Rapid Reference to Lifestyle & Behavior Change: Rapid Reference Seriesby Chris Dunn, Stephen Rollnick
Pub. Date: 05/27/2003
Publisher: Elsevier Health Sciences
Each title in the Rapid Reference series provides the reader with authoritative and accessible information from a clinical expert in the field, to assist with treatment decisions. Each title includes standard core content (epidemiology, management, therapy) combined with the additional information-such as FAQs and patient organizations-needed by the primary care
Each title in the Rapid Reference series provides the reader with authoritative and accessible information from a clinical expert in the field, to assist with treatment decisions. Each title includes standard core content (epidemiology, management, therapy) combined with the additional information-such as FAQs and patient organizations-needed by the primary care practitioners to provide effective patient care. The books also include drug listings, clinical trials, information on future developments, and web site listings, to keep the reader up to speed with new developments and to extend their knowledge of the disease area.
Titles in the series focus on chronic conditions seen most often in the primary care setting. With patients becoming better informed about the nature and management of their conditions, Rapid Reference is a timely new series that offers the primary care practitioners easy access to the best information for patient care and management.
• Expert information succinctly written for ease of use.
• Abundant use of bulleted lists and short tables, for quick access to comparative information.
• Presents evidence-based sources for practice where available, either through research or best-practice guidelines.
• Frequently Asked Questions chapter helps practitioners prepare for patient visits and provide better patient care.
• Drugs appendix lists available drugs, with contraindications and side effects.
• Useful addresses and websites appendix provide additional resources for both the physician and patient
Table of Contents
CHAPTER 1: It's a serious problem
• Brief epidemiology and the disease states caused or exacerbated by patient inaction/non compliance leading to a likelihood of diminishing quality of life and life expectancy (with evidence); drug and other therapies available to help behavior change.
CHAPTER 2: Why bother?
• Behaviour change does happen (example of COPD & smoking where the woman stopped years ago after advice). Also, the man who attributes his efforts to quit drinking to when his general practitioner raised the subject of his drinking in a non-judgmental way and merely showed respectful concern. This man quit drinking 10 years later.
• Examples of behaviour change special patient groups and the comorbidity they need to counter (e.g. hypertensive, obese diabetic), the hypertensive antisocial drinker, the COPD afflicted smoker, the promiscuous drug abuser etc: alcohol, drugs, diet/obesity, smoking, limited exercise, stress, promiscuity diabetes and hypertension and COPD.
• Generic skills can be used in all kinds of consultations - examples
• It can make a difference - general comments on evidence for effectiveness of intervention
CHAPTER 3: Making advice work
• Some guidelines on making the best of brief advice-giving.
CHAPTER 4: The skilful consultation
• Analogy of breaking bad news and examples
• Example of script (diabetes script analysis exercise): consider shifts from skilful consultation to breakdown
• Concordant and discordant consulting
CHAPTER 5: Raising the subject & assessing motivation
• Includes assessment of importance and confidence at the heart of this chapter, with some examples.
• Raising the subject: Why take such care in raising the subject? Four ways to raise the subject; ways to structure the session;
• Assessing motivation: Assessing importance & confidence; Assessing desire or readiness to change; Tip for assessing motivation to change;
• Potholes: getting in and out of them: Raising the subject too abruptly; The question-answer-trap; Investigating bad behaviour; quantity is all that matters;
• Chapter summary and references
CHAPTER 6: Exploring the importance of change
• Why? (nobody attempts change unless they will avoid bad or gain good )
• How? (menu of ways to explore importance)
• Potholes to avoid (lecturing with biomedical information to convince patient that it is more important than he/she thinks)
• Dialogue examples
CHAPTER 7: Enhancing confidence to change
• Why? (healthy people don't set themselves up to fail, so must first feel capable.)
• How? (menu of ways to explore and enhance confidence, offer information about successful cases, teach that multiple relapses predicts success, return to scaling questions, e.g "what would it take for you to...")
• Potholes to avoid (seeming glib or condescending about the difficulty of change, cheer-leading)
• Troubleshooting (hopelessness, "I can't change because the entire world has turned against me...")
• Dialogue examples
CHAPTER 8: Relapse & recovering commitment to change
• Why? (almost everybody relapses, relapse is part of change)
• How? (info about relapse being normal, get agreement to try again with slightly different plan.)
CHAPTER 9: Singing from the same sheet: the value of teamwork
• The importance of nurses and doctors taking the same approach to behaviour change, and how to achieve this great idea!
CHAPTER 10: The world of theory & evidence
• A brief summary of models of behaviour change and a brief summary of evidence
• Menu of several session diagrams
• Quick literature review
• Agreement, patient totally hopeless, uncomfortable with being non-directive, given the weight of these issues, patient blames everything else, patient has psych symptoms you don't feel you can handle?
• Some "fine print" elaborating the major points found in the chapters. Some dialogue examples for specific behaviors.
• Websites and other reading material
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