This document provides an overview of effective doctor-patient communication. It discusses the Kalamazoo consensus statement, which outlines a model for teaching communication skills, including active listening, verbal and nonverbal communication, and creating respect. The 5 A's model is also presented as a framework for behavior change discussions, involving asking about current behaviors, advising changes, assessing willingness to change, assisting with goal-setting, and arranging follow-up. Effective communication involves opening the discussion, gathering information through questioning, understanding the patient's perspective, sharing information, reaching agreements on problems and plans, and providing closure.
Patient-Centered Care and Professional Nursing Practic.docxkarlhennesey
Patient-Centered
Care and Professional
Nursing Practice
Chapter 11
What is Patient-Centered Care (PCC)?
• Care that is respectful of and responsive to
individual patient preferences, needs, and
values and ensuring that patient values guide
all clinical decisions (IOM, 2001)
• Recognizes the patient or designee as the
source of control and full partner in providing
compassionate and coordinated care based on
respect for the patient’s preferences, values,
and needs (QSEN, 2014)
PCC Competency
• The nurse “will provide holistic care that
recognizes an individual’s preferences, values,
and needs and respects the patient or designee
as a full partner in providing compassionate,
coordinated, age and culturally appropriate,
safe and effective care” (Massachusetts
Department of Higher Education, 2010, p. 9)
Dimensions of PCC
• Respect for patients’ values, preferences, and
needs
• Coordination and integration of care
• Information, communication, and education
• Physical comfort
• Emotional support
• Involvement of family and friends
• Transition and continuity
• Access to care
Picker Principles of Patient-
Centered Care
Videos featuring patients “in their own words”
http://cgp.pickerinstitute.org/?page_id=1319
http://cgp.pickerinstitute.org/?page_id=1319
Components of Patient-Centered and
Family-Centered Care Delivery Models
• Coordination of care conference
• Hourly rounding by the nurse
• Bedside report
• Use of patient care partner
• Individualized care established on admission
• Open medical record policy
Components of Patient-Centered and
Family-Centered Care Delivery Models
(cont.)
• Eliminating visiting restrictions in relation to
family members
• Allowing family presence with a chaperone
during resuscitation and other invasive
procedures
• Silence and healing environment
Communication as a Strategy to
Support PCC
• Communication is defined as the nurse
interacting “effectively with patients, families,
and colleagues, fostering mutual respect and
shared decision making, to enhance patient
satisfaction and health outcomes”
(Massachusetts Department of Higher
Education [2010], p. 27)
Empathetic Communication
• Behaviors that facilitate empathetic
communication include:
– Listening carefully and reflecting back a
summary of the patient’s concerns
– Using terms and vocabulary appropriate for the
patient
– Calling the patient by his or her preferred name
– Using respectful and professional language
Empathetic Communication (cont.)
• Behaviors that facilitate empathetic
communication include (cont.):
– Asking the patient what they need and
responding promptly to those needs
– Providing helpful information
– Soliciting feedback from the patient
– Using self-disclosure appropriately
– Employing humor as appropriate
– Providing words of comfort when appropriate
Nonempathetic Communication
• Behavior ...
Effective Communication in Nursing is very essential to meet not only the expectation of patients toward Healthcare services but also to help achieve departmental or organizational goals and objectives.
Miscommunication is one of the leading causes of medical errors that may bring harm or permanent damage to patients. Emphasizing the use of effective communication in the healthcare setting lessen the occurrence of such errors.
Nurses’ patient education is important for building patients’ knowledge, understanding and preparedness for self-management. The ultimate goal of patient educational program is to achieve long-lasting changes in behavior by providing patients with the knowledge to allow them to make autonomous decisions to take ownership of their care as much as possible and improve their own outcomes.
CONCEPT OF PATIENT EDUCATION
Education on health issues is necessary for a patient’s physical and mental health.
Everybody finds themselves in situations where they require special knowledge and skills in order to meet their basic needs and sustain their lives.
All patients have the right to be educated on maintaining their health, disease prevention, and health promotion.
Health promotion is the process of advancing knowledge, influencing attitudes, and determining relevant solutions so that people can make informed choices, change their behavior and subsequently attain a desirable level of physical and mental health improve their social and physical environment.
Effective patient education starts from the time patients are admitted to the hospital and continuous until they are discharged. Nurses should take advantage of any appropriate opportunity throughout a patient’s stay to teach the patient about self-care.
The self- care instruction may include teaching patients how to inject insulin, bathe an infant or change a colostomy pouching system.
