Petrova Tatjana, Kavookjian Jan, Madson Michael B, Dagley John, Shannon David, McDonough Sharon K
Department of Pharmacy Practice, College of Pharmacy, Chicago State University, Chicago, IL, USA.
Department of Health Outcomes Research and Policy, Harrison School of Pharmacy, Auburn University, Auburn, AL, USA.
Res Social Adm Pharm. 2015 Sep-Oct;11(5):696-707. doi: 10.1016/j.sapharm.2014.12.001. Epub 2014 Dec 11.
Motivational interviewing (MI) has demonstrated a significant impact as an intervention strategy for addiction management, change in lifestyle behaviors, and adherence to prescribed medication and other treatments. Key elements to studying MI include training in MI of professionals who will use it, assessment of skills acquisition in trainees, and the use of a validated skills assessment tool.
The purpose of this research project was to develop a psychometrically valid and reliable tool that has been designed to assess MI skills competence in health care provider trainees. The goal was to develop an assessment tool that would evaluate the acquisition and use of specific MI skills and principles, as well as the quality of the patient-provider therapeutic alliance in brief health care encounters.
To address this purpose, specific steps were followed, beginning with a literature review. This review contributed to the development of relevant conceptual and operational definitions, selecting a scaling technique and response format, and methods for analyzing validity and reliability. Internal consistency reliability was established on 88 video recorded interactions. The inter-rater and test-retest reliability were established using randomly selected 18 from the 88 interactions. The assessment tool Motivational Interviewing Skills for Health Care Encounters (MISHCE) and a manual for use of the tool were developed.
Validity and reliability of MISHCE were examined. Face and content validity were supported with well-defined conceptual and operational definitions and feedback from an expert panel. Reliability was established through internal consistency, inter-rater reliability, and test-retest reliability. The overall internal consistency reliability (Cronbach's alpha) for all fifteen items was 0.75. MISHCE demonstrated good inter-rater reliability and good to excellent test-retest reliability.
MISHCE assesses the health provider's level of knowledge and skills in brief disease management encounters. MISHCE also evaluates quality of the patient-provider therapeutic alliance, i.e., the "flow" of the interaction.
动机性访谈（MI）作为一种干预策略，在成瘾管理、生活方式行为改变以及遵医嘱用药和接受其他治疗方面已显示出重大影响。研究MI的关键要素包括对将使用它的专业人员进行MI培训、评估学员的技能掌握情况以及使用经过验证的技能评估工具。
本研究项目的目的是开发一种心理测量学上有效且可靠的工具，该工具旨在评估医疗保健提供者学员的MI技能能力。目标是开发一种评估工具，以评估特定MI技能和原则的掌握与运用情况，以及在简短的医疗保健接触中患者与提供者治疗联盟的质量。
为实现这一目的，采取了具体步骤，首先进行了文献综述。该综述有助于制定相关的概念和操作定义、选择量表技术和反应格式以及分析效度和信度的方法。在88次视频记录的互动中建立了内部一致性信度。使用从88次互动中随机选择的18次互动建立了评分者间信度和重测信度。开发了评估工具《医疗保健接触中的动机性访谈技能》（MISHCE）及其使用手册。
对MISHCE的效度和信度进行了检验。明确的概念和操作定义以及专家小组的反馈支持了表面效度和内容效度。通过内部一致性、评分者间信度和重测信度建立了信度。所有15个项目的总体内部一致性信度（Cronbach's alpha）为0.75。MISHCE显示出良好的评分者间信度和良好至优秀的重测信度。
MISHCE评估医疗保健提供者在简短疾病管理接触中的知识和技能水平。MISHCE还评估患者与提供者治疗联盟的质量，即互动的“流畅性”。
