Behavior Change and Active Listening Concepts

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Questions and Answers

Which of the following statements best describes the contemplative stage of behavior change as outlined by Prochaska and DiClemente?

  • Determination
  • Integration of behavior change into a person's life
  • Struggling with ambivalence (correct)
  • None of the options above

Which of the following behaviors are part of active listening?

  • Maintain eye contact
  • Nodding and making eye contact.
  • Asking for clarification
  • All of the above (correct)

What would be the best physician response to elicit a change talk in the following situation? Physician: "How confident are you on a scale of 0 to 10 that you can make this change?" Patient: "About a 4."

  • You've got some confidence, but not a lot. (correct)
  • Why are you a 4 and not a 0?
  • So, you're about a 4
  • Why are you not a 10?

Which of the following statements is correct according to the James-Lange theory of emotion?

<p>Physiological arousal of the body occurs before the conscious interpretation of an emotion. (C)</p> Signup and view all the answers

Which is NOT part of active listening?

<p>Give advice (C)</p> Signup and view all the answers

When someone incorrectly believes he or she is receiving a real treatment and reports an improvement in his or her condition, it is called...

<p>Placebo effect (D)</p> Signup and view all the answers

Among the different stages characterizing the mechanism for changing risky health behaviors, Pre-contemplation is when:

<p>The patient experiences health related issues but has not gone to see the physician, yet. (C)</p> Signup and view all the answers

Within the framework of motivational interviewing as explained in class: when a physician argues that a patient's behavior needs to change, the patient often responds by:

<p>Arguing against change. (B)</p> Signup and view all the answers

Which of the following is NOT consistent with the Motivational Interviewing approach?

<p>Confronting denial (B)</p> Signup and view all the answers

Physician's statement #h represents

<p>None of the options above (C)</p> Signup and view all the answers

What causes autism?

<p>There is no single cause of autism (D)</p> Signup and view all the answers

According to the Cannon-Bard theory of emotion,

<p>there is a different pattern of physiological activity for each emotion. (C)</p> Signup and view all the answers

Which of these is an unconditioned stimulus?

<p>Shock (C)</p> Signup and view all the answers

When would you use closed questions?

<p>When you do not want the person to keep talking (A)</p> Signup and view all the answers

The Motivational Interviewing approach is:

<p>Directive but patient-centered (D)</p> Signup and view all the answers

Which of the following is NOT a Motivational Interviewing-consistent strategy for handling resistance?

<p>Argument (E)</p> Signup and view all the answers

Self-efficacy is:

<p>The belief that you will be able to accomplish a specific task (C)</p> Signup and view all the answers

Which of the following is NOT considered a source for self-efficacy?

<p>Genetic predisposition (C)</p> Signup and view all the answers

The statement, "You're very determined, even in the face of discouragement. This change must really be important to you." is an example of

<p>Affirmation (B)</p> Signup and view all the answers

Patient-Centeredness is best defined as:

<p>Providing care that is respectful of and responsive to individual patient preferences, needs and values (A)</p> Signup and view all the answers

Paralanguage or paraverbal communication refers to:

<p>The vocal messages of pitch, rate, and loudness. (A)</p> Signup and view all the answers

When a patient expresses anger about a physician’s colleague, which of the following statements would be the most appropriate response?

<p>Tell me what concerns you have and how you were treated (D)</p> Signup and view all the answers

Empathic understanding is which ONE of the following?

<p>Empathic understanding is the ability to feel with patients, as opposed to feeling for patients (C)</p> Signup and view all the answers

In patient-doctor communication, what is the difference between reflecting and paraphrasing?

<p>Reflecting is when you repeat back word for word while paraphrasing means you change it slightly (C)</p> Signup and view all the answers

Negative reinforcement can be defined as: Stimulus ____ response, which ____ the future probability of that response.

<p>Removed, increases (A)</p> Signup and view all the answers

In which of the following conditions involving the use of placebos have NO real changes been detected in the patient

<p>Parkinson’s (A)</p> Signup and view all the answers

First Impressions are based on the following three items:

<p>Appearance, Presentation, Dress (B)</p> Signup and view all the answers

Which is NOT a principle of nonverbal communication?

