• What information would you provide Euan and Mhairi in order to support him with lifestyle changes?
• How could you assist Euan and Mhairi to maintain these changes?

A proposed response to these questions might include:

The significance of the fact that Euan has realised that there are several changes that he can make can be utilised to the advantage of both Euan and the nurse. Lifestyle changes require to be made but emphasis should be placed on making changes that are realistic in the first instance. A sense of achievement often helps to fuel motivation and to sustain change.

A useful model, which could be utilised, is the Prochaska and DiClemente’s (1983) Model of Behavioural Change. This can be used to determine an individual’s stage of motivation in order for behavioural change to be actioned and sustained. It also provides a useful reference point in regard to sustaining change, i.e. it often takes an individual several motivational change cycles to sustain lifestyle changes. 

There are also lots of evidence-based support materials available, for example, the ones cited throughout this chapter, which are readily available online and in printed format. The BHF is an excellent source of information. Information produced on a local basis by the NHS Trust is more than likely to be available also. This information can be used to support Euan in making lifestyle changes.

Ensuring that your knowledge is up to date in regard to local service provision should also help inform Euan in supporting his lifestyle changes:

• Cardiac Rehabilitation (referral and provision of robust evidence-based information and support)
• Diet (promoting healthy eating and referral to the dietician)
• Smoking (referral to smoking cessation clinic and provision of nicotine replacement therapy)
• Recreational Drug Use (provision of robust evidence-based information and support)
• Alcohol consumption (provision of robust evidence-based information and support)
• Exercise (promoting regular healthy levels of exercise)
• Medication (provision of robust evidence-based information and support)
• Helpline (telephone, web-based, email support options)
• Support Group (local and national)
• Employment (return to work, change of employment)

Effective communication is therefore very important to ensure that you engage Euan and Mhairi. The provision of evidence-based information will also demonstrate that you are a knowledgeable and safe practitioner and promote patient safety and choice. It is also important that you tailor the advice given to suit the needs of the individual, their family/carers. Ultimately, all of these actions can assist Euan and Mhairi to maintain these changes.