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{{WBRQuestion
{{WBRQuestion
|QuestionAuthor={{Rim}}, {{AJL}} {{Alison}}
|QuestionAuthor={{Rim}}
|ExamType=USMLE Step 1
|ExamType=USMLE Step 1
|MainCategory=Behavioral Science/Psychiatry
|MainCategory=Behavioral Science/Psychiatry
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|MainCategory=Behavioral Science/Psychiatry
|MainCategory=Behavioral Science/Psychiatry
|SubCategory=General Principles
|SubCategory=General Principles
|Prompt=A 52-year-old male, with a medical history of myocardial infarction and heavy tobacco use, presents to the physician's office for an annual check-up. When asked, the patient explains that he knows his smoking has been a problem, but he is not ready to quit. Based on the patient's reply, which of the stages of change is the patient most likely currently experiencing?
|Prompt=A 52 year old male patient, with a past medical history of myocardial infarction and heavy tobacco use, presents to the physician's office for his annual check-up. During history-taking, the physician notes that the patient has never stopped smoking since his myocardial infarction despite the physician's advice. When asked, the patient explains that he knows his smoking has been a problem for him, but he is currently not ready to stop smoking. Based on the patient's reply, which of the stages of change is the patient currently in?
|Explanation=The patient never stopped smoking, so therefore he cannot be relapsing. Also, the patient acknowledges that there is a problem, so he cannot be in the precontemplation stage. The patient is not ready to make any changes despite his recognition of the problem indicating that he is not in the preparation or action stage. The patient is in the contemplation stage, where he fully understands the problem and acknowledges its presence, but has not yet made any change and is not ready to.  
|Explanation=The patient's explanation reveals that he never stopped smoking in the first place. Thus, the patient cannot be currently relapsing. Also, the patient acknowledges that there is a problem, so he cannot be in the precontemplation stage. However, he is not ready to do any change despite his understanding of the problem; so he is not in the preparation or in action stage. The patient must thus be in the contemplation stage, where he fully understands the problem and acknowledges its presence, but has not yet made any change and is not even ready to change in the time being.  


The stages of change in order are as follows:<br>
The stages of change in order are as follows:<br>
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6- Relapse
6- Relapse


|EducationalObjectives= The contemplation stage of change is when the patient acknowledges that there is a problem, but is not yet ready to change.
Educational Objective:
|References= First Aid 2014 page 513
Contemplation stage of change is defined as the patient acknowledging that there is a problem, but not being ready to change yet.
 
|AnswerA=Precontemplation
|AnswerA=Precontemplation
|AnswerAExp=Precontemplation is when an individual does not acknowledge that there is a problem.
|AnswerAExp=Precontemplation is defined as no acknowledgement of the problem in the first place.
|AnswerB=Contemplation
|AnswerB=Contemplation
|AnswerBExp=Contemplation is defined as the patient acknowledging there is a problem, but not yet ready to change.
|AnswerBExp=Contemplation is defined as the patient acknowledging there is a problem, but not yet ready to change.
|AnswerC=Preparation
|AnswerC=Preparation
|AnswerCExp=During the preparation/determination stage individuals demonstrate readiness to make necessary changes.
|AnswerCExp=Preparation / determination is defined as the stage where the patient shows readiness to make necessary changes.
|AnswerD=Action
|AnswerD=Action
|AnswerDExp=During the action/will power stage, the patient actively changes his behavior.
|AnswerDExp=Action / will power is defined as the stage where the patient is actively changing his behavior.
|AnswerE=Relapse
|AnswerE=Relapse
|AnswerEExp=During relapse, an individual's illness resumes following a period of improvement.
|AnswerEExp=Relapse is defined as the stage where the patient returns to his problem after stopping for a while.
|RightAnswer=B
|RightAnswer=B
|WBRKeyword=stage, smoking, substance abuse, addiction, precontemplation, contemplation, preparation, determination, will power, maintenance, relapse, stages of change,
|WBRKeyword=stage, stages, of, evolution, smoking, substance, abuse, addiction, precontemplation, contemplation, preparation, determination, action, will, power, maintenance, relapse
|Approved=Yes
|Approved=No
}}
}}

Revision as of 15:31, 6 November 2014
Author [[PageAuthor::Rim Halaby, M.D. [1]]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Behavioral Science/Psychiatry
Sub Category SubCategory::General Principles
Prompt [[Prompt::A 52 year old male patient, with a past medical history of myocardial infarction and heavy tobacco use, presents to the physician's office for his annual check-up. During history-taking, the physician notes that the patient has never stopped smoking since his myocardial infarction despite the physician's advice. When asked, the patient explains that he knows his smoking has been a problem for him, but he is currently not ready to stop smoking. Based on the patient's reply, which of the stages of change is the patient currently in?]]
Answer A AnswerA::Precontemplation
Answer A Explanation AnswerAExp::Precontemplation is defined as no acknowledgement of the problem in the first place.
Answer B AnswerB::Contemplation
Answer B Explanation AnswerBExp::Contemplation is defined as the patient acknowledging there is a problem, but not yet ready to change.
Answer C AnswerC::Preparation
Answer C Explanation AnswerCExp::Preparation / determination is defined as the stage where the patient shows readiness to make necessary changes.
Answer D AnswerD::Action
Answer D Explanation AnswerDExp::Action / will power is defined as the stage where the patient is actively changing his behavior.
Answer E AnswerE::Relapse
Answer E Explanation AnswerEExp::Relapse is defined as the stage where the patient returns to his problem after stopping for a while.
Right Answer RightAnswer::B
Explanation [[Explanation::The patient's explanation reveals that he never stopped smoking in the first place. Thus, the patient cannot be currently relapsing. Also, the patient acknowledges that there is a problem, so he cannot be in the precontemplation stage. However, he is not ready to do any change despite his understanding of the problem; so he is not in the preparation or in action stage. The patient must thus be in the contemplation stage, where he fully understands the problem and acknowledges its presence, but has not yet made any change and is not even ready to change in the time being.

The stages of change in order are as follows:
1- Precontemplation
2- Contemplation
3- Preparation/Determination
4- Action/Will power
5- Maintenance
6- Relapse

Educational Objective: Contemplation stage of change is defined as the patient acknowledging that there is a problem, but not being ready to change yet.
Educational Objective:
References: ]]

Approved Approved::No
Keyword WBRKeyword::stage, WBRKeyword::stages, WBRKeyword::of, WBRKeyword::evolution, WBRKeyword::smoking, WBRKeyword::substance, WBRKeyword::abuse, WBRKeyword::addiction, WBRKeyword::precontemplation, WBRKeyword::contemplation, WBRKeyword::preparation, WBRKeyword::determination, WBRKeyword::action, WBRKeyword::will, WBRKeyword::power, WBRKeyword::maintenance, WBRKeyword::relapse
Linked Question Linked::
Order in Linked Questions LinkedOrder::
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