<p>Nonverbal communication is ambiguous. (A)</p> Signup and view all the answers

Learning by trial and error is called

<p>Operant conditioning (D)</p> Signup and view all the answers

One difference between verbal and nonverbal communication is that verbal communication is

<p>Usually continuous. (D)</p> Signup and view all the answers

You visit a new friend for the first time and as you enter his apartment his cat hisses and jumps on you from above the doorway. This happens for several nights. Then one evening you come in for a visit and at the sound of the cat's hiss you jump briskly to one side and the cat lands on the floor next to you. The cat's hiss is the:

<p>Unconditioned stimulus (C)</p> Signup and view all the answers

Flashcards

Erythrocyte Sedimentation Rate (ESR)

A type of blood test that measures the rate at which red blood cells settle to the bottom of a test tube. It is a non-specific test that can be elevated in a variety of conditions, including inflammation, infection, and cancer.

Ceruloplasmin

A protein that carries copper in the blood. It is essential for the function of several enzymes, including those involved in iron metabolism.

Metabolic Acidosis

A condition in which the body's pH is too low. This can be caused by a buildup of acid in the blood, such as from kidney failure, diabetes, or starvation.

Respiratory Acidosis

A condition in which the body's pH is too low due to a buildup of carbon dioxide (CO2) in the blood. This can be caused by problems with breathing, such as emphysema, pneumonia, or asthma.

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Metabolic Alkalosis

A condition in which the body's pH is too high. This can be caused by a loss of acid from the blood, such as from vomiting or prolonged diarrhea.

Signup and view all the flashcards

Respiratory Alkalosis

A condition in which the body's pH is too high due to a decrease in CO2 in the blood. This can be caused by hyperventilation, such as from anxiety or panic attacks.

Signup and view all the flashcards

Aspartate Transaminase (AST)

A type of liver enzyme test that is often used to evaluate liver function. It is released from damaged or diseased liver cells. Elevated AST levels may indicate problems with the liver, such as hepatitis, cirrhosis, or cancer. AST is also known by the alternative name GOT (Glutamate-Oxaloacetate Transaminase).

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Alanine Transaminase (ALT)

A type of liver enzyme test that is often used to evaluate liver function. It is released from damaged or diseased liver cells. Elevated ALT levels may indicate problems with the liver, such as hepatitis, cirrhosis, or cancer. ALT is also known by the alternative name GPT (Glutamate-Pyruvate Transaminase).

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Alpha-Fetoprotein

A type of protein that is produced by the liver and other tissues. It is elevated in blood during pregnancy or in some types of cancer, especially liver cancer. It is also known by the alternative name AFP (Alpha-Fetoprotein).

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Uric Acid

The final product of the breakdown of purines, which are a type of nitrogenous base found in DNA and RNA. Elevated uric acid levels in the blood can cause gout, a painful inflammatory condition that affects the joints.

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Direct Bilirubin

A form of bilirubin that is conjugated with glucuronic acid. This form of bilirubin is water-soluble and can be excreted in the urine.

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Indirect Bilirubin

A form of bilirubin that is not yet conjugated with glucuronic acid. This form of bilirubin is fat-soluble and cannot be excreted in the urine.

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Metabolic Acidosis

A condition in which the body's pH is too low due to a buildup of acid in the blood. This can be caused by a buildup of acid in the blood, such as from kidney failure, diabetes, or starvation.

Signup and view all the flashcards

Respiratory Acidosis

A condition in which the body's pH is too low due to a buildup of carbon dioxide (CO2) in the blood. This can be caused by problems with breathing, such as emphysema, pneumonia, or asthma.

Signup and view all the flashcards

Metabolic Alkalosis

A condition in which the body's pH is too high. This can be caused by a loss of acid from the blood, such as from vomiting or prolonged diarrhea.

Signup and view all the flashcards

Respiratory Alkalosis

A condition in which the body's pH is too high due to a decrease in CO2 in the blood. This can be caused by hyperventilation, such as from anxiety or panic attacks.

Signup and view all the flashcards

Metabolic Acidosis

A condition in which the body's pH is too low due to a buildup of acid in the blood. This can be caused by a buildup of acid in the blood, such as from kidney failure, diabetes, or starvation.

Signup and view all the flashcards

Respiratory Acidosis

A condition in which the body's pH is too low due to a buildup of carbon dioxide (CO2) in the blood. This can be caused by problems with breathing, such as emphysema, pneumonia, or asthma.

Signup and view all the flashcards

Metabolic Alkalosis

A condition in which the body's pH is too high. This can be caused by a loss of acid from the blood, such as from vomiting or prolonged diarrhea.

