Presentation on theme: "CHANGE Project Università degli Studi di Salerno Dipartimento di Scienze dell'Educazione C are of H ealth A dvertising N ew G oals for E lderly people.............………………"— Presentation transcript:
CHANGE Project Università degli Studi di Salerno Dipartimento di Scienze dell'Educazione C are of H ealth A dvertising N ew G oals for E lderly people.............……………… Application of motivational approach to stimulate the less educated elderly people to improve their lifestyle: guideline to the intervention.............……………… Dr Zuzana Simonova (ASL CE) Dr Domenica Rosaria Marotta (Villa delle Magnolie)
CHANGE Project OUTLINE OUTLINE: How can we motivate the elderly to improve their lifestyle in their eating and walking habits? 1. Understand why people find it difficult to improve their lifestyle ( bio- pshyco-social model) 2. Win over resistance towards change 3. Choose the right intervention for the less educated elderly to substantiate change – different stages of change
CHANGE Project 1.Understand why (1/2) Bio-psycho-social Model (Engel, 1977) Bio-psycho-social Model (Engel, 1977) Take into account the deepest bio-psycho-social reasons to identify: Eating – our primary need (pleasure) which automatically regulates behaviour – lifestyle based on consumerism and pursuit of passive pleasure – overeating = mind representations. Poor exercise – saving on energy, unpleasant emotions, information-education-culture- lack of environmental opportunities = RM CAUSES INTERVENTIIONS to activate willingness. B B PSoc
CHANGE Project MOTIVATIONAL INTERVIEW !!! !!! !!! Professional activity supporting a person to win over difficulties in changing habits!!! Help to solve ambivalence between AUTOMATIC and Willing behaviour. Willingness – ability to make moral choices according to our own frame of values and choose the healthy and effective behaviour for our own well-being. (Wall & Eberly, 2002) Connecting to deep desires (emotions) 1.Understand why – aim of intervention (2/2)
CHANGE Project 2. Breaking resistances (1/3) Six main elements towards exercise: 1. Real or expected benefits 2. Individual approach 3. Encouragement to exercise 4. Constant monitoring 5. Social support 6. Explanation of aims Three elements reducing willingness to change? 1.Unpleasant sensations 2.Forced to exercise/be on a diet 3.Relapsing into old habits (Resnik,B., 2005)
CHANGE Project 2. Breaking resistances – For how long? (2/3) For how long? (2/3) >7 MINUTES – The effectiveness in terms of costs/benefits has been proved in the study GREEN PRESCRIPTION in routine primary health care (Ingaire, K et al. (2005). Is Physical Activity Counseling Effective for Elderly People? A Cluster Randomized, Controlled Trial in Primary Care. J Am Geriatr Soc 53:1951 1956.)
CHANGE Project Establish a relationship which favors intersubjectivity (I know you know how I feel) by means of an empathic and non- judgmental style Achieve a thorough understanding of the situation ( how does the person feel about it ?) Allow the person to get in touch with personal and environmental resources (opportunities as friends, clubs for the elderly, wa likng groups, church…) i n order to improve his/her ability to face the difficult situation 2. Breaking resistances – What to do? (3/3)
Contemplation Determination Action Upkeeping Relapse Precontemplation Definitive Way out 3. The stages of change (1/5) Threshold of change Presence of behaviour Absence of behaviour SPILLER V., SCAGLIA M., CEVA S. Il modello transteorico. Una modalità eclettica di terapia, Bollettino delle Farmacodipendenze e Alcoolismo, 2, XXI, 1998.
Contemplation Determination Action Upkeeping Relapse Precontemplation Definitive way out Keep in touch Evoke awareness and doubts Provide information Understanding ambivalence Examine Pros and Cons Provide feasible opportunities Help to make choices Keep the changes made Prevent relapses Favoring therapy 3. Increase the availability to change (2/5) Spiller, V. et all. 1998
CHANGE Project Mindful Eating: Awareness of physical and emotional sensations associated to eating in the nutritional setting (Framson C. et al,2009;Kabat-Zinn 1990,2005) Exercise… 3. Support techniques to strengthen motivation in the stage of DETERMINATION (3/5)
CHANGE Project Mindful Eating means: 1.Carefully evaluate the link between food and well-being (%) 2.Recognize and appreciate the emotional reaction towards food while in the mouth 3.Taste and recognize the consistency, smell, and other characteristics of food Looking for sensations generated before and after eating 4.Weekly planning of food eating 5.Buying food referring to an apposite shopping list 3. Support techniques to strengthen motivation in the stage of DETERMINATION (4/5)
Bibliography 1. Framson C. et al; Development and Validation of the Mindful Eating Questionnaire. J Am Diet Assoc. 2009 Aug;109(8):1439-44. 2. Ingaire et al. (2005). Is Physical Activity Counseling Effective for Elderly People? A Cluster Randomized, Controlled Trial in Primary Care. J Am Geriatr Soc 53:1951-1956 3. Kabat-Zinn: Full Ctastrophe Living: Using the wisdom of your body and mind to face stress, pain and illness, 1990 4. Kabat-Zinn: Wherever you Go, there you are: Mindfulness Meditation in every day life. New York,Hiperion 1994. 5. Kristeller J et al; An exploratory study of a meditation-based intervention for binge eating disorder. J Health Psychology, 4. 6. Montano A. Mindfulness:guida alla meditazione di consapevolezza; una terapia per tutti. Ecomind, 2007 7. Resnick, B & Spellbring A.M. (2005). Understanding what motivates older adults to exercise. J Gerontol Nurs. 26(3): 34-42 8. Spiller V, Scaglia M., Meneghini S., Vanzo A., Assessing motivation for change toward healthy nutrition and regular physical activity. Valdidation of two set of instruments, Mediterranean Journal of Nutrition and Metabolism (2009), DOI 10.1007/s12349-009- 0044-5. 9. SPILLER V., SCAGLIA M., CEVA S. Il modello transteorico. Una modalità eclettica di terapia, Bollettino delle Farmacodipendenze e Alcoolismo, 2, XXI, 1998. 10. Thich Nhat Hanh. 1992 Vita di Siddharta il Buddha. Astrolabio Ubaldini edizioni. 11. Wall,A.D.,& Eberly, M.2002. Five biblical factors in eating disorder development.
CHANGE Project.............………………… Thanks for your attention.............………………… Dr Zuzana Simonova (ASL CE) Dr Domenica Rosaria Marotta (Villa delle Magnolie) Università degli Studi di Salerno Dipartimento di Scienze dell'Educazione