First Call – Week 2

First call – Week 2

The first telephone session, based on Motivational Interviewing skills, could proceed as follows (allow approximately 45 minutes):

1. Agree on focus:

Establish rapport and a collaborative approach.

Set the agenda:

“As you know, each week I am going to call you at the same time, so that you know

when I will ring. It will be just like a regular appointment for both of us. The phone

calls will happen once a week for seven weeks”.

During our phone calls we will have opportunity to do two things:

• Talk about your exercise program.

“It will be good to hear from you about how things are going – things that are going

well, things that are not going so well and what you would like to do for the following

week”.

“Each week we will set goals for your exercises, with the aim of increasing your fitness

and strength as the program progresses. We’ll write the goals down – I’ll ask you to

write them in your diary and I will write them down as well, so that we both

remember”.

• “Opportunity to discuss other areas of your health where you may want

to make some changes. This might include things like managing chest infections or

flare-ups, managing your medications, weight management and diet, managing

breathlessness, quitting smoking or any other areas of your health that are important

to you at the moment”.

“Advantage of this program– you get to choose which areas you’d like to focus on.

My job is not to tell you what to do, but more as a guide, using my experience with

other patients to help you make decisions that make sense to you.”

2. Discuss exercise goals:

“I would like to start with understanding what happens when you exercise.

Can you tell me what usually happens when you exercise?

Can you tell me about what happened when you exercised in the last week?”

Explore experiences of exercise, in the last week and more generally.

3. Reflect:

“From what you are telling me it sounds as if….”

4. DARN statements as required:

“How important is it for you to do more exercise?”

5. Commitment and action:

“What do you think you will do this week about exercise?”

Check their confidence scale.

6. Discuss health goals:

“On page 39 of Better Living with COPD: A Patient Guide, you will see some areas that can be important in managing your lung problems, where some people in your situation consider making changes. These include:

Exercising for better health

Understanding your medications

Maintaining a healthy diet and managing your weight

Managing breathlessness

Managing flareups and chest infections

Quitting smoking

Making the most of your health professionals

Managing stress and anxiety

Getting the right support

Training in self-management  of acute exacerbations is a key element of pulmonary rehabilitation. This topic should be discussed at least once during the program.

Are there any of these areas that you would like to talk about today? Or is there something else you would like to talk about today?

I’d like to start by understanding how you feel about……..

I’d like to start by understanding what happens when……..”

7. Reflect:

“From what you are telling me it sounds as if….”

8. DARN:

“How important is it for you to stop smoking?”

9. Commitment and action:

“What do you think you will do this week about …?”

Check their confidence scale.

10. Summarise the phone call

Ensure the home diary has been correctly completed.