MEANING OF PATIENT EDUCATIONThe Latin origin of the word doctor “decree” means “to teach" and the education of patients and their families, as well as communities, is the responsibility of all physicians.
Family physicians are uniquely suited to take a leadership role in patient education.
Family physicians build long- term, trusting relationships with patients, providing opportunities to encourage and reinforce changes in health behavior.
Patient education enables patients to assume better responsibility for their own health care, improving patients’ ability to manage acute and chronic disorders.
Patient education provides opportunities to choose healthier lifestyles and practice preventive medicine.
Patient education attracts patients to the provider and increases patients’ satisfaction with their care, while at the same time decreasing the provider’s risk of liability.
Patient education promotes patient-centered care and as a result, patients’ active involvement in their plan of care.
Patient education increases adherence to medication and treatment regimens, leading to a more efficient and cost- effective health care delivery system
Patient education ensures continuity of care and reduces the complications related to illness and incidence of disorder/disease.
Patient education maximizes the individual’s independence with home exercise programs and activities that promote independence in activities of daily living as well as continuity of care needed
By the end of this session participants should be able to:
1-Define Health Education (HE), Counselling, and Communication.
2-Identify the principles for effective communication.
3-Describe good counseling and HE components.
Patient-Centered Care and Professional Nursing Practic.docxkarlhennesey
Patient-Centered
Care and Professional
Nursing Practice
Chapter 11
What is Patient-Centered Care (PCC)?
• Care that is respectful of and responsive to
individual patient preferences, needs, and
values and ensuring that patient values guide
all clinical decisions (IOM, 2001)
• Recognizes the patient or designee as the
source of control and full partner in providing
compassionate and coordinated care based on
respect for the patient’s preferences, values,
and needs (QSEN, 2014)
PCC Competency
• The nurse “will provide holistic care that
recognizes an individual’s preferences, values,
and needs and respects the patient or designee
as a full partner in providing compassionate,
coordinated, age and culturally appropriate,
safe and effective care” (Massachusetts
Department of Higher Education, 2010, p. 9)
Dimensions of PCC
• Respect for patients’ values, preferences, and
needs
• Coordination and integration of care
• Information, communication, and education
• Physical comfort
• Emotional support
• Involvement of family and friends
• Transition and continuity
• Access to care
Picker Principles of Patient-
Centered Care
Videos featuring patients “in their own words”
http://cgp.pickerinstitute.org/?page_id=1319
http://cgp.pickerinstitute.org/?page_id=1319
Components of Patient-Centered and
Family-Centered Care Delivery Models
• Coordination of care conference
• Hourly rounding by the nurse
• Bedside report
• Use of patient care partner
• Individualized care established on admission
• Open medical record policy
Components of Patient-Centered and
Family-Centered Care Delivery Models
(cont.)
• Eliminating visiting restrictions in relation to
family members
• Allowing family presence with a chaperone
during resuscitation and other invasive
procedures
• Silence and healing environment
Communication as a Strategy to
Support PCC
• Communication is defined as the nurse
interacting “effectively with patients, families,
and colleagues, fostering mutual respect and
shared decision making, to enhance patient
satisfaction and health outcomes”
(Massachusetts Department of Higher
Education [2010], p. 27)
Empathetic Communication
• Behaviors that facilitate empathetic
communication include:
– Listening carefully and reflecting back a
summary of the patient’s concerns
– Using terms and vocabulary appropriate for the
patient
– Calling the patient by his or her preferred name
– Using respectful and professional language
Empathetic Communication (cont.)
• Behaviors that facilitate empathetic
communication include (cont.):
– Asking the patient what they need and
responding promptly to those needs
– Providing helpful information
– Soliciting feedback from the patient
– Using self-disclosure appropriately
– Employing humor as appropriate
– Providing words of comfort when appropriate
Nonempathetic Communication
• Behavior ...
Effective Communication in Nursing is very essential to meet not only the expectation of patients toward Healthcare services but also to help achieve departmental or organizational goals and objectives.
Miscommunication is one of the leading causes of medical errors that may bring harm or permanent damage to patients. Emphasizing the use of effective communication in the healthcare setting lessen the occurrence of such errors.
Nurses’ patient education is important for building patients’ knowledge, understanding and preparedness for self-management. The ultimate goal of patient educational program is to achieve long-lasting changes in behavior by providing patients with the knowledge to allow them to make autonomous decisions to take ownership of their care as much as possible and improve their own outcomes.
