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Compliance/Adherence/Motivation, Patient example: Recent (Andrew F.)…

- - - - How would you like to be viewed by the people you treat?
        
        Important that we step away from the Guru/fixer/intervenor role
    - - Fits a biomed model which if followed exclusively fails to cut the mustard.
    - - Alcoholics Anonymous (Serenity Prayer), commonly quoted as follows: “God grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference.”
    - - Our adive wasn't relevant to their problem
      - Our advive wasnt feasible to fit in with their lives
      - Our advie hasn't helped them
      - They have adopted and want to maintain a patient role
  - - - Identifying
    - - Jack (2010) Barriers to treatment adherence in physiotherapy outpatient clinics: a systematic review
        
        Physical activity levels and exercise
        
        Self-efficacy
        
        Anxiety, depression and helplessness
        
        Social or family support/activity
        
        Pain
      - Domains that can be either facilitators or barriers (Dobson 2016)
        
        Beliefs about capaabilities
        
        Optimimism
        
        Social Identity
        
        Beliefs about consequences
        
        Skills
        
        Reinforcement
        
        Knowledge
        
        Intentions
        
        Goals
        
        Memory, Intention and Decision processes
        
        Environmental context and resources
        
        Social influences
      - Adherence and motivation is much higher if we are:
        
        It is relevant to THEIR problem
        
        The plan is feasible and fits in with their life
        
        Working on our THEIR goals
    - - Think about who you would take a movie recommendation from? Usually a person who knows you well. Someone who has credit in the bank with you. Would you take a movie recommedation from an absolute stranger?
    - - Motivational Interviewing snippets
        
        Motivation is what gets you started habit is what keeps you going.
        
        Check-ins/reviews/modifications
        
        Inspiration/motivation can be fickle in those who are in pain/ on their rehab journeyand often it can be a more achievable task to reduce friction to tee up success.
        
        Habit stacking
        
        Accountability
        
        reducing friction
        
        make it hard to fail
        
        start super small
        
        Prepare for you at your weakest because riding the wave of motivation is transient and unpredictable
        
        elicit/evoke change talk
        
        steps for pre-contemplation stage
        
        Ask permission
        
        steps for contemplation stage
        
        steps for preparation stage
      - Self determination theory (Deci & Ryan, 2000)
        
        Autonomy
        
        Competence
        
        Relatedness
        
        Intrinsic vs extrinsic