Die theoretischen Perspektiven, um unmotivierte Personen zu motivieren, ihr Gesundheitsverhalten zu optimieren! Zusammenfassung: Keine Motivation = Keine Chance
2 prominente Modelle der Verhaltensänderung Selbstbestimmungstheorie : unterscheidet Motivationsarten und Gründen für Verhalten A-motivierte können keine Gründe nennen und haben schlechte Compliance [14-19] Transtheoretisches Model: charakterisieren Stufen im Bezug zum Gesundheitsverhalten kein Interesse keine Verhaltensänderung möglich [20]
2 prominente Modelle der Verhaltensänderung Selbstbestimmungstheorie: Transtheoretisches Model
2 prominente Modelle der Verhaltensänderung Beide Modelle haben geringer Effekt auf A-motivierte Patienten, evtl., weil sie die zugrundeliegenden Überzeugungen zu wenig berücksichtigen [25-27] Ungesunde Verhaltensweisen bestehen aus 2 Faktoren [21-24]: 1 Bewusste Entscheidungen: Entscheidungsbalance der wahrgenommenen Vorteile und Nachteile einer Verhaltensänderung (Nutzen-Kosten-Analyse) 2 Unbewusste, spontane und impulsive Cues aus der Umgebung: Belohnungssystem (Dopamin) (Schwierigkeit der Änderung liegt u.a. hier)
A-Motivation Folge von mangelnder Selbstwirksamkeit, Erwartungen, Überzeugung [1,2] Motivationsänderung durch Selbstvertrauen und Wertschätzung der Verhaltensänderung möglich. Zirka 30% nicht an Änderung interessiert Keine Verhaltensänderung möglich [4,5] selbst wenn dies geringere Mortalität bedeutet (11-14 Jahre) [11,12] Interventionen [3,6-11,13] Zwang (Rauchverbote, Hohe Steuern auf Alkohol, weit entfernte Parkplätze (Arbeit) Goal-Setting Selbst-Monitoring Aktionsplanung Implementierungsabsichten MI (Motivational Interviewing)
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