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In goal setting, let your patient lead
Goal setting is a skill that is taught and learned, and it is an essential component of diabetes education.
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Author Geoffry F. Abert once said, “The most important thing about goals is having one.” Most people know what they “should do” to live a healthier life.
When asked, the person on the street will say that he or she should lose weight, exercise more, eat less, or quit smoking. Although these are important steps to take toward a healthy lifestyle, many people — not just people with diabetes — find it difficult to take them.
For people with diabetes, it is critical that these steps are taken, but changing one’s behavior and habits has emotional, psychological, physical and environmental barriers. So, in the limited amount of time that we have to spend in each encounter with patients, how do we support their efforts to change their behavior and achieve positive long-term health outcomes? The key to behavior change is goal setting.
Setting and achieving goals
The AADE7 Self-Care Behaviors provide a patient-friendly language to use when discussing healthy behaviors and diabetes self-care, but it is not the end of the story.
Once patients understand that healthy eating, being active, monitoring, taking medication, problem solving, healthy coping, and reducing risks are key behaviors that are essential to successful diabetes self-management, they then move on to set goals and make a plan to achieve those goals.
Goal setting is a skill that is taught and learned, and it is an essential component of diabetes education. It is not enough for patients to understand that they need to “lose weight” or “exercise more.” They must learn to set goals that are SMART: Specific, Measurable, Attainable, Realistic and Timely. By setting achievable goals that can be accomplished in small steps, patients are encouraged to keep moving forward.
 Amparo Gonzalez |
Having the knowledge, skills and tools to set attainable goals is only half of the story.
The most important aspect of goal setting is to work on those goals that are important to your patient. It is not enough for you to tell the patient that he needs to lose 10 lb by the next visit. It is also not enough for the patient to leave the doctor’s office saying “I need to lose weight.”
Patients need information on how to lose the 10 lb and must make a plan for meeting their goal. Remember, patient confidence and conviction is the force behind the effort put towards the achievement of the goal. The patient must be ready to initiate changes and must choose which behavior(s) to focus on first. Goal setting works best if it is a collaborative effort of the entire care team and the reinforcement and effort has one loud voice.
Here is an example of patient choice and confidence in selecting the goals: The patient who smokes will probably understand the importance of quitting, but may not be ready to take that step. So instead, focus on the goals that the patient is motivated to accomplish, such as walking for 30 minutes three days a week.
Once the patient begins to see improvements and makes progress with that goal, he or she can then move on to tackle another goal, with an even greater amount of confidence. Be sure to celebrate small successes and reinforce the positive; always be there for support and don’t condemn the patient who has trouble achieving goals.
Celebrate success
Set your patients up for success by including members of their care team, from friends and family to physicians and educators. They will all play their own part in helping the patient achieve goals. If the patient is trying to lose weight, but his or her partner loves fast food, it will be more difficult for the patient to stay on pace to achieve their goal of eating better. Help the patient find alternatives that he or she and their partner will enjoy. Perhaps suggest a cooking class, or ways for your patient to cope with temptation. With members of the patient’s support system on board, he or she has greater chance to succeed in their goal of losing weight. The effects of the patient’s goal-setting may even be residual, since family members may also participate in achieving similar goals.
No patient should tackle these life-changing goals alone, and they will feel more confident with the support of family and friends.
Once the goals are set, check in regularly with your patient to evaluate his progress. Assess the patient’s progress and work with them to modify their behaviors to accomplish the goal. Remember, this could be a major lifestyle change for your patient, so continue to offer encouragement and involve all members of the patient’s care team.
For more information:
- For more information and educational videos about the AADE7 Self-Care Behaviors, visit www.mydiabetespartner.org.