Reflective Analysis on Diabetes Management Using Motivational Interviewing and Behavioral Models
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Introduction: Reflective Analysis on Diabetes Management Using Motivational Interviewing and Behavioral Models
This assignment's main purpose is to develop a reflection on mock consultations using the Gibbs model (Gibbs,1988).The technique used to conduct the consultation was motivational interviewing (MI), and the format and SMART goals were used. Adaptive SMART stepped-care treatment helps in weight loss and control of diabetes in an effective way through different treatment procedures (Grilo et al. 2020). Also considering the context of biopsychological model use, a brief discussion about the biopsychological model and a critical discussion on the biopsychosocial-spiritual determinants of food choice are taken under focus (Mescouto et al., 2022). Furthermore, theories on health behaviour changes are taken under focus, that helps to understand their importance ((Bosnjak et al. 2019). Along with that, a 15-minute mock consultation video has been provided here.
A healthy, balanced diet provides an effective way to control psychological functioning. It includes fruits, vegetables, milk, whole grains, and fat free food. The six stages of the Transtheoretical model (TTM) describe pre-contemplation, contemplation, preparation, action, maintenance, and termination. The psychology of eating disorders gives rise to different diseases, including diabetes. The TTM model influences changes in health behaviour to reduce the risk of diabetes (Cleveland Clinic, 2023). Diabetic patient have to follow several restrictions yet the psychological state of the individual affected by diabetes have a tendency towards eating more sweets. They found difficulties in compiling with the dietary regime and exhibit restrictive eating behaviour. Diabetic patients express a feeling of dietary deprivation and rigid dietary control to maintain weight management and proper diet. Stress, boredom, anxiety, or prolonged feelings of joy influence the eating behaviour of human beings and increase the risk of diabetes. Studies reflect that diabetic patients are 2-3 times more likely to have depression than people without diabetes (CDC, 2023). Different therapy and medicines are used to treat diabetes, along with diet control and exercise.
Biopsychosocial and spiritual determinants of food choice
The biopsychosocial model helps to understand any individual's medical conditions in the context of biological, psychological, and social factors. This model is especially useful for the chronic pain experiences of patients with an understanding of their psychophysiological and behavioural patterns (Mescoutoet al., 2022). Is a method used by health care professionals to change the client's mentality regarding to food behaviour.
Food and food choices are the modern approaches and typical central components for management of health problems, including coronary heart disease, diabetes, and any other type of food-related disease. The Food Standards Agency (FSA) defines food choice as the food selections for consumption, that is affected by the contesting, supporting, and interacting influences of various factors (Stalls, 2020, p 101). Besides that, it is influenced by local, global, regional, and national agriculture, business, the environment, economy, and culture. A personal client’s relationship with the environmental, economic, and social impacts, including the food variety and the actions of the food industry to encourage them, depends, to a degree, on the client’s sensorial, psychological, and physiological reactions to food. Food choices affect the health as well as individuals' well-being, communities, and families.
This report shows the expected growth of diabetic patients in future. The brain is the primary regulator of satiety signals and expresses energy levels On the other hand body fat level are indicated by the adiposity index. Satiety signals such as “peptide cholecystokinin” help activate neuronal circuits that provide instruction for prohibiting eating (Mukhtar, 2023, p. 93–101). Along with that, several factors can influence food choices, such as hunger, appetite, taste, income availability, cost., education, skills, time, access, culture, family meal pattern and peers, and family and cultural influence.
Personal and social factors
During childhood, irregular food and food deprivation availability have been shown to contribute to the development of inadequate eating behaviours such as emotional attachment towards food or overeating, as well as less healthy food choices in general. Early food poverty in youth and related perspectives and manners towards meals is collaboration between adult obesity and childhood poverty that acts as potential mechanisms. Cultural ideals can also influence the food choices of individuals. Along with that, family's structure is also responsible for food choice.
Richman (2022) stated that in some reports, it has been established that family member and children can influence an individual's food choices, procuring decisions, and food preparation decisions. With the decline of financial resources and food security, low- to medium-income people are choosing quantity and price over Quality and choice. In this context, poverty is another factor that influences food choices, as several families belong below the poverty level. They are always trying to adopt a strategy for attending such types of events in that free food can be delivered or food can be sold at low prices or old and discarded food can be provided to them.
