Health Education: Session 6

• a submission or yielding to predetermined goals through regimens prescribed or established by others As such, this term has a manipulative or authoritative undertone that implies an attempt to control the learner's right to decision-making.

  Compliance
• A commitment or attachment to a prescribed, predetermined regimen This term is used interchangeably with compliance in the measurement of health outcomes.

  Adherence
• Biomedical, including patient demographics, severity of disease, and complexity of treatment regimen

  Biomedical theories
• Focuses on external factors that influence the patient's adherence such as rewards, cues, contracts, and social supports

  Behavioral/Social Learning theories
• Feedback loop of sending, receiving, comprehending, retaining, and acceptance

  Communication Models
• Weighing the benefits of treatment and the risks of disease through the use of cost-benefit logic

  Rational belief theory
• nonsubmission or resistance of an individual to follow a prescribed, predetermined regimen

  Noncompliance
• the patient declines to follow a previously agreed-upon treatment recommendation

  Nonadherence
• Power originates from within and is related to personal abilities

  Internal
• Fate is a powerful outside influence

  Chance external
• Others such as family, friends, and associates are powerful influences

  Others external
• Doctors have power to control outcomes

  Doctors external
• Definition: to set into motion, from the Latin word (); a psychological force that moves a person toward som

  Motivation movere
• Movement in the direction of meeting a need or reaching a goal

  Lewin's Theory of Motivation
• Motivational Factors

  May be incentive toward or obstacles to achieving desired behaviors Domains that may be influenced by the educator as a facilitator or blocker:

  Cognitive (thinking processes) Affective (emotions and feelings) Psychomotor (skill behavior) Social circumstances
• are premises on which an understanding of a phenomenon is based.

  Motivational axioms
• Learning occurs best when a state of moderate anxiety exists. In this optimal state for learning, the learner's ability to observe, focus attention, learn and adapt is operative

  State of Optimal Anxiety
• Goals that are within the person's grasp and possible to achieve will likely be something toward which an individual will work.

  Realistic Goals
• Desire to move towards a goal and readiness to learn are factors that influence motivation. Desire cannot be imposed to the learner but can be significantly influenced by external factors.

  Learner Readiness
• Success is self-satisfying and feeds the learner's self-esteem. In a cyclical process, success and self-esteem escalate, moving the learner toward accomplishment of additional goals.

  Learner Success
• Expressions of constructive emotional state

  Affective Variables
• Capacity to perform required behavior

  Physiologic Variables
• Previous successful experiences

  Experiential Variable
• Appropriateness of physical environment, Social support systems, Family Group

  Environmental Variables
• Prediction of positive relationship

  Educator - Learner Relationship System
• Rules that set the stage for motivation State of optimal anxiety (moderate) Learner readiness Realistic goal setting Learner satisfaction/success

  Uncertainty-reducing or maintaining dialogue
• Commonly used Motivational Strategies - Concept mapping - Attention, relevance, confidence, and satisfaction (ARCS) model (Keller, 1987) - Motivational interviewing
• Enables the learner to integrate previous learning with newly acquired knowledge through diagrammatic "mapping"

  Concept mapping
• Focuses on creating and maintaining motivational strategies used for instructional design. This model emphasizes strategies that the educator can use to effect changes in the learner by creating a motivating learning environment

  ARCS model
• introduces opposing positions, case studies, and variable instructional presentations

  Attention
• capitalizes on the learners' experiences, usefulness, needs, and personal choices.

  Relevance
• deals with learning requirements, level of difficulty, expectations, attributions, and sense of accomplishment

  Confidence
• pertains to timely use of a new skill, use of rewards, praise, and self-evaluation

  Satisfaction
• is a technique in which you become a helper in the change process and express acceptance of your client.

  Motivational interviewing
• Five Principles of Motivational Interviewing (READS)

  Roll with resistance Express empathy Avoid argumentation Develop discrepancy Support self-efficacy
• Resistance is a legitimate concern for the clinician because it is predictive of poor treatment outcomes and lack of involvement in the therapeutic process.

  Roll with resistance
• Four Types of Client Resistance Arguing Denying Interrupting Ignoring
• "is a specifiable and learnable skill for understanding another's meaning through the use of reflective listening. It requires sharp attention to each new client statement, and the continual generation of hypotheses as to the underlying meaning"

  Empathy
• Arguments with the client can rapidly degenerate into a power struggle and do not enhance motivation for beneficial change. When it is the client, not you, who voices arguments for change, progress can be made.

  Avoid argumentation
• Discrepancy is initially highlighted by raising your clients' awareness of the negative personal, familial, or community consequences of a problem behavior and helping them confront the substance use that contributed to the consequences.


  Develop discrepancy