Bombardier Charles H, Cunniffe Mary, Wadhwani Rohini, Gibbons Laura E, Blake Kimberly D, Kraft George H
Department of Rehabilitation Medicine, Multiple Sclerosis Rehabilitation Research and Training Center, University of Washington School of Medicine, Seattle, WA, USA.
Arch Phys Med Rehabil. 2008 Oct;89(10):1849-56. doi: 10.1016/j.apmr.2008.03.021.
To determine if motivational interviewing-based telephone counseling increases health promotion activities and improves other health outcomes in people with multiple sclerosis (MS).
Randomized controlled trial with wait-list controls and single-blinded outcome assessments conducted at baseline and at 12 weeks.
MS research and training center in the Pacific Northwest.
Community-residing persons (N=130) with physician confirmed MS aged 18 or older who were able to walk unassisted at least 90 m (300 ft).
A single in-person motivational interview followed by 5 scheduled telephone counseling sessions to facilitate improvement in 1 of 6 health promotion areas: exercise, fatigue management, communication and/or social support, anxiety and/or stress management, and reducing alcohol or other drug use.
Health Promotion Lifestyle Profile II plus fatigue impact, subjective health, and objective measures of strength, fitness, and cognition. Intent-to-treat analyses of change scores were analyzed using nonparametric tests.
Seventy persons were randomized to treatment and 60 to the control condition. The treatment group reported significantly greater improvement in health promotion activities, including physical activity, spiritual growth, and stress management as well as in fatigue impact and mental health compared with controls. In addition, the exerciser subgroup showed greater improvement than controls in self-selected walking speed.
A less intensive, more accessible approach to health promotion based on telephone counseling and motivational interviewing shows promise and merits further study.
确定基于动机性访谈的电话咨询是否能增加多发性硬化症（MS）患者的健康促进活动并改善其他健康结果。
采用随机对照试验，设置等待名单对照组，并在基线和12周时进行单盲结局评估。
太平洋西北地区的MS研究与培训中心。
130名社区居住者，年龄在18岁及以上，经医生确诊患有MS，能够在无辅助情况下至少行走90米（300英尺）。
进行一次面对面的动机性访谈，随后安排5次电话咨询，以促进6个健康促进领域中1个领域的改善，即运动、疲劳管理、沟通和/或社会支持、焦虑和/或压力管理，以及减少酒精或其他药物使用。
健康促进生活方式量表II加上疲劳影响、主观健康以及力量、体能和认知的客观测量指标。使用非参数检验对变化分数进行意向性分析。
70人被随机分配到治疗组，60人被分配到对照组。与对照组相比，治疗组在健康促进活动方面有显著更大的改善，包括身体活动、精神成长和压力管理，以及在疲劳影响和心理健康方面。此外，运动亚组在自我选择的步行速度方面比对照组有更大的改善。
基于电话咨询和动机性访谈的一种强度较低、更易获得的健康促进方法显示出前景，值得进一步研究。
