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Health Coaching Tips to Actively Engage Patients/Clients

Whether one complies with treatment plans is a decision made through the social context of one’s life, not always because of an order, a prescription or health teaching or directive.

Tips to Actively Engage Patients!

The Center for Advancing Health (2010) states that “patient engagement is not synonymous with “compliance”, which signifies a directive that is responded to; rather than a person’s involvement in the process whereby information and professional advice is in concert with one’s own needs, abilities, and preferences.
While the healthcare provider may be the expert in clinical interventions for chronic conditions, the patient is the expert about “her/himself.” When the two collaborate as partners in healthcare, behavior change can happen, improving outcomes and decreasing overall costs. This approach can be used face-to-face, telephonically, and Internet video, to name the most popular.

Tools for Engagement to Enhance Patient/Provider Partnership:

Skilled Listening:

Providers should do less of the talking, and more listening. Are you a good listener? Access NSHC’s Listening Self-Assessment to find out!
How Well Do I Listen, Self Assessment
Guiding the Agenda:

Ask the patient/family what is most concerning to them about the health behavior change they believe they need or want. Consider all concerns mentioned.  Guide the patient to drill down to those most important to him/her.

Addressing Ambivalence:

(Conflict that maintains the patient’s/client’s status quo)
Have the patient list the reasons he/she hasn’t changed the behavior and the reasons the behavior needs to change. Have the patient decide which of
those behaviors have priority.

MI Adapted for Brief Encounters (Miller & Rollnick, 2013)

Help the patient drill down to the real issue(s) or dilemma by using open-ended questions/statements/responses and empathy.              
Example of open-ended question:  “Tell me what concerns you about ____”  (taking insulin, quitting tobacco; changing eating habits, losing 35 lbs.) 
*Note: Don’t interrogate, but explore.  

Giving Information:

Traditionally, we as providers give information based on what we think the patient/family needs to hear without regard for what the patient/client already knows or has immediate concerns about. Miller, et al. recommend asking permission and providing information accordingly.  
Example: Patient with a new diagnosis of high blood pressure…  “What do you understand about high blood pressure?  Would you like some more information about it?”

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