Change models | nursing | Chamberlain College of Nursing


Prochaska and Diclemente’s model of change behavior is one of the examples of organizational theories. The selected change model I chose is Prochaska and Diclemente’s change theory specifically designed for smoking patients focused on smoking cessation for the first time. This theory has 5 stages which are pre-contemplation, contemplation, preparation, action, and maintenance. Pre-contemplation is where the individuals are not yet ready to accept the change and have very little knowledge of the change and outcome. The contemplation stage is where the individual becomes conscious of the problem yet not ready for the change. In preparation, the individual is focused and take necessary action to address the behavior. Action is the stage where the individual puts all efforts to modify the change and use multiple processes. Maintenance is the final stage that helps to replace the new outcome produced by the change and therefore will maintain the new behavior and this stage takes up to 6 months to bring better clarity and a quality patient outcome (Fidanci, I, et al,. 2017). What makes me choose this model is “change in behavior for anyone is not easy” and that is a true statement, saying that this model helps to evaluate after each stage and keeps motivating to move forward to the next stage to achieve the goal.

Prior to the third stage, it is difficult for patients to stay focused on the change. Therefore, the patients here will choose different strategies to stay in the action plan. Doing another activity with the same hand when they smoke helps to divert the patients, offering a reward at the end of the day, someone to talk to when the patients feel like smoking, to remove any obstacles from their environment that reminds them of smoking, staying strong in their commitment. All these approaches have brought a change in the behavior of patients therefore provided evidence for this model (Fidanci, I, et al,. 2017).

During all phases of this change model, getting input from the stakeholders will help in research and narrow down the actions necessary for this change. The patients in the initial stages need adequate motivation and education on why the change takes place, appointing clinical educators could help the patient to understand the pros of quitting the behavior. The patients when they reach the third stage require someone to talk to and to guide the actions since they started to put the effort into it. Screening centers for example Smoking Cessation at Lung Examination (SCALE) Collaboration can help to screen the patient’s risk for lung cancer (Kathuria, H, et al,. 2017). Nurses should use their critical thinking to identify the decision-making changes by the patient during the third stage because the patients could easily quit the action plan. Family support and community support during the fourth stage is extremely important as this will increase motivation for the patient. The action plan needs a lot of commitment and energy and it should be a collaboration between the patient, health care team, family members, and community. Since this is a cyclic model, the maintenance stage will refer to the screening centers to evaluate the patient’s change in behavior and overall health (Park, E. R. et al,. 2020).

Each stage provides patient evaluation which helps to identify the barriers and do necessary changes in the stages. This would require honesty, encouragement, commitment to keep the process moving on to attain the goal. Patients’ lack of knowledge, not showing interest, lack of motivation to complete the task signifies that the change model is not on a positive attempt. Identifying the needs of the patient at all the stages is important to know the effectiveness and therefore it is the team’s response to address the barrier and provide adequate support for the patient to achieve the behavioral change.  

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