The nurse decided to use a learning model based on Skinner with a client with diabetes to improve compliance with dietary and blood glucose assessment requirements. Which would be the best way to implement this program?
A) Give rewards for a lower blood sugar level and a food diary that reflects moderate dietary compliance.
B) Eliminate the reward and punish the client when she fails to comply with dietary guidelines.
C) Demonstrate positive reinforcement by decreasing dietary guidelines and blood sugar parameters.
D) Institute a strict timeline to accomplish goals.
Ans: A
Feedback:
According to Skinner (1953), health behaviors are seen as incremental steps toward a final goal. In the learning model, the nurse establishes and reinforces a goal and rewards the client for partial accomplishment, if necessary. Incremental increases are then made as the pattern of behavior is shaped toward a specific goal. Reinforcement is used to motivate the client to either continue or discontinue a behavior. Giving rewards for a lower blood sugar level and a food diary that reflects moderate dietary compliance is the best example of implementing a learning model of behavior change. Punishment and enforcing a strict timeline do not provide positive reinforcement and thus are not good examples of the learning model. Lowering the requirements of the goal is also not a good example of this model, as the goal should not change.
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