Trans theoretical Model and Motivational Interview in Nursing

This essay examines the application of the Trans theoretical Model (TTM) and motivational interviewing in nursing, using a case study of Harry, a 58-year-old man facing hip replacement due to being overweight. The essay details the TTM's stages (pre-contemplation, contemplation, preparation, action, maintenance, and termination) and how they apply to Harry's behavior change regarding his eating habits. It explores cognitive, affective, and evaluative processes crucial for change, including awareness, emotional connection, self-determination, and social influences. The role of health professionals in employing motivational interviewing techniques, such as active listening and empathetic communication, is emphasized to guide Harry toward healthier habits. The essay concludes by highlighting the significance of motivation and the TTM in fostering positive behavioral changes for patients facing health challenges.

RUNNING HEAD: Bachelor Of Nursing
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Trans theoretical Theory Of Change And Motivational Interviews

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This essay is based on the given case study of Harry, an old man in the age of 58 years he is
facing the hip problems and admitted for the hip replacement. After the deep observation and
examination based on the previous case study and a communication with him the main issues
found for the hip issues was his physique with the overweight that is 165 kg. This essay is the
detailed study to apply the Trans theoretical model to study the behaviour of the Harry to
accept the change and the motivational questionaries’ to make the effective efforts according
the model and the behaviour of Harry to introduce and accept the change to improve the
habits of related to heath stay healthy in order to avoid the surgical or medical treatment in
the hospital. Majorly this essay will follow the two aspect related to the introduction of the
change using the Trans theoretical model (Brannon, Fiest, & Updegraff, 2013).
Change in the behaviour is not possible only by motivating for the good health.
To motivate the human influencing role is played by the health and human services.
Trans theoretical model was introduced and developed by Prochaska and DiClwemente in
the year 1970s, evolved over the examination or studies on the group of people that quieted
smoking habit with their own will. They conducted the studies to identify the will or thing
that was behind the quieting the smoking. The reason they identifies was their willpower or
determination that led them to do this. Hence the model developed by them called Trans
theoretical Model (TTM) focused or based the premeditated change or the decision making
power of the individual (Wu & Chu, 2015). This is a model that focuses on aspect that
change in behaviour is not easy but the internal motivation and change in the habitat help to
maintain the continuous change. The TTM theorizes the six levels of the stages in the change.
These stages are the Pre-contemplation, contemplation, preparation, action, maintenance, and
termination. In the initial duration of the stage or method introduction termination was not a
part of the cycle because of the negative impact on the overall process. To motivate the Harry

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for reducing the weight this cycle will help accordingly. Pre-contemplation stage is the phase
where people are unaware about the habits they are unaware or careless towards the habits
causing the health issues. Harry is a chef and also a food loving man hence he behaves like
food is the essential part of his life and being a chef he need to love and enjoy the food but
this habit in the past years create many issues in his health. Being Unaware about the habitual
aspect of the food he continue to eat the food he wants and in large quantity. Here the
challenge for the nurse leader is to make the Harry aware about the risk casing habit (Giles,
Sniehotta, McColl, & Admas, 2016).
Contemplation is the initial stage where a person starts focusing to follow the steps to achieve
the good health. Harry here firstly intend and identify the foodie habit is the main issue
behind the challenges he is facing, after the believing of the problematic habit he need to
make the determination to start working in order to gain the health and safety .Determination
and preparation is the phase where people have clear thought in mind to make the efforts to
change their regular habit or behaviour with the strong will power and inner determination
(Arkowitz, Miller, & Rollnick, 2015). Action of the change in the habit is the movement that
led the person to apply the change in the behaviour to make the stability in the health. Harry
here after the determination will follow the guidelines and instructions given by the nurse
leader to change the habit of overeating. This slowly faces the challenges but the only force
that will lead him to continue is his will power (Johnstone, 2018).
Maintenance is the process that person focus the changes he applied and practiced in the last
stages to keep them continue. Harry after applying the required changes in the habit need to
maintain the habits and practice continue for the next time without trying to replace the actual
motivations. Termination is the success stage if achieved the health and if person has reached
the required stage he terminate the old habits causing the challenges to the health and he will
not replace the habit of healthy living. Harry after getting rid of the overweight and other

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health issues caused due to overeating will try to keep the habit continue and not replace the
health with the other bad habits (Prochaska, Redding, & Evers, 2015).
To growth over the phases of variation, and change Harry will face the cognitive, affective
and evaluative cycle. This cycle help to develop the different strategies to look and maintain
the change. Cognizance Rising leads the process to aware the people about the importance of
the healthy body. Emotional or dramatic strategy helps to use the emotions of a person to
make the connection of the feeling about the healthy body. Self-revolution or determination
to achieve the desired health and the process to determining the level they want to achieve.
Environmental issues led the awareness in the person about the impact of his bad habits on
the health of the other (Simone, Mikkonen, Bressan, Vehviläinen‐Julkunen, & Kvist, 2019).
Social aspects help to achieve the health target by motivating them towards the health. Self-
motivation led the people to make the efforts to achieve the better health. People living in the
family, friends and society impact the health concern of the person. The challenges and the
examples settlement in front of the person about challenges faced by the others due to the
improper habits for the health are helpful. Positive motivation and the rewarding strategies
led the positive energy in the person to make the effective efforts the continuous focus on the
stability of the good health habit with the ignorance of the bad habits that led the issues to the
health (Honeycutt & Milliken, 2012). Harry will pass the different stages to meet the health
benefits the above discussed strategies will influence him. The role of the health officer in the
overall process will to motivate him by asking the motivational questions (Sanaeinasab,
Saffari, Sajedi, Sepandi, Shohaib, & Koenig, 2019).
Motivational question or interview taken by the health instructor or the nurse leader is
beneficial in many ways for the leader and the patient. Simple motivation and advice are not
taken seriously because person think it as the burden but the discussion about his daily

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routine asking the queries about the reason behind the habit and also involving him in the
interview is the main part of the change. When a person feel engaged in the communication
he delivers the correct information and also listen the guidance properly. Hence the
motivation by the interest led the result of the changed behaviour. Harry is the person who
loves the food and this sure that he will not focus the normal guidance of avoiding the food
habit hence a leader should adopt various steps that are discussed below (Wu & Chu, 2015).
Listening is the best skill to start the conversation. The main focus of the leader here is to
listen the experience of harry to make the effective plan for him. The motivation is not one
day process it comes after a long efforts, leader here need to deal with the negative thinking
and the feelings that distract the Harry from the goal and lead him with the proper
determination (Arkowitz, Miller, & Rollnick, 2015). Judging others is an easy task but worst
is to acing the issues, hence besides giving the instruction communicate the role of the change
in their life and care for their thinking reviews and the fear of the losing the self-
determination and at last keep person aware about the positive impact of the change ling in
their lives. These all motivational interview and theories applied by the leader led the positive
result in the change behaviour of the Harry (van der Maas, 2017).
This essay concludes the importance of the motivation and the role of the Trans theoretical
model of introducing the change in the behaviour of the patient for their habits. These habits
are the part of their normal and routine life and they didn’t get any reason to change as
discussed in the given case study. Harry can change the behaviour of eating the food and
facing the many health issues caused due to the overweight but this all will need the effective
motivation and continuous process to make him change accordingly.

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