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Assignment Task
 

Written Assessment: You are required to write a formal academic essay. The essay will require an introduction, body, conclusion and reference list. All in-text citations must have a corresponding entry in the reference list.

Purpose: The aim of this essay is to enable students to demonstrate an understanding of and ability to apply the Transtheoretical Model of Change (Stages of Change Model) within an evidence-based framework. In addition to this, students will identify components of Motivational Interviewing which could be utilised to assist with enabling a patient to change their health behaviours.


Daniel is a 35-year-old male who has been admitted to a surgical ward for an ankle fracture repair surgery after falling off a ladder. Daniel is a smoker and has been smoking up to 25 cigarettes per day since he was 15 years old. You are a Registered Nurse working on this ward. It is a non-smoking hospital. You have been allocated to care for Daniel and be his primary care nurse for the next week whilst he is in hospital.
Daniel states to you, “I’ve been worried about my health lately. I smoke up to 25 cigarettes per day and I have noticed that I have started coughing a lot more recently and I get mucous stuck in my throat. I also wheeze and gasp for breath a lot more now when I exercise. I have noticed my health declining due to my smoking; however, I love smoking. It means everything to me. When times are good or times are tough, my smokes are always there for me. Cigarettes make me happy. When I have a night out, I can smoke even more than 25 because it is so social to be smoking with my mates. I know I need to change this, and my GP is encouraging me to address my smoking habits. I want to change. I want to stop smoking and be fitter and healthier. I don’t want to develop emphysema or lung cancer later in life. I have tried to give up in the past, but I wasn’t successful.
Two days ago, my GP informed me that I needed to be admitted to this hospital for surgery on my ankle. I realised this was a non-smoking hospital and I would have to give up smoking, so I purchased Nicorette gum and patches and began using them. I have not smoked now for the
last two days. Can you please help me be successful with quitting smoking whilst I am in hospital and for good?”.
You decide that Daniel is in Stage 4, the Action Stage of the Transtheoretical Model of Change. You decide that you need to use Motivational Interviewing techniques to assist Daniel to cease smoking and move towards Stage 5, the Maintenance Stage of TTM. You are aware that you only have one week to assist Daniel so that he can have better health outcomes and cease smoking forever. In your essay you need to explain how you will do this, whilst backing up your arguments with current research.
The stages of the Transtheoretical Model of Change are:
1. Pre-contemplation – not ready
2. Contemplation – getting ready
3. Preparation – ready
4. Action – taking action
5. Maintenance – monitoring
6. Termination – complete

You will need to:
a) Outline how you will utilise Motivational Interviewing techniques to assist and support Daniel in the Action Stage of smoking cessation and to work towards the Maintenance Stage.
b) Outline what new behaviours Daniel would need to engage in to be successful in the Action Stage and to achieve better health outcomes long term and to reach Maintenance and Termination.
c) Outline what techniques you should avoid using with Daniel as they may have negative impacts and outcomes.
d) Outline the plan for Daniel’s discharge you would organise so that he
1. has ongoing support once he is discharged,
2. can continue to progress in his health behaviour changes, and
3. can eventually reach his goals to the Maintenance and Termination Stages.
Utilise evidenced based literature to support your discussion. For the purposes of this paper, while seminal work (early literature) may be referenced, current literature is a requirement. At least ten references are required in this essay and most should be research articles (reflecting the higher levels of evidence).

 

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