Behaviour Change Protocol
This is a series of questions to help patients commit to a
behaviour change plan that will lead to improved
adherence3.This can be printed directly
from your browser, however the results may not be reproduced
as clearly as presented here. A printer friendly version can
be obtained by downloading the questionnaire in Adobe
Acrobat PDF format.
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Behaviour Change Protocol 1.
What part of living with asthma is most
difficult for you?
Focuses on
patient's concerns, which may differ from
professional's concerns
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2. How does (the situation described
above) make you feel?
Allows depth of feeling to be
expressed
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3. How would this situation have
to change for you to feel better about it?
Allows patient to identify how the situation
could be and how they would feel if it were
improved
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4. Are you willing to take action
to improve the situation for yourself?
Helps patient see how committed they are to
changing situation
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5. What are some steps you
could take to start this off?
Helps develop plan, note
barriers and resources
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6. Is there one thing that you
will do when you leave here to improve
things for yourself?
Focuses
on what patient can do to start the process
- write if possible
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3. Adapted from the model provided in
Anderson, R.M., et al. 1991, Learning to empower
patients: results of a professional education
program for diabetes educators, Diabetes Care, 14(7), pp. 584-7,
and used as a tool in health professional
training conducted by the Lung Health Promotion
Course at the Alfred Hospital in Melbourne.