Craig Hassed; Week 7 MED1011; HEP
Wellness model is where happiness and health are natural, positively create conditions where that can happen and reducing barriers to this are important. Holistic approach addresses health from where wellness drops to average wellbeing, conventional healthcare addresses drop to illness.
Essence is education, stress management, spirituality, exercise, nutrition, connectedness, environment.
Preventative medicine has primary, secondary and tertiary levels of prevention. Primary is in healthy person, stopping disease process before it is established, by managing risk factors and lifestyle modification (stop smoking, exercise, eat well, social support, good mental health). Secondary prevention is where asymptomatic disease process is underway, slowing progression of disease, includes lifestyle modification but also disease treatment (screening for cancer, treating hypertension). Tertiary is where disease is established, providing rehabilitation and preventing further complications. Primary is most effective but is most difficult and least used.
4 key lifestyle factors for CVD: smoking, BMI <30, 3.5h/wk of physical activity and healthy dietary principles. Ornish program is group support, stress mangement, low fat vegetarian diet, moderate exercise, stopping smoking. Best outcome when employing lifestyle change is combining lifestyle advice with enabling strategies, which allow someone to act on health advice and knowledge. Strategies include stress management and raising awareness, goal setting, improving motivation, working with the cycle of behaviour change and self-efficacy/internal locus of control.
Motivational interviewing is helping client to have motivation, is a quiet and eliciting interview. BASK: Behaviour (what people do), attitudes (what people believe they can do), skills (what people can do), knowledge (what people understand). SMART is specific, measurable, achievable, realistic, timely. Prochaska Di Clemente cycle of behaviour change is pre-contemplation, contemplation, preparation, action, maintenance or relapse. Ask patient questions to identify what stage they are in.