Applying the model of change to Chronic Ilness
Chronic illnesses are defined as conditions that last 1 year or more and require ongoing medical attention and limit daily activities. When you’re diagnosed with a chronic illness questions run through your head such as "Will my life still be normal?" "How do I manage this illness?" "Will I still be able to keep doing the things I enjoy?" Your 'new normal' will include a change of lifestyle,changes to your social calendar, and life will include hospital visits.
The process of change is creating the perception that a change is needed, the process of moving toward your new normal, developing healthier choices to manage the illness and strengthening your life with healthier behaviours.
The five stages of change are pre-contemplation, contemplation, preparation, action, and maintenance.
Stage One: Pre-contemplation
The Precontemplation stage occurs when the patient has no intention, now, or within 6-12 months to change their behaviour. For example, “I have no intention of taking all of ‘those’ medications” and “I’m not going to stop drinking alcohol.” People in this stage defend their bad habits even if they are aware of the benefits. They may be defensive in the face of other people’s efforts to pressure them to behave in a healthier way. This is also known as being in denial of having a chronic illness.
Stage Two: Contemplation/ self re evaluation
In the contemplation stage, patients become aware of the personal consequences of ignoring their doctors and spend time learning how to live a healthier way of life. During this stage patients are more open to receiving information about their bad habits, and about the benefits and sacrifices they should make, reflecting on their feelings and thoughts concerning their unhealthy choices. This stage can take as little as a couple of weeks or as long as a lifetime to get through the contemplation stage. Some people think and think about giving up their unhealthy choices but die before having gotten beyond this stage.
Stage Three: Preparation/Determination.
Patients have made the commitment to make a change. Their motivation for changing is reflected by statements such as: “I’ve got to do something about this illness”, “this is serious’' and “something has to change so I can live as long as I can without flares.” Patients are taking small steps toward stopping their unhealthy choices. Patients try to gather information about what they will need to do to change their behaviour. This includes support groups and trying to find out what strategies and resources are available to help them. Patients intend to take steps to change.
Stage Four: Action
The action stage is where the patient believes they have the ability to change their unhealthy choices and actively take the steps to change by using a variety of strategies and finding the most suitable. This is the shortest of all the stages. There is no specific time frame to overcome this stage. The amount of time patients spend in this stage varies. This is a stage when patients depend on their own willpower and may use short-term rewards to sustain their motivation. During this stage it’s important to seek support from others as a way to stay accountable for the choices that are made. Hopefully, patients will then move to stage five.
Stage Five: Maintenance
Maintenance involves being able to successfully avoid any temptations to return to the unhealthy choices. The goal of the maintenance stage is to maintain a healthy lifestyle. It’s important for patients to remind themselves of how much progress they’ve made by treating themselves occasionally. (Choose healthy treats like buying a nice peace of clothing, shoes and, or jewelry). patients need to remind themselves of how much progress they make. People in maintenance piece together their new lives while learning new skills to deal with their 'healthy' life choices and trying to avoid a relapse by preparing coping strategies in advance.
To be honest, I think I’m still in the contemplation stage. I was diagnosed with Lupus at age 12 and I have had liver disease from the age of one. My reasoning is because I still drink alcohol, but my doctor’s have told me I should not be drinking at all! I drink 2-3 nights per week and I am fully aware of the consequences and benefits if I stop drinking.
