The concept of readiness to change
The concept of readiness to change
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DOI：
10.1046/j.1365-2648.2003.02593.x
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发表时间：
2003-04-01
影响因子：
3.8
通讯作者：
Gottlieb, LN
中科院分区：
文献类型：
--
作者：
Dalton, CC;Gottlieb, LN
瞄准准备就绪与变化有关，但人们对这一概念知之甚少。本研究的目的是检查准备;其参照物，相关因素和由此产生的后果。在护理过程中的五个客户生活与多发性硬化症超过7个月的时间使用反思实践模式，数据系统地收集使用开放式，然后更集中的问题。在42个客户端的遭遇（28个面对面的遭遇，14个电话联系）收集的数据进行了分析，使用Chinn和克雷默的概念分析技术。准备就绪的概念是归纳得出的。准备就绪既是一种状态，也是一个过程。在客户可以创造变化之前，他们需要准备好改变。有许多因素促使人们做好准备。其中包括：（a）客户认为健康问题不会得到解决，（B）客户身体状况的变化具有新的意义，（c）客户感觉能够更好地管理其压力，（d）客户有足够的精力，（e）客户认为他们在进行改变时得到充分的支持。当这些因素中的一个或多个出现时，客户就会准备考虑改变。准备就绪的过程包括认识到变革的必要性，权衡成本和收益，当收益大于成本时，规划变革。改变和采取行动的愿望决定了客户的准备程度。当他们体验到高度的准备时，他们会报告较少的愤怒，较少的抑郁，并以更积极的态度看待他们的状况。相反，当他们经历了一个低程度的准备，他们报告说，感到沮丧，害怕和脆弱的变化面前。护理在创造支持变革的条件方面发挥着重要作用。为了发挥这一作用，护士需要能够评估变化的准备情况和使其成为可能的因素，然后以促进准备的方式进行干预。
Aim. Readiness is associated with change, yet there is little understanding of this construct. The purpose of this study was to examine readiness; its referents, associated factors and the resulting consequences.Methods. In the course of nursing five clients living with multiple sclerosis over a 7-month period using a Reflective Practice Model, data were systematically gathered using open-ended and then more focused questioning. Data collected during 42 client encounters (28 face-to-face encounters; 14 telephone contacts) were analysed using Chinn and Kramer's concept analysis technique.Findings. The concept of readiness was inductively derived. Readiness is both a state and a process. Before clients can create change they need to become ready to change. A number of factors trigger readiness. These include when: (a) clients perceive that a health concern is not going to resolve, (b) a change in a client's physical condition takes on new significance, (c) clients feel better able to manage their stress, (d) clients have sufficient energy, (e) clients perceive that they have adequate support in undertaking change. When one or more of these factors is present clients become ready to consider change. The process of readiness involves recognizing the need to change, weighing the costs and benefits and, when benefits outweigh costs, planning for change. The desire to change and to take action determines clients' degree of readiness. When they experience a high degree of readiness they report less anger, less depression, and view their condition in a more positive light. In contrast, when they experience a low degree of readiness they report feeling depressed, afraid and vulnerable in the face of change.Conclusion. Nursing has an important role to play in creating conditions to support change. To fulfil this role, nurses need to be able to assess readiness for change and the factors that enable it and then to intervene in ways that facilitate readiness.