www.diabeticretinopathy.org.uk

General

Smoking, diabetes, and the consultation

David Kinshuck

 

Nicotine addiction, assessing dependance & motivation to stop

Essentially the degree of addiction can be judged by the

This is reviewed here, and in an excellent article for professionals here in the BMJ. Simple advice as to how to stop.

 

Suggested phrasing in consultations

 

Strategies used in intensive behavioural support

 

Changing behaviour...guiding, scaffolding

Guiding style is best BMJ:

Clinician
  • Your test result is high today ( informing ) and I wonder what sense you make of this (asking followed by listening )?
Patient
  • I don't know. I am not surprised because it's hard enough getting by day to day without worrying about this as well.
Clinician
  • Everyday life can't stop because you have diabetes (listening).
Patient
  • Yes, exactly, but I know I do need to be careful.
Clinician
  • In what way?
Patient
  • I need to watch my diet and get more exercise. I know that, but it's not so easy.
Clinician
  • What might be manageable for you right now?
Patient
  • It's got to be exercise, but please don't expect great things from me.
Clinician
  • Well, a change in diet or exercise will be a great help ( informing ). How might you succeed with more exercise (asking )?

 

Cessation interventions in routine health care

Use the 5 'A's approach flow chart BMJ.   Coleman)

Links for professionals