Change is difficult for people, no matter the reason for needing to change. The idea of changing one’s behavior can cause a wide variety of emotions ranging from paralyzing fear to volatile anger. But, when it comes to healthcare, change may be more than medically desirable; it may be a matter of life and death.
To begin to understand how to help patients make the necessary behavioral changes, you must first understand what objections patients may present. Butterworth (2008) identified many reasons people don’t change behavior. These are:
- Their values don’t support it
- They haven’t worked through their ambivalence about it
- They don’t think they can
- They don’t it’s important
- They aren’t ready for it
- They don’t have a good plan
- They don’t have adequate support
All too often when one or more of these objections is presented, the provider will argue the value of the needed change, reiterate the medical advice, and the instructions (Butterworth, 2008). Naturally, the patient will respond with specific reasons why the patient cannot or will not follow the advice; commonly known as the “Yeah-But Dance”, which has been found to be ineffective for change and a predictor of negative clinical outcomes (Butterworth, 2008, p. S22).
A provider can no longer merely “tell the patient what to do” and then deem the patient as “noncompliant” after he or she refuses to make the behavioral change (Huffman, 2014, p. 543). Instead, patients and their family members must be treated as participants in the process (Gruman et. al.,2011).
When providers understand the reasons people don’t change behavior and they’ve created a 50/50 partnership with patients and their family members, what is the next step? Next week’s blog will discuss the strategies!
Butterworth, S. W. (2008). Influencing patient adherence to treatment guidelines. Journal of Managed Care Pharmacy, 14(6 Supp B), 21-24.
Gruman, J.,Jeffress, D., Edgman-Levitan, S., Simmons, L., & Komos, W.A. (2011). Supporting Patient Engagement in the Patient-Centered Medial Home. Center for Advancing Health. Retrieved from http://www.cfah.org/file/CFAH_PACT_WhitePaper_current.pdf
Huffman, M. (2014) Using Motivational Interviewing Through Evidence-Based Health Coaching. Home Healthcare Nurse, 32(9), 543-548.