1-You make a great point about using open-ended questions to get the most information out of Ms Li. I never considered this but it makes sense. This is is important in this situation as it will open up an opportunity for dialogue and will help Ms. Li feel more comfortable about opening up. By having this type of interaction with her, she will be more apt to share any abuse she may or may not be dealing with at home. Cultural competence is definitely vital in this situation.

2-Tamara, good point about the possiblitity that the patient may not be ready to take action right at the moment you are talking to them.  I had a patient one time disclose to me that she was in an abusive situation years ago. A community member from a volunteer organization had given her his business card and said she should call when she was reday for help. That young lady carried his card around for over one year and eventually did call.  In the end, she received the resources she needed. You never know when your patient will be ready to take action. As nurses, we have to keep reaching out and giving them the tools they need.

3-This is a good reminder to us, as nurses to be patient with individuals who may not be responding to education/ teaching in the way we initially hoped.  Cultural influences are introduced to us early in life and it’s often times what people fall back on in times of crisis. Just because a patient may not appear to “take our advice” it doesn’t mean thay may not reflect on the conversation later and be ready to begin positve, health-seeking behaviors at a later time.

4-It occurred to me that this age group likely has children and could make it a family affair of exercising and spending that time together. It could be a time where everyone is together in one place working as a team. This would also set a good example for children as the rise of obesity and health related problems is growing in this age group. Children follow what they know and if they only know a sedentary lifestyle than that is what they will likely pattern. I also think you make a great point about showing patients visual evidence of the risks and also the benefits. Most people are visual and we live in a world that is centered around tangible evidence so this would most likely have a big impact on the client.

5-I think one way to motivate patients is to properly educate them on the risks of not exercising with their health conditions. Most people need to know facts and need to know the “why” behind it. Helping them see that it doesn’t have to be a drastic change but rather a gradual change that they incorporate into their every day life and build on will help them not feel overwhelmed. Also, helping them set up a reward system for themselves would help. For instance, for every 5 or 10 pounds they lose, they get to buy themselves something new or at the end of the month, however much weight they lost, they get to spend that amount of money on something for themselves. Something tangible that they can set a goal and work toward would be helpful. Everyone needs an incentive to motivate them.

6-I believe so too! We as people tend to repeat what we are comfortable with. If we make the experience enjoyable people are more likely to repeat the task. Zumba classes have seem to have picked up in my area and may of the staff go to these classes together to keep each other motivated. Being a male in this line of work sometimes makes it hard to find someone to go to the gym with so i have had to reach out to some of my friends outside of the work place to help me stay motivated.