Motivating your patients to make positive lifestyle changes. Stephen Neabore, MD - Barnard Medical Center Washington, DC

Transcription

1 Motivating your patients to make positive lifestyle changes Stephen Neabore, MD - Barnard Medical Center Washington, DC

2 Motivation Motivation is the art of getting people to do what you want them to do because they want to do it. Dwight D. Eisenhower, 1954 ***Full disclosure: Eisenhower library actually quotes this as Leadership instead of Motivation

3 Stephen Neabore, MD New York University BA, Psychology EMT, Paramedic, Firefighter: NYC Medical School: St. George s University Residency: NY Methodist Hospital, Brooklyn, NY Weight management clinic Barnard Medical Center Board Certified, Internal Medicine Endurance sports; scuba diving

4 Why Motivate? From Latin movere: to move We have the knowledge & position Patients looking for change Guidance and leading by example Determine path to success We help our patients move

5 Who motivates us? Parents and family Teachers Athletes Doctors, nurses, dietitians, other health professionals Personal trainers

6 Motivation -> Action The path to success is to take massive, determined action. Tony Robins

7 Big steps! Smokers who completely abstain from cigarettes have greater and longer lasting success than those who try to gradually wean. Lindson-hawley N, Banting M, West R, Michie S, Shinkins B, Aveyard P. Gradual Versus Abrupt Smoking Cessation: A Randomized, Controlled Noninferiority Trial. Ann Intern Med. 2016;164(9):

8 Know yourself and your patient What we can or cannot do, what we consider possible or impossible, is rarely a function of our true capability. It is more likely a function of our beliefs about who we are. Tony Robbins

9 Know Your Audience Patient alone or with friend / family Is family supportive? How does the patient view his or her current state of health? Poor health and needs major help Good and looking to fine tune Does this align with your impression? Health trends throughout life

10 Purpose What are the patient s goals? What are your goals for the patient? Remember: Not everyone is open to changes in lifestyle or may not be ready right now

11 Purpose If you could change one thing right now, what would it be? What have you tried? What has worked for you in the past? What has not worked for you? What have you not tried but think might be effective?

12 Purpose How do we align patient goals with improved health? External support is a MUST! Family, Friends, Coworkers, Church, etc.

13 The Simple 7 Stop smoking Eat better Get active Lose weight Reduce blood sugar Control cholesterol Manage blood pressure

14 Dr. Steve s Additional Two Keep stress low Daily mindfullness, meditation, breathing exercises, visualizations, journaling Get adequate sleep Sleep study to rule out sleep apnea if needed

15 Jang BG, Conradi K, Mckenna MC, Jones JS. Motivation. The Reading Teacher. 2015;69(2): doi: /trtr.1365.

16 Attitude A set of acquired feelings about [an activity] that consistently predispose an individual to engage in or avoid [the activity] How much do you like? Jang BG, Conradi K, Mckenna MC, Jones JS. Motivation. The Reading Teacher. 2015;69(2): doi: /trtr.1365.

17 Attitude Has this person tried various lifestyle changes in the past? What have been his / her experiences? Are changes associated with higher levels of stress? Does the person need close guidance?

18 Interest A positive orientation toward a particular topic Why are you interested in this? What aspects do you find the most interesting? *Interest can counteract a negative attitude* Jang BG, Conradi K, Mckenna MC, Jones JS. Motivation. The Reading Teacher. 2015;69(2): doi: /trtr.1365.

19 Interest Focus on topics of interest: Exercise Eating with family and friends Learning new recipes Feeling better Improved weight, cholesterol, etc.

20 Value An individual s beliefs about the extent to which an activity is generally useful, enjoyable, or otherwise important Is it important for you to be good at this? Jang BG, Conradi K, Mckenna MC, Jones JS. Motivation. The Reading Teacher. 2015;69(2): doi: /trtr.1365.

21 Value Is a change in lifestyle worth it? Do you have the time and / or resources? What would it mean for your future? Does the person acknowledge the value of improved lifestyle? **Invest in your health**

22 Self-efficacy An individual s judgment of his or her ability to accomplish a specific task How well do you think you are doing this task? What are your chances of success? Jang BG, Conradi K, Mckenna MC, Jones JS. Motivation. The Reading Teacher. 2015;69(2): doi: /trtr.1365.

23 Self-efficacy Does the person prefer to work things out by himself or herself? Consider health coaching Recurring classes or dietitian meetings Online communication Phone calls

24 Self-concept An individual s overall self-perception as someone performing the activity, including his or her sense of competence and the role ascribed to this activity as a part of his or her personal identity Ex: Do you think of yourself as a? Jang BG, Conradi K, Mckenna MC, Jones JS. Motivation. The Reading Teacher. 2015;69(2): doi: /trtr.1365.

25 Self-concept Preconceptions a person has about himself or herself in relation to the task Shaped by prior experiences ** I ve [lost weight, improved my diet, stopped smoking, etc.] in the past so I know I can do it again **

26 Goal An individual s orientation and intentions toward the task; the primary reason(s) an individual performs this task Example: Why are you doing this? Jang BG, Conradi K, Mckenna MC, Jones JS. Motivation. The Reading Teacher. 2015;69(2): doi: /trtr.1365.

27 Goal What is your goal? Family and friends may have own goal for person How will we know when you have achieved the goal? What happens next? How will you maintain your success? Jang BG, Conradi K, Mckenna MC, Jones JS. Motivation. The Reading Teacher. 2015;69(2): doi: /trtr.1365.

28 Additional points Listen to your patient Frequent followups What is working? What is not working? Extra resources Websites Health coaches and personal trainers Mental health professionals

29 Summary Motivation is key Take time to discuss goals and motivation at every visit Use motivation to help patients reach goals Make use of any and all outside resources Be a cheerleader and encourage your patients whether they are achieving goals or struggling

30 Thank you!