I’m going to kick right off from where I finished last week – if you haven’t read the preceding blog on lifestyle prescriptions vs action plans I recommend you do so before diving in here!
The health professional ideally needs to be both the ‘expert’ and the ‘coach’ for a patient/client. In an initial consultation the aim is for the professional and the patient/client to work together to agree an agenda for the journey you are embarking on together.
The health care professional will explain their role is to offer a diagnosis and present management options to the patient. In an initial meeting the health professional’s diagnosis to the patient will be shared and a lifestyle prescription offered, acknowledging corresponding potential health benefits if these new behaviours are successfully implemented.
The patient/client’s need to, with the help of the health professional, identify the areas where they are ready and willing to commit to making lifestyle changes. Current areas of progress should be highlighted and encouraged. It is often best to start with behaviours which are easily achieved yet deliver a meaningful difference the patient/client can observe. These quick successes can then be build upon.
Identify the patient/client’s confidence and importance level of each area of lifestyle change. This can be done by asking:
- “On a scale of 0 to 10, how confident are you that you will master these new behaviour/lifestyle changes in the next 3-6 months?”
- “On a scale of 0 to 10, how important is it to you that you can master these new behaviour/lifestyle changes in the next 3-6 months?”
(picture reference: Rollnick S, Manson P, Butler C. Health Behaviour Change, A Guide for Practitioners 2002)
- A score of 7 or above indicates the patient/client being more likely to success in their goal.
- If there score is less than 7, help them to identify ways which would increase their confidence level.
- Correlate their confidence and importance level with the stages of change model discussed in last week’s blog:
- Precontemplation = 0-3/10
- Contemplation = 4-6/10
- Preparation = 7/10
- Action = 8-9/10
- Maintenance = 10/10
Ask the patient/client to summarise their goal, what resources they need to achieve this and how their focus on the goal will be sustained.
Use SMART goals.
Discuss what value the patient will get from the new behaviour change and appropriate strategies to overcome obstacles.
If necessary, sign post to relevant projects, events or programmes which could help them achieve their goal (for example, you could use the LiveWell Activity tracker (can find this by scrolling down on their homepage) if living in or around Dorset), or perhaps you’re a Park Run practice and encourage the patient to join you).
Ensure commitment to the action plan! This could be a handshake or the patient/client signing and dating the written action plan.
Example of an action plan:
|Action plan – strength training|
|How much/intensity?||At a speed I can continue a conversation|
|How long?||5 squats|
|How often?||3 times a day|
|With whom?||With my spouse (and children when they are awake)|
|Where?||In my kitchen|
|When?||When making meals (frequency of new habit matched to when this ingrained behaviour will occur)|
|Support system||My spouse and children performing my new habit with me.|
|Biggest barrier||Feeling tired after work|
|Solution to barrier||Remind myself that squats will help me feel more energised|
I hope giving a distinction between a lifestyle prescription and action plan, along with a brief guide as to how to great an action plan, has helped.
Let me know if it has!