Behaviour modification for cardiovascular and respiratory health Flashcards
(23 cards)
what is the biopsychosocial approach
How psychological and social factors are involved in disease processes
Psychological consists of behavioural factors and cognitive factors
eg Cardiovascular (24%) and respiratory (20%) diseases are leading causes of death in UK
Strongly influenced by lifestyle
Can have significant psychosocial impacts
what does the biopsychosocial approach involve
lifestyles
psychosocial factors
environments
health services
what is the IMB model
Simplest summary of 3 key elements needed for behaviour change
Components may be multifaceted
info > motivation and behavioural skills > behaviour
what is the TTM
pre-contemplation > contemplation > preparation > action (relapse) > maintenance
what are the components of health promotion
Info/knowledge
Beliefs
Motivation + persistence (to overcome setbacks)
Skills
Plan
Opportunities
Habits (healthy and unhealthy)
Feedback and rewards
Support
Environmental context
how can healthier choices be facilitated by smack, shove and nudge
Smacks eliminate choice eg legislation (smoking ban, drinking age limits)
Shoves restrict choice
Eg fat tax, sugar tax, minimum unit pricing
Eg banning take aways near schools
Central government legislation can improve health and health outcomes
Nudges guide and enable healthier choices
Eg change ‘choice architecture’ to make healthy options more visible, easier, cheaper or the default options = effective ways to change diet
Local government action is important to promote and facilitate healthier lifestyles
what are individual cognitive factors
Contemplation and planning
Identify important cognitive and affective factors
Develop required skills for initiation and maintenance
Eg info,
perceived susceptibility, severity, benefits, barriers (and actual barriers)
attitudes
normative beliefs – descriptive/injunctive
self-efficacy
motivation (and maintenance)
behavioural skills
what are action and maintenance
cues to action (but not just shocking images, boundary conditions and habit)
monitoring progress (rewards to accomplishments, material and psychological
managing relapse
learning from relapse and strengthening skills and motivation
what are multi component interventions
one to one, group and pharmacotheraoy
provide info, motivation (initial and ongoing), skill development and peer support
Stoptober is a population level opportunity to change
how effective are the NHS smoking cessation programmes
Effective for supporting smokers to quit in short and long term
Group interventions may be more effective than 1:1 interventions
Buddy systems may increase effectiveness of 1:1 interventions
Intensity oof intervention appears to be integral to efficacy
what is relapse and recovery like for smokers
Relapse common among smokers who attempt to quit
Evidence strongest for interventions focused on identifying and managing behaviour therapy and strategies
Combing behaviour therapy and nicotine replacement may be most effective
what is psychosocial impact of CVD
Symptoms of depression, anxiety, PTSD distress more likely in those diagnosed with CVD
Psychosocial distress is more likely among people who
Perceive more serious consequences of CVD
Less coherent understanding of their condition
Have stronger initial emotional response to MI or stroke
what did interview based studies find out about the psychosocial impact of CVD
Synthesis of interview based studies revealed that patient finds experience a big change to an unfamiliar identity
They had to find new limits as they sought to achieve a new normal in a lifestyle that was also worth living
Poorer psychological wellbeing predicts
Poorer adherence to medication or behaviour change
Poorer prognosis
how can psychosocial interventions benefit CVD
alleviate stress (and lead to better outcomes) Cultivating resilience and adaptive responses to stressful situations has been identified as a important part of secondary prevention Eg group intervention focused on knowledge, coping skills, stress management, counteracting anxiety and depression, relaxation techniques and improving social relations and social support Reduce likelihood of premature death by 1/3 over a 7 year follow up
Lifestyle and behavioural impact of CVD
Cardiac rehabilitation is effective and cost effective
Reduce overall mortality and cardiac mortality
Patients less likely to attend rehabilitation if:
Less chest pain or other symptoms
Less understanding of their condition
Less belief that their condition is controllable
Lower income
Living alone
Perceive health professionals to downplay importance of exercise
Believe mediation more important for health
Around ½ drop out of rehab programs
how long are lifestyle changes maintained for
65% change to healthier diet but only ½ maintain after a year
60% smokers quit (but only around half stay for a year)
how can risk of relapse be minimised
Plan to minimise risk of relapse
Note that its common
Plan how to manage triggers or temptations
Plan alternative responses
Importance of managing relapse (framing of it and learning from it)
What can cardiac rehab involve
Health promo/education Behaviour change (exercise, smoking, diet) Stress management Psychotherapy for depression or anxiety Support groups
what are SMART goals
Specific Measurable Achievable Relevant/realistic Time Limited
For person who needs to believe that their current behaviour is bad for them, better off if they change or have a good chance of succeeding if they try
what is motivational interviewing
1:1 approach
Helps to overcome ambivalence, enhance commitment and motivation to change, address barriers to change
Facilitating self-monitoring and behaviour change in asthma
Patient centred interventions
Education and skills development – monitoring lung func and triggers
Developing action plans
Modifying unhelpful illness beliefs (eg lack of control)
Less hospitalisation and use of health care and less school/work absences
an example of Interventions being delivered in various ways
Eg tailored text messages that can address illness perceptions and treatment perceptions to boost medication adherence (useful for those who find it hard to engage in face to face and effective and cost effective)
