TOOL FOR ENGAGING STAFF/CLIENTS IN DISCUSSION OF SELF-MANAGEMENT GOALS PORT ALBERNI TEAM
We Stole: The topic list developed for group workshops by the Native Health Center
We wove those topics into a colorful, quick client survey form
Rate Your Satisfaction with your Health Status A. Your knowledge of HIV 1 2 3 4 5 B. Your understanding of your HIV medications C. Your nutritional status D. Your level of physical activity
E. The safety of your sexual practices 1 2 3 4 5 F. Your ability to manage your time, work, money 1 2 3 4 5 G. Your emotional health
We use the survey as a jumping-off point for discussion of self- management goals
We use the back-side of the survey form to record the 1 goal that is chosen to be worked on for the next quarter Date of Survey: Goal: First Steps: Resources:
At the next visit we review how things are going with meeting the self-management goal
In 3 months the survey is repeated Rate Your Satisfaction with your Health Status