Besides that, some are adopting specific strategies over nutritional quality food by including prioritising meat rather than other types of nutritious food such as fruit or vegetables. This is due to their financial limitations or trying to save more. In another report, it was established that children's influence on food choices is due to their mother's consumption. Family diet is also affected by the family remembering the choice. On the contrary, Loos, and Yeo (2022) stated that young adults are taking more nutritious food, including vegetables and food. Stress can also change food choices, as it can shut down appetite.
Employment status
Work-life has also had an influential impact on their food choices, as low- or medium-wage workers work for long hours, shift work, and have inflexible schedules, as well as multiple jobs that have a huge impact on their energy and time. And as per their time management, they must choose food. This is unsatisfactory for balancing diet food as they are eating takeout meals, eating at restaurants, skipping meals and many more (Winpennyet al. 2020). Those workers who are working in a flexible time have enough time to fulfil their responsibility to their families and meet their family needs. In this, they are including cooking skills and planning. On the other hand, working mothers who are working full time are spending less time cooking, preparing less food or making those types of food which can be made quickly. Education has also an effect on food choice, as few people know about proper diet (de Castro et al. 2019). In several studies, it has been found that a lack of knowledge leads towards unhealthy food habits.
Theories for health behaviour change
Theory of Planned Behaviour
The Theory of Planned Behaviour helps to make assumptions about the individual's actions that are according to their behaviours, attitudes, perceived behavioural control and subjective norms. This theory helps an individual to correlate with individual’s intentions and behavioural engagements (Bosnjaket al. 2019). Through this, it can be understood that individual can react to different scenarios and different settings. That helps the practitioner to understand the resources of barrier existences and proper approaches for encouraging individuals' behavioural change. This theory takes the strategy of helping in programming the implementer's design investments that help in identifying a participatory behavioural approach of an individual (Yurievet al. 2020). However, this theory does not consider other types of variables such as behavioural factors, motivations and intentions that include individuals' moods, threats, fear, past experiences, joy and many more.
Motivation to facilitate dietary changes
Motivation is an important factor that helps facilitate dietary changes. Understanding the concept with the help of theories that can be aligned with the situation will be beneficial. This will help to have clear measures regarding the change in healthy eating habits. The theory that can be aligned with the situation is the Self-determination theory (SDT), as every individual has three basic psychological needs, including autonomy, competencies, and relatedness (White et al., 2021). These three needs are considered to enhance dietary changes by changing self-behaviour towards dietary needs. The theory also states that these needs are the key areas that need to be fulfilled to increase the motivation of a person. This implies that the persons should be provided with a sense of choice for controlling their dietary choices. There can be promotion of education that generates a sense of social well-being and support.
The theoretical model (TTM) of behaviour change that states there is a need to frame strategies to support the individuals with every step towards their behavioural changeconsists in six stages, each stage requires a different technique or strategy,precontemplation,preparation,action ,maintenance and termination (Jiménez-Zazoet al. 2020).
Another theory that can be aligned with the need to promote motivation to facilitate dietary changes is the Health Belief Model(HBM) (Jose et al. 2021). This theory suggests that there is a need to be aware the persons with the severity of the illness that can be mitigated with the change in behaviour. This will help the individual to analyse the barriers to behaviour change to mitigate those and indulge a sense of motivation to get engaged in the healthy behavioural approach. This implies that there is a need to access the change in behaviour of the individuals facing any health-related difficulties. This will help to provide an accurate solution to the individual for addressing the changes that are required to be accomplished to lead a healthy life.
Reflection of mock consultation
This reflection was made using the Gibbs cycle, which is the most common model of reflection (Gibbs, 1988). This fifteen-minute mock consultation took place at UCBroom MH342 on April 22, 2023, at 13.30.In her presence was the nutritionist, with the support of a colleague who was the observer and the client.The reason for the appointment was all about dealing with a patient with a family history of diabetes. I was extremely nervous because I did not preparemy case study very well, because I had some family issues. Also, because this is a very sensitive subject, I observed the client was also a bit nervous at the start. But during she was more relaxed.
