Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK.
Patient Educ Couns. 2011 Aug;84(2):e37-43. doi: 10.1016/j.pec.2010.07.036. Epub 2010 Aug 30.
To assess whether medical nurses can deliver motivational enhancement therapy (MET) and cognitive behavioural therapy (CBT) to a competent level and whether treatment fidelity is maintained.
Training consisted of classroom teaching, written materials, a training caseload, and audio-visual feedback. We used the Motivational Interviewing Treatment Integrity (MITI), the Revised 12-item Cognitive Therapy Scale (CTS-R), and components of the Motivational Interviewing Skill Code (MISC) to assess competency and treatment fidelity. Two independent clinical psychologists who were blind to the allocation rated a random selection of 40 sessions.
Six nurses were trained in both interventions. For the MET the mean (SD) scores for empathy and spirit on the MITI scale were 5.1 (0.7) and 4.6 (1.0) respectively and for CBT the total mean (SD) CTS-R score was 52.1 (7.5), which was acceptable competency in both treatments. The two interventions were distinguishable.
Results suggest that nurses can be trained to deliver diabetes-specific MET and CBT competently and maintain treatment fidelity.
Findings of this study provide preliminary evidence to suggest that nurse-led psychological interventions could be incorporated into the traditional diabetes setting.
评估医学护士是否能够达到胜任水平并保持治疗的忠实度，以提供动机增强治疗（MET）和认知行为疗法（CBT）。
培训包括课堂教学、书面材料、培训病例和视听反馈。我们使用动机访谈治疗完整性量表（MITI）、修订后的 12 项认知治疗量表（CTS-R）和动机访谈技能代码（MISC）的组成部分来评估能力和治疗忠实度。两位独立的临床心理学家在不知道分配情况的情况下对随机选择的 40 个疗程进行了评估。
六名护士接受了这两种干预措施的培训。对于 MET，MITI 量表上的同理心和精神的平均（SD）得分为 5.1（0.7）和 4.6（1.0），而 CBT 的总平均（SD）CTS-R 得分为 52.1（7.5），这两种治疗方法的得分都在可接受的范围内。两种干预措施是可区分的。
结果表明，护士可以接受培训，以胜任地提供特定于糖尿病的 MET 和 CBT，并保持治疗的忠实度。
本研究的结果提供了初步证据，表明以护士为主导的心理干预措施可以纳入传统的糖尿病治疗环境中。