Signup and view all the flashcards

Respiratory Alkalosis

A condition in which the body's pH is too high due to a decrease in CO2 in the blood. This can be caused by hyperventilation, such as from anxiety or panic attacks.

Signup and view all the flashcards

Metabolic Acidosis

A condition in which the body's pH is too low due to a buildup of acid in the blood. This can be caused by a buildup of acid in the blood, such as from kidney failure, diabetes, or starvation.

Signup and view all the flashcards

Respiratory Acidosis

A condition in which the body's pH is too low due to a buildup of carbon dioxide (CO2) in the blood.

Signup and view all the flashcards

Metabolic Alkalosis

A condition in which the body's pH is too high. This can be caused by a loss of acid from the blood, such as from vomiting or prolonged diarrhea.

Signup and view all the flashcards

Respiratory Alkalosis

A condition in which the body's pH is too high due to a decrease in CO2 in the blood. This can be caused by hyperventilation, such as from anxiety or panic attacks.

Signup and view all the flashcards

Hemophilia

A condition in which there is a decreased production of coagulation factors, leading to a tendency to bleed easily.

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Von Willebrand Disease

A genetic disorder that affects the ability of the blood to clot properly. It is caused by a deficiency or abnormality in von Willebrand factor, a protein that helps platelets stick together and to blood vessel walls. This results in easy bruising and prolonged bleeding, especially after surgery or injury.

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Respiratory Acidosis

A condition in which the body's pH is too low due to a buildup of carbon dioxide (CO2) in the blood. This can be caused by problems with breathing, such as emphysema, pneumonia, or asthma.

Signup and view all the flashcards

Metabolic Acidosis

A condition in which the body's pH is too low due to a buildup of acid in the blood, such as from kidney failure, diabetes, or starvation.

Signup and view all the flashcards

Metabolic Alkalosis

A condition in which the body's pH is too high due to a loss of acid from the blood, such as from vomiting or prolonged diarrhea.

Signup and view all the flashcards

Respiratory Alkalosis

A condition in which the body's pH is too high due to a decrease in CO2 in the blood. This can be caused by hyperventilation, such as from anxiety or panic attacks.

Signup and view all the flashcards

Thrombophilia

A condition in which the ability of the blood to clot is increased abnormally, which increases the risk of blood clots forming in the blood vessels.

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Prothrombin Time (PT)

A type of blood test that measures the time it takes for blood to clot. It is often used to monitor patients who are taking anticoagulants, which are medications that thin the blood and prevent blood clots from forming.

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Partial Thromboplastin Time (PTT)

A type of blood test that measures the time it takes for blood to clot. It is often used to monitor patients who are taking anticoagulants, which are medications that thin the blood and prevent blood clots from forming.

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Fibrinogen

A type of blood test that measures the level of fibrinogen in the blood. Fibrinogen is a protein that is essential for blood clotting.

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D-Dimer

A type of blood test that measures the level of D-dimer in the blood. D-dimer is a fragment of fibrin that is produced when a blood clot breaks down.

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Creatinine

A type of blood test that measures the level of creatinine in the blood. Creatinine is a waste product that is produced by the muscles. Elevated creatinine levels in the blood can indicate problems with the kidneys.

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Creatinine Clearance

A measure of how well the kidneys are filtering waste products from the blood. It is calculated by measuring the amount of creatinine in the urine and blood.

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Glucose

A type of blood test that measures the level of glucose in the blood. Glucose is a type of sugar that is the body's main source of energy.

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Albumin

A type of blood test that measures the level of albumin in the blood. Albumin is a protein that is essential for maintaining fluid balance in the body and for transporting nutrients and hormones.

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Study Notes

Contemplative Stage of Behavior Change

  • Outlined by Prochaska and DiClemente
  • Characterized by struggling with ambivalence
  • Not determination or integration into a person's life

Active Listening Behaviors

  • Maintaining eye contact
  • Nodding and making eye contact
  • Asking for clarification
  • Combining all the above

Physician Response for Change Talk

  • Eliciting a change talk from the patient
  • Effective response to a patient expressing confidence level of 4 out of 10: "You've got some confidence, but not a lot" or "Why are you a 4 and not a 0?". "Why are you not a 10?"

