Clinical Practice Research Unit, School of Health, University of Central Lancashire, Preston, PR12HE, UK.
Stroke. 2011 Jul;42(7):1956-61. doi: 10.1161/STROKEAHA.110.602227. Epub 2011 Jun 23.
The purpose of this study was to determine whether motivational interviewing (MI), a patient-centered counseling technique, can benefit patients' mood and mortality poststroke.
This was a single-center, open, randomized, controlled trial. The setting was a hospital with a stroke unit. Four hundred eleven consecutive patients on the stroke register were >18 years old, not known to be moving out-of-area postdischarge, not receiving psychiatric or clinical psychology intervention, and were without severe cognitive or communication problems preventing participation in interviews. All patients received usual stroke care. Patients in the intervention group also received 4 individual, weekly sessions of MI. The primary outcome was the proportion of patients with normal mood measured by the 28-item General Health Questionnaire (normal <5; low ≥5) using a mailed questionnaire at 12 months poststroke.
At 12-month follow-up (including imputed data), 37.7% patients in the control group and 48.0% patients in the intervention group had normal mood. Twenty-five (12.8%) of 195 patients in the control group and 13 (6.5%) of 199 patients in the intervention group had died. A significant benefit of motivational interviewing over usual stroke care was found for mood (P=0.020; OR, 1.66; 95% CI, 1.08 to 2.55) and mortality (P=0.035; OR, 2.14; 95% CI, 1.06 to 4.38).
Results suggest that motivational interviewing improves patients' mood and reduces mortality 12 months poststroke.
URL: www.controlled-trials.com. Unique identifier: ISRCTN54465472.
本研究旨在确定以患者为中心的咨询技术——动机性访谈（MI）是否有益于改善患者卒中后的情绪和降低死亡率。
这是一项单中心、开放、随机、对照试验。试验地点是一家设有卒中单元的医院。连续登记的 411 例卒中患者年龄均＞18 岁，出院后预计不会搬离本地区，未接受精神科或临床心理学干预，且认知或交流问题不严重，不影响参与访谈。所有患者均接受常规卒中护理。干预组患者还接受了 4 次每周的 MI 个体访谈。主要结局是通过邮寄问卷在卒中后 12 个月评估患者的情绪正常比例，采用 28 项一般健康问卷（正常＜5；低≥5）。
在 12 个月的随访（包括推断数据）中，对照组有 37.7%的患者和干预组有 48.0%的患者情绪正常。对照组 195 例患者中有 25 例（12.8%）和干预组 199 例患者中有 13 例（6.5%）死亡。与常规卒中护理相比，动机性访谈显著改善了患者的情绪（P=0.020；OR，1.66；95%CI，1.08 至 2.55）和死亡率（P=0.035；OR，2.14；95%CI，1.06 至 4.38）。
结果表明，动机性访谈可改善患者卒中后 12 个月的情绪，并降低死亡率。