CONCEPT OF PATIENT EDUCATION
Education on health issues is necessary for a patient’s physical and mental health.
Everybody finds themselves in situations where they require special knowledge and skills in order to meet their basic needs and sustain their lives.
All patients have the right to be educated on maintaining their health, disease prevention, and health promotion.
Health promotion is the process of advancing knowledge, influencing attitudes, and determining relevant solutions so that people can make informed choices, change their behavior and subsequently attain a desirable level of physical and mental health improve their social and physical environment.
Effective patient education starts from the time patients are admitted to the hospital and continuous until they are discharged. Nurses should take advantage of any appropriate opportunity throughout a patient’s stay to teach the patient about self-care.
The self- care instruction may include teaching patients how to inject insulin, bathe an infant or change a colostomy pouching system.
MEANING OF PATIENT EDUCATIONThe Latin origin of the word doctor “decree” means “to teach" and the education of patients and their families, as well as communities, is the responsibility of all physicians.
Family physicians are uniquely suited to take a leadership role in patient education.
Family physicians build long- term, trusting relationships with patients, providing opportunities to encourage and reinforce changes in health behavior.
Patient education enables patients to assume better responsibility for their own health care, improving patients’ ability to manage acute and chronic disorders.
Patient education provides opportunities to choose healthier lifestyles and practice preventive medicine.
Patient education attracts patients to the provider and increases patients’ satisfaction with their care, while at the same time decreasing the provider’s risk of liability.
Patient education promotes patient-centered care and as a result, patients’ active involvement in their plan of care.
Patient education increases adherence to medication and treatment regimens, leading to a more efficient and cost- effective health care delivery system
Patient education ensures continuity of care and reduces the complications related to illness and incidence of disorder/disease.
Patient education maximizes the individual’s independence with home exercise programs and activities that promote independence in activities of daily living as well as continuity of care needed
By the end of this session participants should be able to:
1-Define Health Education (HE), Counselling, and Communication.
2-Identify the principles for effective communication.
3-Describe good counseling and HE components.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
1. Module 1.4: The foundations
of communication
Dr. Naushi Mujeeb
Professor, Dept of Physiology
2. • This module provides students with an introduction to doctor-
patient communication.
• Communication is a fundamental prerequisite in the medical
profession.
• Competency addressed-
• The student should be able to:
• Demonstrate ability to communicate to patients in a patient,
respectful, nonthreatening, non- judgmental and empathetic manner.
• A strong, therapeutic, and effective relationship is the sine qua non of
physician—patient communication
3. • The Kalamazoo consensus statement provides a working model of
teaching communication skills and may be used to impart
communication skills.
• In Kalamazoo, Michigan, Conference was conducted for three days on
Physician—Patient Communication in Medical Education.
• The aim of this invitational conference was to identify and specifically
articulate ways to facilitate communication teaching, assessment, and
evaluation.
• Effective listening, verbal and nonverbal communication and creating
respect in patient encounters would be the skills that is needed in this
profession.
4. • The five ‘A’s elements of behaviour change model may also be used.
• 5 A’s- Ask, Advise, Agree, Assist, Arrange
• The 5As are a framework for clinicians to ASK about current
behavior, ADVISE a change, ASSESS willingness to change
and willingness to enroll in a community program supporting
physical activity, ASSIST with goal-setting and ARRANGE
follow-up.
5. • Communication-
• Open the Discussion-
• Allow the patient to complete his or her opening statement
statement
• Elicit the patient's full set of concerns
• Establish/maintain a personal connection
6. • Gather Information
• Use open-ended and closed-ended questions appropriately.
appropriately.
• Structure, clarify, and summarize information.
• Actively listen using nonverbal (e.g., eye contact) and verbal
verbal (e.g., words of encouragement) techniques.
7. • Understand the Patient's Perspective-
• Explore contextual factors (e.g., family, culture, gender, age,
socioeconomic status, spirituality)
• Explore beliefs, concerns, and expectations about health and
and illness
• Acknowledge and respond to the patient's ideas, feelings, and
and values
8. • Share Information-
• Use language the patient can understand
• Check for understanding
• Encourage questions
9. • Reach Agreement on Problems and Plans-
• Encourage the patient to participate in decisions to the extent
extent he or she desires
• Check the patient's willingness and ability to follow the plan
plan
• Identify and enlist resources and supports
10. • Provide Closure-
• Ask whether the patient has other issues or concerns
• Summarize and affirm agreement with the plan of action
• Discuss follow-up (e.g., next visit, plan for unexpected outcomes
outcomes
