General strategies for motivating people to change their behavior.

There is evidence of nurse dissatisfaction with the outcomes of patient education; some patients are seen as insufficiently motivated to change their health-related behavior. Research findings from the field of health psychology are relevant to the issue of increasing patient motivation to change. In terms of motivating health behavior change, the research findings indicate the importance of the client's belief in the severity of threat to health and personal vulnerability, as well as in the feasibility and effectiveness of a particular health measure. The HBM has generated much research confirming the importance of these beliefs. Research evidence also indicates the importance of the self-efficacy mechanism as a predictor of such outcomes as cessation of smoking and returning to a physically active life after a heart attack. There are unsettled questions about the role of fear in motivating behavior change, but experts agree that high levels of induced fear may result in denying or ignoring the threat. If fear is used, it must be coupled with recommendations for efficacious behavior change. The findings of attitude-change research have yielded practical information on increasing the persuasiveness of information appeals using such techniques as saving the most important point for the beginning and end of the message. Techniques such as self-monitoring and systematic desensitization are also available to help motivate change. The problem of maintaining behavior change is challenging, and further research is needed on how best to prevent relapse or to aid clients in restoring change once relapse occurs. The experts advise tailoring the interventions to aid maintenance of behavior change to the particular stage of change. For example, bolstering motivation to change is important in the initial stage. As important providers of health care education, nurses need to be fully informed of the research findings relevant to effective interventions designed to motivate health-related behavior change.