Page 124 - Essentials of Nursing Leadership and Management, 5th Edition
P. 124
CikguOnline
2208_Ch08_103-114.qxd 11/6/09 5:58 PM Page 111
chapter 8 | People and the Process of Change 111 CikguOnline
table 8-2
Which Stage of Change Are You In?
While studying how smokers quit the habit, Dr. James Prochaska, a psychologist at the University of Rhode Island, developed
a widely influential model of the “stages of change.”What stage are you in? See if any of the following statements sound
familiar.
Typical Statement Stage Risks
“As far as I’m concerned, I don’t have any 1 You are in denial. You probably feel coerced by
problems that need changing.” Precontemplation other people who are trying to make you
“I guess I have faults, but there’s nothing that (“Never”) change. But they are not going to shame you
I really need to change.” into it—their meddling will backfire.
“I’ve been thinking that I wanted to change 2 Feeling righteous because of your good
something about myself.” Contemplation intentions, you could stay in this stage for
“I wish I had more ideas on how to solve my (“Someday”) years. But you might respond to the emotional
problems.” persuasion of a compelling leader.
“I have decided to make changes in the next 3 This “rehearsal”can become your reality. Some
2 weeks.” Preparation 85% of people who need to change their
“I am committed to join a fitness club by the (“Soon”) behavior for health reasons never get to this
end of the month.” stage or progress beyond it.
“Anyone can talk about changing. I’m actually 4 It is an emotional struggle. It is important to
doing something about it.” Action change quickly enough to feel the short-term
“I am doing okay, but I wish I was more (“Now”) benefits that give a psychic lift and make it
consistent.” easier to stick with the change.
“I may need a boost right now to help me 5 Relapse. Even though you have created a new
maintain the changes I’ve already made.” Maintenance mental pathway, the old pathway is still there
“This has become part of my day, and I feel it (“Forever”) in your brain, and when you are under a lot of
when I don’t follow through.” stress, you might fall back on it.
Adapted from Deutschman’s Which Stage of Change Are You In? “Typical statements” adapted from Stages of Change: Theory and Practice by Michael
Samuelson, executive director of the National Center for Health Promotion.
table 8-3
Five Myths About Changing Behavior
Myth Reality
1. Crisis is a powerful impetus for change. Ninety percent of patients who have had coronary bypasses do not sustain
changes in the unhealthy lifestyles, which worsens their severe heart
disease and greatly threatens their lives.
2. Change is motivated by fear. It is too easy for people to go into denial of the bad things that might
happen to them. Compelling positive visions of the future are a much
stronger inspiration for change.
3. The facts will set us free. Our thinking is guided by narratives, not facts. When a fact does not fit
people’s conceptual “frames”—the metaphors used to make sense of the
world—people reject the fact. Also, change is best inspired by emotional
appeals rather than factual statements.
4. Small, gradual changes are always Radical, sweeping changes are often easier because they yield benefits
easier to make and sustain. quickly.
5. People cannot change because Brains have extraordinary “plasticity,”meaning that people can continue
the brain becomes “hardwired”early in life. learning complex new things throughout life—assuming they remain
truly active and engaged.
Adapted from Deutschman’s Fact Take: Five Myths About Changing Behavior. Deutschman, A. (2005/May). Change or die. Fast Company, 94, 52–62.

