Goals and Encouragement in HealthCare

Communication and collaboration between doctors and patients is a topic that I am happy to see in Tweetchats. In the last #HCSM on Sunday evening, August 18 at 9:00pm the final question dealt with goal-sharing with healthcare practitioners. Is there standardization, how are goals communicated to HCPs and what if the goals that the doctor has for the patient are different from the patients' goals?

This link leads to a storify (my first one ever) of some of the enlightening responses. You can see some of the responses for yourself.  Tweetchats are an outstanding way to get a view of a subject from more than one perspective.

                                   Iris                     AMcKinnon

It was a fascinating topic and my favourite story was by Dr. Iris Thiele Isip Tan. Her patient was so excited to reach her goal that she jumped up and hugged her. So achieving the goal empowered the doctor and the patient! as Dan Goldman said. And neither will forget the moment.

That is the ideal result of collaboration between doctors and patients to reach goals.  

Which brings me to what I think is the secret ingredient that helps people become more literate and engaged.  Encouragement. When people manage to achieve even a small step on the road to improvement some congratulatory words from the doctor are a real accelerant for many. 
Here's a commercial for encouragement. I just saw it through reading RA Warrior's blog this morning. Being encouraged is often an exceptional event. We can all make it more common.

Here are some guidelines to goal setting:

 

Whether your goal is climbing a mountain, planning a party or improving your health there are ways to reach that goal.  When you take a self management course you find out that goal setting is one of the most useful tools in the chronic disease management kit. 

                                     Wait! Do I need to open the box?

There are no secrets to effective goal setting - just guidelines to help you succeed.  You can chose something very difficult but then break it into achievable steps. That's your Action Plan. Then work on each step one after another.

1. You need to be specific about your goal. Not "I will lose weight next week" but "I will not eat after dinner on Monday or Wednesday" for example, or "I will walk for 1/2 hour on Tuesday and Thursday in the evening".

2. As in the example above you want to be able to measure the goal. Not eating after dinner on two days is the goal and it is easy to tell if you succeed.

3. It also has to be realistic and achievable. If you know in advance that you will never accomplish it you need revise your goal. A rule of thumb is to rate the likelihood you'll do it on a 10 point scale. Your confidence should be at a 7 or better.

4. Your goal should be relevant to you and your plan.

5. Making it specific as to time is also a proven method of making your action more likely. 

Even with these you should think about what obstacles or setbacks might come up and make a plan for that too. If there's a surprise party and you need to eat cake you could choose another day to abstain from sweets.

                        Digital image courtesy of the Getty's Open Content Program
 

Climbing this mountain in one day would be beyond me now but I'm sure I could do it by preparing gradually.

Good Luck on your new plan!

Information. Shared and Not Shared

There's a reason I see that darn Phil Mickelson ad for Enbrel everywhere I go when I'm browsing.  That one and Lumosity are dogging my virtual footsteps at website after website.  I know where they come from of course.  Over the years I have dropped many fragments of information about myself on electronic media. Some were freely given and some were not. 

                                         freakingnews.com
And all of those bits of information have made me a target for those who advertise and profile.  It's obvious from my browsing habits that I have an interest in diseases where high priced biologics are used so that accounts for Phil and the Enbrel. And advertisers are also assuming I may be starting to worry about my cognitive abilities as well. 

In the middle of a tweetchat recently I suddenly became more conscious of this situation and interpreted the feeling by thinking of Hansel and Gretel dropping breadcrumbs going through the woods. When I said this others in the chat agreed, with J. Shore saying he feels like that "Only on days that end in y".

We're all out there leaving information where it can easily be found by others and making our individual trails. Dr. Ann Becker-Schutte, a psychologist from Kansas City, gave me a different perspective in the #EOL chat when she said "But you are helping more people than yourselves find the way home."

That is a motivating factor for many people posting in online blogs and commenting about their experiences.  They are trying to use their experiences to inform and help others who have an interest in similar topics. People faced with a new health experience in particular are likely to find the experiences of others to be helpful.

For years I have been reading health related blogs written by both patients and a variety of health care professionals. They have been touching, informative, educational and all have contributed to making me healthier. I think people interested in health form one of the strongest social media communities.  When you look at the #rheum, #hcsm and #hcsmca on Twitter you find links to more resources than you will have time to digest.

So pick your favourites and dive in.

This used to be a free game that made me question my cognitive ability. I never Beat the Chimp but it's good for your brain to try some of these games. 

Acceptance and Support

I have liked the phrase "unconditional positive regard" for years but have never done any research about the concept.  It sounded like an aspirational goal that would be a good practice for life and work.

When I started to look it turns out to be a therapy term that was described as having "seeped out" of being used for therapy and into common usage.  It was a way to describe the attitude a therapist should have (ideally) when doing talk therapy.

                                      Freud's Couch from sunilification.net

David G. Myers says the following in his Psychology: Eighth Edition in Modules:

"People also nurture our growth by being accepting—by offering us what Rogers called unconditional positive regard. This is an attitude of grace, an attitude that values us even knowing our failings. It is a profound relief to drop our pretenses, confess our worst feelings, and discover that we are still accepted. In a good marriage, a close family, or an intimate friendship, we are free to be spontaneous without fearing the loss of others' esteem."  (source:Wikipedia)

I think there is no better place to experience the positive results of this attitude of valuing than Twitter.  Maybe I have been lucky but I seldom run across negativity and meanness there.  Other social media may be less positive. Based on things I have heard and because of laziness I avoid Facebook.  I've heard it described as Twitter with homework.

                                        wallblog.co.uk

One of the criticisms of unconditional positive regard is that it is impossible to do in real life where even our own kids are hard to accept all of the time.  But there is no reason to avoid trying to achieve this level of acceptance of others.

                                    Our kids...    cakesdecor.com

It may be easier to do online than in real life.  When people are mean right in front of you they are harder to ignore than when you can just hit delete or skip over a tweet that offends you.  

It's great to see so much generosity and encouragement that cuts across all levels especially in Health Care Social Media (HCSM). What a great and friendly way to learn and to improve your health literacy.

                                www.symplur.com

One of the tweets that got a lot of retweets was my resolution to comment on blogs and interact more. That proves to me that a lot of people already want to be supportive and helpful.  I suspect it is finding time to lead our own lives that is the limiting factor.  

It's not easy.  Sometimes it's hard to find words.  And of course by saying something negative about Facebook above I have already gone against my aspirational goal.  Maybe it was bad habits from the office - often the main sport is complaining. 

    Schemers from Downton Abbey

You can do so much good by supporting and encouraging, and then there's the pair above! Conniving and setting a bad example every season!

Twitter Chats

I have participated in a few twitter chats recently and met a lot more people in the patient and health care professionals area.  The chats are so invigorating and the new ideas for sites and methods to find out information are given so readily.

The first time was very intimidating.  There were so many tweets coming in from so many people at once that it was hard to follow.  That was the chat for #HCSM (Health Care Social Media) on Sundays at 9:00pm eastern.

The second time was Wednesday night for the #HCSMCA (Health Care Social Media Canada).  It was a smaller chat and I am learning. It was easier to participate in that one.  Their usual time is Wednesdays at 1:00pm eastern time.

The sense of community and purpose in chats is inspiring.

I like to search PubMed for health information and read blogs, mostly health related, but doing that can be too much of the same thing.  The adrenaline is missing with documents unless someone actually comes to conclusion that make your blood boil.