Individualized Intervention Model Aiming to Permanently Change Life Habits which Have an Impact on Modifiable Risk Factors

Abstract

Background: A great challenge for clinicians working in a rehabilitation or prevention setting is to succeed in getting their clients to be physically active and to make them change their life habits. Five years ago at Centre de Réadaptation Lucie Bruneau, an interdisciplinary rehabilitation team took that challenge. This team is specialized in stroke rehabilitation and, in the last 5 yr, it has noticed a decline in the health condition, quality of life and social participation of its patients. Here are some statistics that illustrate the situation: 57% are < 49 yr old, 24% have 3 modifiable risk factors, another 24% have four or more and 18% have five; 35% have associated heart, vascular problems or diseases; for most of them, there’s a 20% chance of having another stroke.
 
 Methods: From these observations, an innovative concept of intervention was born. It is a part of the rehabilitation process and is based on research in a variety of fields: the transtheoric model of Prochaska and DiClemente, the person centered neurodynamic approach; the ecological, psycho-biological (affordance) and pedagogical approaches. The team systematically identifies the risk factors in an individualized intervention plan which is based on the “handicap production process” model. From the start to the end of the rehabilitation program and according to his needs, the patient will be brought to understand, adopt and integrate new life habits in the following spheres: food, smoking, and physical activity. 
 
 Results: This global responsibilization optimizes and strengthens their long term commitment. Concerning physical activity, results obtained from a pilot study show us that 70% of our patients maintain their level three months after their discharge. 
 
 Conclusion: This type of intervention could be used in other type of settings (rehabilitation or prevention): hospital, school, CLSC’s and community centers.