Benarous X, Legrand C, Consoli S M
Unité fonctionnelle de psychologie et psychiatrie de liaison et d'urgences, service universitaire de psychiatrie de l'adulte et du sujet âgé, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, 75908 Paris cedex 15, France.
Hôpital européen Georges-Pompidou, AP-HP, 20, rue Leblanc, 75908 Paris cedex 15, France; Laboratoire de psychopathologie et processus de santé (EA 4057), institut de psychologie, université Paris-Descartes, 71, avenue Édouard-Vaillant, 92100 Boulogne-Billancourt, France.
Rev Med Interne. 2014 May;35(5):317-21. doi: 10.1016/j.revmed.2013.08.009. Epub 2013 Sep 17.
Many situations in common medical practice, especially in chronic diseases, require patients to be mobilized for health behavior decisions: for daily intake of an antihypertensive drug, performing a mammography for cancer screening, as well as adopting new diet habits in diabetes. Ability to initiate a health behavior depends on several parameters. Some of them are related to the patient, his personality, his illness and treatment's perception; others directly rely on the physician, his attitude and his communication style during the visit, independently of patient's level of resistance to change. Motivational interviewing (MI) is a communication technique, first developed for patients presenting a substance abuse disorder, to explore their ambivalence, overcome their resistances and give them the willingness of a better self-care. Its general principles and basic techniques can be applied by every practitioner and deserve to be better known, given that scientific literature provides evidence for generalizing it in a variety of medical conditions, in structured patient education programs as well as in usual follow-up, for which time is generally restricted. This article provides an overview of MI recent applications and argues for its diffusion in everyday medical practice.
在普通医疗实践中，尤其是在慢性病治疗中，许多情况都需要患者积极参与健康行为决策：每日服用降压药、进行乳腺癌筛查的乳房X光检查，以及在糖尿病治疗中养成新的饮食习惯。启动健康行为的能力取决于多个参数。其中一些与患者本身、其个性、对疾病和治疗的认知有关；其他则直接取决于医生，取决于医生在诊疗过程中的态度和沟通方式，而与患者对改变的抵触程度无关。动机性访谈（MI）是一种沟通技巧，最初是为患有药物滥用障碍的患者开发的，用于探究他们的矛盾心理、克服他们的抵触情绪，并给予他们更好自我护理的意愿。鉴于科学文献为在各种医疗状况下、结构化患者教育项目以及通常的随访（而随访时间通常有限）中推广该方法提供了证据，其一般原则和基本技巧可供每位从业者应用，并且值得更多人了解。本文概述了动机性访谈的最新应用，并主张在日常医疗实践中推广该方法。
