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基于动机访谈的咨询策略在糖尿病护理中的效果评价。

Effect evaluation of a Motivational Interviewing based counselling strategy in diabetes care.

机构信息

Department of Health Promotion, Maastricht University, Caphri, The Netherlands.

出版信息

Diabetes Res Clin Pract. 2010 Dec;90(3):270-8. doi: 10.1016/j.diabres.2010.09.012. Epub 2010 Oct 14.

Abstract

AIM

The present study assessed the effects of a Motivational Interviewing (MI) based counselling training for nurses on clinical, behavioural and process outcomes among diabetes type 2 patients.

METHODS

The study is an RCT with follow-up measurements after 12 and 24 months. Thirty-three nurses and 584 patients participated. Nurses in the experimental condition received the training; control group nurses were trained after the study. The training consisted of two training sessions, two follow-up meetings, written feedback and three direct feedback sessions. Basic MI-principles and techniques and an MI-based counselling protocol were addressed.

RESULTS

Results indicated disadvantageous effects on fat intake and HDL and advantageous effects on chance locus of control and knowledge. No effects were found on vegetable or fruit intake, physical activity, HbA1c, weight, blood pressure, total cholesterol, LDL, triglycerides, health care climate, quality of life or on self-efficacy.

CONCLUSIONS

As in other MI studies, mixed results were found. It would be premature to recommend dissemination of MI in diabetes care. More studies are needed in real-world settings with health care professionals of the field instead of intensively trained MI interventionists. Knowledge should be gained about adequate training and factors contributing to the implementation of MI in daily practice.

摘要

目的

本研究评估了基于动机访谈(MI)的护士咨询培训对 2 型糖尿病患者临床、行为和过程结局的影响。

方法

这是一项 RCT 研究,随访测量时间为 12 个月和 24 个月。33 名护士和 584 名患者参与了研究。实验组护士接受培训,对照组护士在研究结束后接受培训。培训包括两次培训课程、两次随访会议、书面反馈和三次直接反馈会议。培训内容包括基本的 MI 原则和技术以及基于 MI 的咨询方案。

结果

结果表明,在脂肪摄入、HDL 方面有不利影响,在机遇控制和知识方面有有利影响。在蔬菜或水果摄入、体育活动、HbA1c、体重、血压、总胆固醇、LDL、甘油三酯、医疗保健氛围、生活质量或自我效能方面未发现影响。

结论

与其他 MI 研究一样,本研究结果喜忧参半。在糖尿病护理中推广 MI 还为时过早。需要在现实环境中对该领域的医疗保健专业人员进行更多研究,而不是对经过强化培训的 MI 干预者进行研究。应该了解适当的培训以及有助于将 MI 实施到日常实践中的因素。

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