Patient Readiness:
Is Your Patient Ready to Make Dietary Changes?

One of the hardest things registered dietitians and many other health providers face is patient readiness. Armed with educational materials, resources, support groups, and supplemental information, you enter a patient’s room to provide education about nutrition and a specific illness. As you are presenting your materials, you sense the patient is not really _______________ (fill in the blank: interested, listening, understanding, or motivated).

Your options disappoint you. You can:

• Leave reading materials and hope that the patient will read them
• Keep talking, knowing the patient is not planning to take your recommendations to heart
• Give it a few days and try again

Figuring out where your patients are in their readiness to adopt or incorporate nutritional recommendations is essential in the education process. This way you do not waste your time or your patients’ time if they are not ready to do the required nutrition work. It is worth asking one or two key questions before you begin your education or intervention. This helps you speak better to your patients, meeting them where they are at and helping you best utilize the resources that you have.

Psychologists Prochaska and DiClemente came up with a transtheoretical model to determine if people are ready to make changes in their lives. This model is called the Prochaska and DiClemente’s Stages of Change Model. It is helpful in determining an education tactic.

In order to figure out where your patient lies, ask open-ended questions to see what types of responses you get. Examples include:

• What do you know about nutrition and your illness?
• What are you thinking about changing in your life, so that you can keep yourself healthy?
• What kind of support do you have to help take care of your health when you leave the hospital?
• What role do you think your diet has had on your health?

Answers from some of these questions may help determine where your patient falls in the Stages of Change Model. Tailoring your education to meet your patients where they are may benefit both you and your patients, helping you zero in on the best techniques and information to share.

As you apply these principles in your practice, remember to try to remain as nonjudgmental as possible. Encourage your patients to take responsibility for where they are in their readiness to change. Show empathy in your pursuit to help them toward better health.

References and recommended readings
Cherry K. Stages of change—how to keep a resolution. Available at: http://psychology.about.com/od/behavioralpsychology/ss/behaviorchange_3.htm. Accessed April 12, 2011.

DiClemente CC, Prochaska JO. Self-change and therapy change of smoking behavior: a comparison of processes of change in cessation and maintenance. Addict Behav. 1982;7:133-142.

UCLA Center for Human Nutrition. Prochaska and DiClemente’s Stages of Change Model. Available at: www.cellinteractive.com/ucla/physcian_ed/stages_change.html. Accessed April 12, 2012.  

Review Date 4/12
G-0581