Description: Individuals take foods according to their moods and feelings. The patient has prepared a three-day food diary that contains an increased amount of sugar and fat. There is lack of fruits and vegetables as a result, I was bound to try the biopsychosocial model. This model has been selected by me as it helps to have a clear understanding of human health and illness not only based on biological factors but also focusing on the psychological and social factors (Doyle, 2020). This model is termed to be the recreation of the biomedical model that only focuses on the biological factors.
Feelings: Emotions of the individual significantly create an impact on food preferences and eating behavior. This approach promotes more accurate information regarding the health condition of a patient (Adeani et al. 2020). This has helped me to recognise that the individual dealing with diabetes might have other reasons apart from biological aspects that can be the social and psychological aspects including the stress, living standards, and lack of social support.
Evaluation: Unhealthy diet and irregular food intake create a negative impact on both the physical and psychological health of an individual. This also helped me to understand the complexity of human health and illness more clearly and precisely. This model is particularly helpful in curing chronic illnesses (Engel, 1977). Hence, I believe that there is a need to make the patient understand the benefits of having the right choice with the health conditions. The patient is trying to defend the inefficient habit related to the bad food eating habits that are not beneficial to their health. The main motive of the patient is to deny the benefits showing less interest towards healthy food eating habits (Raihan et al. 2023). Dealing with all these information, I have proceeded with a fifteen-minute mock consultant.
Furthermore, using the transtheoretical model (TTM) the most common model with six steps used to understand human behaviour. I have analysed that the patient is in the stage of pre-contemplation that is the stage whereby an individual is not able to understand the difference between the best suitable conditions for their health benefits.
Analysis: People preferred unhealthy food more and thus it create an impact on psychological status. I have started the consultation with an introduction of mine and based on the answers provided by the patient I have made a report based on the requirements of the patients that is needed for curing the illness. To have a clear understanding I interrupted the patient sometimes and asked counter questions for the statement provided by the patient. I have done this to bridge the communication gap between me and the individual to create a sense of belongingness (Rivas et al. 2019). I have found that the patient was overweight according to the BMI indexes a measure that health professionals use to determine the healthy weight or not of the client (NHS, 2022). I later realised failed to explain to her what is BMI also the values to reach my conclusion.
Conclusion: Healthy diet helps to control the psychological balance of human beings. In conclusion, should prepare better my interview techniques and improve my communication skills.
Action plan: A balanced diet influences the psychology of eating behavior to overcome and fight against different diseases. I think that I successfully explained to her the different types of diabetes to her. In evaluation, I believe that overall was a great experience. I was confident on my consultation but had some negatives the consultation was rushed and unplanned.
The next consultation was booked I will take deep breaths to relax, study better the client medical history and allocate more time 20 minutes and have some leaflet ready.
Below stated is the SMART objective plan that is necessary for handling a patient with care and in this case, there is a need to make the patients understand with the consequences if they are not able to deal with their health illness.
S (SPECIFIC)
M (MEASURABLE)
A (ATTAINABLE)
R (REALISTIC)
T (TIMEBOUND)
To understand the health and safety processes in dealing with the patient
Related to health and safety measures implemented for the patients for evaluation of risk
This objective is attainable with procedures and design preventing measures for the patients
Terms, tools, methodologies, and techniques to prevent occurrences of unsafe operations at the time of handling the patients with care (Longmore et al. 2020).
Within a period of 1 month, these objectives can be achieved
Table 1: SMART objectives
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Conclusion
Concluding with the study it can be said that there are different sets of factors that affect the choice of food that are involved in the biopsychosocial-spiritual determinants. These determinants are said to be involved with the biological factors such as the genetic factors, psychological factors as well as social factors. There is an urge to have a clear conception of the factors to frame effective mitigation measures that will help in enhancing the healthy eating behaviour. In addition, the theories that have been stated regarding the changes for improving health behaviour are supposed to form a framework that will help in understanding the way of making decisions among the individuals. This will also help in analysing the different possible solutions for enhancing the interventions that facilitate change in behaviour. Overall, it can be said that there is a need to consider the biological, psychological, social, and spiritual aspects of an individual towards exercising behaviour change.
References
Journals
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Book
Bolton, D. and Gillett, G., 2019. The biopsychosocial model of health and disease: New philosophical and scientific developments (p. 149). Springer Nature.
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