Theoretical Framework and EBP

I was able to meet a female, 41-year old Hispanic patient in the clinic last week who was diagnosed with hypothyroidism, borderline diabetes, obesity, and hypertriglyceridemia. In this discussion post, I want to focus on her triglycerides level. On June 24, 2015, she had a laboratory test to check her lipid panel. The result was 888 mg/dl triglycerides. This made the doctor give her all the education about having high triglycerides including its risks as well as medications to manage the triglycerides. She was asked to come back to the clinic in 3 to 4 months to re-check her lipid panel. In October of the same year, her triglycerides went down within normal level of 137 mg/dl. She did her lipid panel again in February 2016 and her triglycerides level was 149 mg/dl. I will incorporate this patient’s situation to the transtheoretical model of behavior change. This theoretical framework assesses an individual’s readiness to act on a new healthier behavior. It provides strategies or processes of change to guide the individual through the stages of change to action and maintenance. The stages include precontemplation, contemplation, preparation, action, maintenance, and termination (Prochaska & Velicer, 1997). Obviously, she is not in the precontemplation anymore. It is because precontemplation is the stage wherein a person is not aware of the problematic behavior. Before her lipid panel was checked in June, she was not aware that her lifestyle was not helping her overall healthy state. The next stage is contemplation. This stage was when she started a healthier behavior. Her doctor took the advantage of this phase of her behavior change by making the patient aware of all the pros of changing to a healthier lifestyle. The treatment plan that her doctor has made for her revolved around focusing on the positive aspect of changing the behavior while disregarding the negatives. She successfully passed this stage as evidenced by a normal level of triglyceride on October 2015 and February 2016. The next stage is the preparation phase. After all the education and information about the dangers of having a high triglycerides level, the patient is ready to start taking action. She took small steps such as doing regular exercise and eating healthy balanced diet. Her doctor’s treatment plan in this stage was based on the fact that the patient is willing to make the steps to a healthier being. The treatment plan focused on getting support from patient’s family and friends because this stage is about the more support the patient gets, the more likely she is going to keep progressing. I believe that the next stage is where Mrs. T. N. is at the moment. It is the action phase of behavior change. Action stage is where a person has changed his or her behavior and is working hard to keep moving ahead. On her last clinic visit, she verbalized that she was getting used to the routine of living a healthier lifestyle. She is working hard to reach the goal of a normal triglycerides level for the next lipid panel blood test. What is important at this phase is to consistently give the patient praises of continuing to be in the path of a healthier behavior. As the patient continues to progress in this stage, she will then go to the next phase which is maintenance in which an individual finally exhibits the new behavior consistently for over six months. And when the patient continues to adapt the healthy behavior, she will then go to the last phase and that is termination. From this phase, the patient is evidenced to be incorporating the healthy behavior for the rest of her life. If she fails to do it, she will then go back to the first stage of the theoretical framework and go over the same phases all over again. Conclusively, transtheoretical model of behavior change indeed helps assess where on the spectrum a person falls and helps guide treatment efforts accordingly.


Prochaska, J., & Velicer, W. (1997). The transtheoretical model of health behavior change. American Journal of Health Promotion, 12(1), 38-48. doi:


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