It is important to assess the willingness and ability of a patient to learn any new lifestyle or behavior changes of the patient who has or had an illness or condition, such as having had an MI. In the Journal of Research in Medical Sciences it states, “According to the (Health Behavior Model) HBM, people will perform a given (health) behavior if they themselves see that it will provide benefits according to their perception of their situation and needs”. (Assari, 2011, Volume 16).
The HBM reports that there are four conditions a patient needs to believe to change his/her behavior: 1) that he/she is at risk for a reoccurrence of the condition, 2) that the consequences of the condition are serious, 3) that specific behavior changes will reduce his/her risks, and 4) that he/she can overcome the barriers to the behavior change. Knowing which condition(s) the patient believes can help the nurse to design appropriate teaching interventions. For example, if a patient does not know or understand his/her risk factors for a specific condition, then the nurse can teach him/her about his/her risk factors.
If the patient understands his/her risk factors, but believes the behavior change is unachievable, the nurse can focus teaching on ways to help the patient overcome and manage his/her perceived barriers. For a post MI patient who perceives that improved diet and activity are unreachable or unmanageable goals to decrease his/her risk of consequences or/and reoccurrence of a MI, I could use the HBM to help change his/her beliefs to provide favorable changes in his/her behavior or lifestyle that will decrease his/her risks and improve overall health outcomes.
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Nursing diagnosis: Altered perception of beliefs and risks related to having had a MI. Interventions: 1)Provide teaching materials (literature, videos, etc…) that explains/shows that poor diet and inactivity are high risk factors for reoccurrence and complications of having a MI. Review dietary restrictions and also have the dietitian speak to the patient (and family).
2)Provide teaching materials that explain/show the seriousness of complications (arrhythmia, cardiogenic shock, heart failure, pulmonary edema, etc…) of having a MI. 3)Provide eaching materials that shows evidence that improved diet and activity decrease risk factors of having a MI. Also explain/ teach of other (physical and psychosocial) benefits of improved diet and activity.
Provide teaching materials that explain/ show how to overcome barriers to changing behaviors, the benefits of change and also how to manage behavioral and lifestyle changes. Explain different mechanisms to implement diet control and exercise programs. Encourage participation in a cardiac rehabilitation exercise program and also in support groups. Nursing outcomes: )The patient will verbalize the importance of balancing activities and exercise, as tolerated, with adequate rest periods. 2)The patient will verbalize the importance of diet and achieving an ideal weight. 3)The patient will explain recognition his/her condition and acceptance of the behavioral and lifestyle changes he/she needs to make. 4)The patient will maintain hemodynamic stability. In conclusion, the nursing care plan, for a patient who is post MI, will usually need to focus on behavioral and lifestyle changes for optimal patient health outcomes. As reported, it is beneficial to the nurse’s teaching to assess the patient’s willingness and ability to learn.
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