James-Lange Theory of Emotion

  • Physiological arousal precedes the conscious interpretation of emotion
  • Not abolishing physiological arousal, as that still results in signs of emotion, nor that autonomic nervous system responding the same to all types of emotion.

Active Listening Essential Parts

  • Looking at the person
  • Encouraging the person to talk
  • Using empathy
  • Not giving advice

Placebo Effect

  • When someone incorrectly believes they are receiving treatment, and reports improvements

Precontemplation Stage of Behavior Change

  • A stage of changing risky health behavior
  • The patient expresses health concerns but is yet to consult a doctor.
  • A patient demonstrates awareness of a reason to change a risky health behavior and a reason for not changing it.

Motivational Interviewing Patient Responses

  • A patient often responds to physician arguing for change by arguing against change and not by accepting the need to change.
  • Other possible reactions include seeking or requesting advice; or progressing to the next stage of change.

Motivational Interviewing Approach

  • Rolling with resistance is a strategy
  • Avoiding argumentation is a strategy
  • Supporting self-efficacy (confidence in ability to change) is a strategy
  • Not confronting denial is a strategy

Cannon-Bard Theory of Emotion

  • Physiological changes in the body and emotional experience occur simultaneously
  • A different pattern of physiological activity does occur for each emotion, not the same, in exactly the same way

Unconditioned Stimulus

  • A stimulus that elicits a response without prior learning. Not shock, money, or music; rather, something that triggers an innate response

Closed Questions in Motivational Interviewing

  • Use them when you don't want the person to keep talking
  • Or to help gather specific information from a client; avoid use when the client has difficulty breathing, understanding the speaker, or when they feel the interaction is too forceful or unwelcoming

Motivational Interviewing Approach in Class

  • Primarily educational, directive, yet patient-centered

Principles of Nonverbal Communication

  • It is possible not to communicate nonverbally
  • Nonverbal communication occurs even if no words are used
  • Nonverbal communication is ambiguous
  • Nonverbal communication is bound to culture

Learning By Trial And Error

  • Classical conditioning, operant conditioning, a type of learning where a person's behavior is changed by reinforcement

Verbal vs. Nonverbal Communication

  • Verbal communication is usually deliberate
  • Nonverbal communication is often multidimensional/unintentional by the speaker, whereas verbal communication is usually deliberate in a speaker
  • Verbal communication is continuous; nonverbal communication can be in discrete segments

Classical Conditioning

  • A key element of classical conditioning and a form of associative learning
  • A stimulus that produces an automatic response (the unconditional stimulus) pairs with a neutral stimulus.
  • Eventually, the neutral stimulus gains the ability to produce the response (which it did not do previously but now does due to the pairing) (the condition stimulus). This new response to the neutral stimulus is known as the conditioned response.

Conditioned Stimulus

  • A previously neutral stimulus that, after association with an unconditioned stimulus, comes to trigger a conditioned response. The unconditioned stimulus comes first, always; the conditioned stimulus is the neutral stimulus that learns to illicit a response following association with the unconditioned stimulus

Conditioned Response

  • The learned response to a previously neutral stimulus.

Unconditioned Stimulus

  • A stimulus that naturally and automatically triggers a response.

Unconditioned Response

  • An unconditioned response is the natural, innate response to a stimulus that does not need to be learned

Patient-Centeredness

  • Respecting the patient's preferences, needs, and values.
  • Providing care that is sensitive to the patient
  • Evidence-based medicine with patient's needs (and values) integrated appropriately.
  • More holistic healing and less emphasis on conventionally-prescribed treatment
  • The philosophy that focuses more on holistic healing and less on conventional medicine

Paralanguage or Paraverbal Communication

  • The methods of vocal communication such as tone, rate, and loudness of voice

Physician Response to Patient Anger

  • Listen to the patient's concerns and complaints (without interrupting)
  • Inquire as to the patient's concerns (with a quiet, patient tone) and show that you are hearing and acknowledging them
  • Ask the patient how the situation was handled or treated or what actions or suggestions have been put forth to improve it
  • Avoid judgment.
  • Avoid defensiveness/resistance to the complaint.
  • Emphasize that you want to hear the details of the situation and the experience of the patient—not necessarily just the outcome.

Empathic Understanding

  • Understanding the patient's perspective, conveying genuine concern and care, not just passively hearing what they say, but engaging with their experience and feelings.
  • Understanding what is not explicitly said is also a part of genuine empathy.

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