Trans theoretical Model and Motivational Interviewing for Harry's Care

This essay analyzes the application of the Transtheoretical Model of Change (also known as the Stages of Change Model) in the context of a nursing care scenario involving a 58-year-old male named Harry, who has recently undergone a hip replacement and is significantly overweight. The essay explores how nurses can utilize the model, which includes stages such as pre-contemplation, contemplation, preparation, action, maintenance, and cessation, to guide Harry towards successful weight management. It details how motivational interviewing techniques can be integrated to support Harry through each stage, addressing potential barriers and fostering a positive direction for his future health. The essay emphasizes the importance of a strategic plan, including dietary modifications, and provides evidence-based literature to support the proposed interventions, aiming for sustainable behavioral change. This approach acknowledges the non-linear nature of the change process, incorporating potential setbacks and relapse, and offers strategies to overcome these challenges, ultimately promoting Harry's long-term health and well-being.

Application of the Trans theoretical Model in nursing care
The Trans theoretical model is developed byProchaska and DiClemente in the year of 1970.
It is also known as Stages of Change Model. It is a significant theory of treatment that
supports the person to begin a healthy habit. This theory also provides a plan, the process of
modification that directs an individual. The theoretical model composed of six stages of
modification. Pre – contemplation, contemplation, preparation, action, continuation, and
cessation. This is the process of achieving a healthy habit in a regularised pathway (Archer,
2018). It is beneficial for the patients wanted to attain a healthy goal like quitting smoking,
weight reduction, quitting alcohol and drugs. It is the safe model which is been used by many
and benefited (Krebs,2019). This model helps the individual to attain a healthy habit
successfully. This assessment helps in assisting Mr. Harry who recently had the Hip
replacement and weighs about 165kgs. The nurse has to support harry to use The Trans
theoretical model and implement the stages to reduce the weight of Harry.
Harry has to use this The Trans theoretical model in stages which helps him to attain the
healthy habit successfully. The first stage is called as pre contemplation stage. This stage is
composed of a mixture of thoughts (Andrés, 2011). Some of them are unaware that their
behavior is spoiling their health and life and some have denial thoughts, they convince
themselves as the habit is not harming their health. This is an essential stage that insists the
person choose the path. In this stage, the nurse has to communicate with Harry and analyze
his choice about behavioral change. Few questions have to be placed before him to make him
think about the importance of behavioral change. Ask him whether he is aware of his present
health condition and need for the behavioral change? Ask him whether he has tried any
weight reducing behavior in the past? (Elwyn, 2015).Place another question; asking for,

which incident alarmed him that he needs a behavioral change? These three questions
motivate harry to think about initiating behavioral change using Stages of Change Model.
The second stage of the Trans theoretical model is known as the contemplation stage. An
individual who required a behavioral change with the support of the Trans theoretical model
is aware of the health benefits of acquiring behavioral change. But the cost for the behavioral
change will be the primary barrier for the person to initiate this model. The nurse has to place
a few questions to rule out the barriers of this particular stage (Di Noia, 2010).Ask Harry
whether he has any barrier to initiate this model? Does he really want a change? What does
he think as supportive factors that help him to initiate this behavioral change? These
motivational questions will help the nurse to understand what all the potential barriers for the
behavioral change which helps the nurse to make a strategic plan to help Harry to accomplish
the behavioral change.
The third stage of The Trans theoretical model is the preparation stage. This is a vital stage in
which a person prepares his mind, body, and soul to achieve his goal. In this stage, an
individual has to make a written strategic plan with easily achievable goals and a plan to
achieve the goals. In this stage, a person has to think of simple change that gives significant
result in the behavior. In the case of Harry, he has to make simple diet plan that is easily
achieved able and find encouraging results (Mastellos, 2014). In this stage, Harry has to make
written goals and paste it in his room in an easily visible area to see the goals and motivate
him towards the behavioral change. This stage is a self help stage in which, Harry has to
prepare himself both physically and emotionally to achieve his goals and he has to appreciate
his achievements by offering a small gift. This self motivation helps him to achieve his goals
without the support of the other person.

