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VOL: 99, ISSUE: 32, PAGE NO: 27


- Achieving changes in health-related behaviour forms an element of many of the National Service Frameworks.

- Helping patients make healthy choices is a challenge for all nurses.

- Individuals have freedom of choice and some patients may choose to continue with unhealthy behaviour (such as smoking) because they believe the benefits outweigh the risks.

- Changing health-related behaviour is a complex process involving psychological, social and environmental issues.


- Prochaska and DiClemente (1983) identified stages in the process of behaviour change.

- Research has demonstrated that this behaviour change model is effective in changing a variety of health-related behaviours such as drug abuse and weight control (Ewles and Simnett, 1999)

- Using this model, health care professionals can help patients to make changes by focusing on moving them one step further around the cycle.


- At this point the patient has no awareness of a need to change.

- Health education and advice from health care professionals can be used at this stage to raise awareness of the unhealthy behaviour.

- Questions, delivered in a nonjudgemental way such as ‘how do you feel about your smoking?’ may prompt consideration of the health-related behaviour.


- This is where the change starts.

- Patients in this stage are sufficiently motivated to begin to think about making a change.

- Patient self-empowerment is key to moving through this stage of the cycle.


- Patients in this stage are making a serious decision to change an aspect of their health-related behaviour.

- In this stage health care professionals can help turn a decision into action by developing an action plan.

- Coping strategies and sources of support should be identified.

- A date to change behaviour and to review progress can be set.


- Patients in this stage are changing their health-related behaviour.

- Support during this phase can be given through continued sessions with a health care professional, as part of a support group, from friends and family, via telephone helplines or a combination of some or all of these.


- This is the stage where patients are endeavouring to maintain the behaviour change they have made.

- Using the coping strategies identified during the commitment stage will improve maintenance.

- Continuing to gain support is also vital.

- Satisfaction is gained from maintaining the behavioural change.

- Most patients are not successful at maintaining their health behaviour change at their first attempt.


- In this stage they have relapsed back into their old behaviour.

- Health care professionals who can help patients identify this relapse as a stage on the way to making their change can move them on to the contemplation stage again.

- On average smokers take three cycles of the change model to successfully quit smoking (Prochaska and DiClemente, 1983).


This is the stage where a health-related change has been successfully made and can be maintained.

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