Health EDUCATION MID TERM C

• Compliance


  Submission or yielding to the recommendations or will of others
• Compliance


  • Observable behavior
  • Can be directly measured
  • In healthcare compliance is seen with an authoritative tone
  • Practitioner = Authority
  • Consumer = Submissive
• Locus of control


  Refers to an individual's sense of responsibility for his behaviors and the extent to which motivation to take action originates from within self (internal) or is influenced by others (external)
• Locus of control


  • Educator will make an attempt to partly control decision making by the learner
  • Internal: self-directed, they have their own control
  • External: influenced by health outcomes, fate
  • Inconclusive data on compliance and internals vs externals
  • Has connection with compliance in some therapeutic regimen but not all
• Noncompliance


  Nonsubmission or resistance of the individual to follow a prescribed, predetermined regimen
• Noncompliance


  • Noncompliant behavior: Blaming, Judgemental, Disobedience
  • People tend to make excuses for noncompliance, even if they have nothing to lose
  • Places client under unnecessary health risk and increases health care costs
• Reasons for Noncompliance


  • Knowledge
  • Motivation
  • Treatment factors → side effects
  • Disease issues → prognosis
  • Lifestyle issues → transportation
  • Sociodemographic factors → social and economic status
  • Psychosocial variables → depression and fear
  • Noncompliant behavior could be desirable and prove beneficial in stressful situations
• Motivation


  A psychological force that moves a person to take action in the direction of meeting a need or goal, evidenced by willingness or readiness to act
• Motivation


  • Internal factors
  • External factors
  • Implicit motivation = Movement in the direction of meeting a need or toward reaching a goal
  • Health provider's role → facilitator to reach desired goal and prevent delays
• Hierarchy of Needs


  • Maslow's Motivational Theory
  • Complexity of the concept of motivation
  • Not all behavior is motivated
  • Hierarchy of Needs: Physiological, safety, love/belonging, self-esteem, and self actualization
  • Needs are related to their level of potency
• Motivational Factors


  • Personal attributes
  • Environmental factors
  • Learner relationship systems
• Motivational Factor: Personal Attributes


  • Can be: physical, developmental, psychological components of the individual learner
  • Can shape an individual's motivation to learn
  • Learners views about the complexity and the extent of changes that are needed can shape motivation
• Motivational axioms


  Rules that set the stage for motivation
• Motivational Axioms


  • The state of optimum anxiety
  • Learner readiness
  • Realistic goal setting
  • Learner satisfaction/success
  • Uncertainty reduction/maintaining dialogue
• State of Optimum Anxiety

  • Learning occurs best when a state of moderate anxiety exists
  • Low levels of anxiety: low level of motivation
  • Moderate levels of anxiety: comfortably managed & promotes learning
  • High/severe levels of anxiety: reduces ability to perceive environmental, concentration, & learning
  • Optimum state for learning- when perception, abstract thinking, concentration, and information processing are enhanced
  • Learning is achieved during learning/challenging situation- this is how learning works in an anxiety provoking situation
• Learner Readiness


  • Desire cannot be imposed on a learner but it can be influenced by external forces and promoted by the educator
  • Incentives as rewards and reinforcers: Tangible, Intangible, External, Internal
• Parameters for motivational assessment of the learner

  • Previous attempts
  • Curiosity
  • Goal setting
  • Self-care ability
  • Stress factors
  • Survival issues
  • Life situations
• Assessment of Motivation


  • Subjective: Dialogue, Nonverbal cues, Self-reports
  • Objective: Observation of expected behaviors
• Motivational Interviewing


  Method of being ready to change in order to promote desired health behaviors
• Motivational Strategies


  • Clear communication, clarifying directions and expectations, organizing material in a meaningful way for the learner, environmental manipulation, positive verbal feedback, and providing opportunities for success
• Selected Models and Theories

  • Health Belief Model
  • Self Efficacy theory
  • Protection Motivation Theory
  • Stages of Change Model
  • Theory of reasoned action
  • Therapeutic alliance model
• Health Belief Model


  • A framework or paradigm used to explain or predict health behavior composed of the interaction between individual perceptions, modifying factors, and likelihood of action
  • Developed in 1950s to examine why people did not participate in health screening programs
  • 2 premises on which model is built: Eventual success of disease prevention, Belief that health is highly valued
• ARCS model


  Attention, Relevance, Confidence and Satisfaction - main focus is to create and maintain motivational strategies used for instructional design
• Attention


  • Gaining and sustaining the learner's attention
• Relevance


  • Ensuring the instructional content is relevant to the learner
• Confidence


  • Helping the learner believe they can succeed
• Satisfaction


  • Providing the learner with a sense of achievement and positive reinforcement
• Motivational interviewing


  The educator must ask: "what specific behavior, under what circumstances, in what time frame, is desired by the learner?"
• Client realization


  Client eventually comes to realization and will self-report that they are ready to make a change
• Interviewer seeks


  To gain knowledge about health beliefs
• Explore


  Client's motivation for adherence to health regimens
• Selected Models and Theories

  • Health Belief Model
  • Self Efficacy theory
  • Protection Motivation Theory
  • Stages of Change Model
  • Theory of reasoned action
  • Therapeutic alliance model
• Health Belief Model


  A framework or paradigm used to explain or predict health behavior composed of the interaction between individual perceptions, modifying factors, and likelihood of action
• Health Belief Model was developed in 1950s to examine why people did not participate in health screening programs
• Health Belief Model premises

  • Eventual success of disease prevention
  • Belief that health is highly valued
• Health Belief Model Components

  • Individual perception
  • Modifying factors
  • Likelihood of action
• Individual perception


  Subcomponents of perceived susceptibility or perceived severity of a specific disease
• Modifying factors


  • Demographics variables (age, sex, etc)
  • Sociopsychological variables (personality, locus of control, etc.)
  • Structurable variables (knowledge about and prior contact with disease)
• Likelihood of action


  Subcomponents of perceived benefits of preventive action minus perceived barriers to preventive action
• Self-Efficacy Theory


  A framework that describes the belief that one is capable of accomplishing a specific behavior