Question

Case Study: The community health nurse is preparing a smoking cessation program to be presented at the local high school for individuals who are thinking about quitting smoking. The community health nurse is identifying appropriate education activities that include the three domains of learning and the three stages of change

1. The community health nurse has to consider the three stages of change in considering individual reasons to stop smoking. What are the three stages of change?

2. Planned or managed change is a purposeful, designed effort to effect improvement such as smoking cessation with the help of a change agent who is the community health nurse. What are the eight steps of planned change that the community health nurse needs to consider?

3. The community health nurse understands that encompassing strategies are the critical change strategies to consider in planning the health education program. What are the three major change strategies that must be considered by the community health nurse?

Answer 1

Three stages can be :

• Denial and Acceptance

Smokers often deny that smoking is a problem. This difficulty with acceptance is called “denial”. Denial may continue until you have a negative personal experience related to smoking including poor health, illness of loved ones, or other related triggers that may influence you to quit. When this happens, it is common to realize the negative impact smoking may have on your life, and this often leads to acceptance and consideration of quitting smoking.

• Contemplation and Planning

When you are ready to consider quitting, you want to make a change and you see smoking as a problem. Whether it’s financially, physically, or emotionally affecting your life, you are ready to take the next steps to develop a plan to quit. Your quit plan is one of the most important steps in the process of quitting. It involves identifying your triggers and re-learning your habits without cigarettes; educating yourself on what dependence is, how it works, and identifying a possible quitting aid; lastly, it is important to reach out to your support system and talk with your family and friends about your decision to quit.

• Action, Maintenance, and Relapse

The last three stages of quitting include action, maintenance, and relapse. As you are carrying out your identified quit plan, you are in the active stage. You are no longer smoking and you have officially quit. The maintenance stage involves working to continue your quit plan while continuing not to smoke. You may begin to experience withdrawal symptoms during this stage, so managing withdrawal symptoms is one of the battles you may face during this time. Relapse, or starting to smoke again after trying to quit, is very common. Many people start smoking again to stop the withdrawal symptoms that they are experiencing. This is why it is so important to be prepared and include ways to manage withdrawal symptoms as part of your quit plan. It is very common to cycle through the stages of quitting many times before succeeding with quitting. Quitting is not easy, there is no sugar-coating it.

Ending the Cycle ( An extra point)

There is no doubt that you will be tempted and have a strong desire to start smoking again during your path to quitting. We recommend that when you have a strong desire to smoke, you go back and think about why you decided to quit in the first place, including your personal reasons, and the health benefits of quitting. If you relapse, you are not alone; nearly half of the people who quit smoking go back to it within a year. We recommend that you use your past experience to improve your chances for success when you try quitting again.