WBR0512
| 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. |
| 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:: |