This is the stage of action. This stage requires support and inner zeal towards the goal. Many
fail in this stage because they make a resolution and begin the process of behavioral change
without proper plan and support, thus finally end up in failure. This stage has to be planned
perfectly analyzing the potential barriers and the outcome. The behavioral change should not
begin with sudden and drastic change; instead, it has to be started with the small goals in
regular manner (Macchi,2015). In the case of Harry, he confessed that he is foodie and he is
around the food all the day, so has to make small change in his behavior and expect only the
small change in his weight. As small achievements will encourage him to make greater goals
and prevents failure. In this stage Harry can cut off only the food items that rich in oil and
cholesterol. For example, food that is made of cheese and fried food, instead he can fill his
tummy with salads and fruits while he works.
This is the fifth stage of The Trans theoretical model. This stage is called as maintenance
phase or continuation stage. In this stage, an individual has to avoid all the old habits that
may be a hindrance for the achievement of the goal and try to find new habits that support the
behavioral change. This stage encourages the person to try new habits that will help him to
sustain the behavioral change. All the old habits need to be replaced with the new ones for a
better result. The person can face small failures in this stage, but he has to encourage himself
to move forward instead of worrying about his small failure (Prochask, 2015). Because
setback is common in all the behavioral change, and it is the part of the process. In the case of
Harry, he has to work towards the goal achievement and should not worry about the small
setbacks. Chances of setback are more in the case of Harry because he works with food every
day. But, he has to continue his behavioral change. He can seek support from his friends in
the workplace to help harry to continue his new healthy behavior.

This is the last and very important stage of the Trans theoretical model. In this stage, an
individual may become more frustrated and disappointed due to repeated relapse in the
behavioral change (Tseng, 2017). This emotional set back is common in all the trials of
behavioral change. The person in this stage has to understand that relapse is common in the
behavioral change because the understanding helps the person to continue the process
successfully. The person starting the Trans theoretical model should be aware of the
possibilities of relapse . Because awareness helps the person to avoid the stage of frustration
in the behavioral change. The right solution to overcome this stage is to start the process
again. In this stage, the person can do re-examine the whole process before he starts with the
new beginning. Reconsidering the barriers and the causes for failure, a new plan can be
developed to achieve the goal. In the case of Harry, the chances of undergoing this stage are
more compared to others as he works with food (Tuah,2011). Harry has to find more
supportive solutions that help him to sustain the process without relapse.
Strategical plan to care for harry is prepared to help him to achieve the behavioral change. To
implement the Trans theoretical model patient has to understand the model and aware of the
stages involved. He should have a proper strategic plan and to execute the behavioral change.
Since he had a hip replacement he cannot implement exercise to reduce the weight. He can
only do simple exercises. The only mode of weight reduction for Harry is diet. He has to plan
a weight reducing diet with the help of a nutritionist. He has to avoid food rich in cholesterol
and increase the intake of salads and veggies (AL KURDI, 2016). As he is a chef, he can
prepare his food with less oil and more vegetables. He can increase the number of meals
instead of taking more food at a time. Periodical weight measurement helps him to rule the
changes and it will encourage him to follow his diet. Harry has to understand that Relapse in
the process of goal achievement is normal but he has to continue the behavior or begin a new
one.

The Trans theoretical model is beneficial for the people seeking a model for a behavioral
change. In the case of Harry, motivational questions were raised to encourage him to begin
behavioral change using Stages of Change Model. Discharge plan for Harry includes diet,
exercise, regular medication and regular follow up. He has to follow, low cholesterol diet
which helps him in the process of weight reduction (de Menezes, 2016). As he had undergone
a Hip replacement surgery, harry cannot try tough exercises to reduce weight, instead, he can
keep himself active and do mild exercise. He has to continue all the prescribed medication as
per doctor’s advice. He has to do regular follow up to maintain his health and to prevent
further complications. Harry has to do simple lifestyle modification to have painless and
happy aging.
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abstract

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