optimal independence and avoid unnecessary interventions and disruptions to their lives.

K40: Understand own role and contribution when involved in the care of a person who is undergoing discharge or a transition of care between professionals, settings or services.

K41: Know the roles, responsibilities, and scope of practice of different members of the nursing and interdisciplinary team, and own role within it.

K43: Understand the influence of policy and political drivers that impact health and care provision.

 

SKILLS:

S1: Act in accordance with the Code: Professional standards of practice and behaviour for nurses, midwives, and nursing associates (NMC, 2018), and fulfil all registration requirements.

 

S5: Safely demonstrate evidence-based practice in all skills and procedures required for entry to the register: Standards of proficiency for nursing associates Annex A & B (NMC 2018).

 

S7: Communicate effectively using a range of skills and strategies with colleagues and people at all stages of life and with a range of mental, physical, cognitive, and behavioural health challenges.

 

S8: Recognise signs of vulnerability in self or colleagues and the action required to minimise risks to health.

S9: Develop, manage, and maintain appropriate relationships with people, their families, carers and colleagues.

S13: Apply the aims and principles of health promotion, protection and improvement and the prevention of ill health when engaging with people.

S14: Promote preventive health behaviours and provide information to support people to make informed choices to improve their mental, physical, behavioural health and wellbeing.

S15: Identify people who are eligible for health screening.

S16: Promote health and prevent ill health by understanding the evidence base for immunisation, vaccination, and herd immunity. Accurately undertake risk assessments, using contemporary assessment tools

S35: Accurately undertake risk assessments, using contemporary assessment tools.

 

 

BEHAVIOUR:

 

B1: Treat people with dignity, respecting individual’s diversity, beliefs, culture, needs, values, privacy, and preferences

B2: Show respect and empathy for those you work with, have the courage to challenge areas of concern and work to evidence based best practice.

 

B3: Be adaptable, reliable, and consistent, show discretion, resilience, and self-awareness.