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基层护理护士在动机性访谈中的表现:一项定量描述性研究。

Primary care nurses' performance in motivational interviewing: a quantitative descriptive study.

作者信息

Östlund Ann-Sofi, Kristofferzon Marja-Leena, Häggström Elisabeth, Wadensten Barbro

机构信息

Department of Public Health and Caring Sciences, Uppsala University, BMC, Box 564, Uppsala, 751 22, Sweden.

Faculty of Health and Occupational Studies, University of Gävle, Gävle, 801 76, Sweden.

出版信息

BMC Fam Pract. 2015 Jul 25;16:89. doi: 10.1186/s12875-015-0304-z.

Abstract

BACKGROUND

Motivational interviewing is a collaborative conversational style intended to strengthen motivation to change. It has been shown to be effective in addressing many different lifestyle problems as well as in chronic disease management, and many disease prevention guidelines promote use of motivational interviewing. The aim of the present study was twofold: to assess to what extent the primary care nurses in the study perform motivational interviewing according to the Motivational Interviewing Treatment Integrity Code and to investigate how the participating primary care nurses rated their own performance in motivational interviewing.

METHOD

The study was based on twelve primary care nurses' audio-recorded motivational interviewing sessions with patients (total 32 sessions). After each session, the nurses completed a questionnaire regarding their experience of their own performance in motivational interviewing. The audio-recorded sessions were analyzed using Motivational Interviewing Integrity Code 3.1.1.

RESULTS

None of the nurses achieved beginning proficiency in all parts of any motivational interviewing sessions and two nurses did not achieve beginning proficiency in any parts or sessions. Making more complex than simple reflections was the specific verbal behavior/summary score that most nurses achieved. Beginning proficiency/competency in "percent open questions" was the summary score that fewest achieved.

CONCLUSION

Primary care nurses did not achieve beginning proficiency/competency in all aspects of motivational interviewing in their recorded sessions with patients, where lifestyle change was discussed. This indicates a need for improvement and thus additional training, feedback and supervision in clinical practice with motivational interviewing.

摘要

背景

动机性访谈是一种旨在增强改变动机的协作对话方式。已证明其在解决许多不同的生活方式问题以及慢性病管理方面有效,许多疾病预防指南也提倡使用动机性访谈。本研究的目的有两个:评估研究中的初级保健护士在多大程度上按照动机性访谈治疗完整性准则进行动机性访谈,并调查参与研究的初级保健护士如何评价自己在动机性访谈中的表现。

方法

该研究基于12名初级保健护士与患者进行的动机性访谈录音会话(共32次会话)。每次会话后,护士们完成一份关于他们在动机性访谈中对自己表现的体验的问卷。使用动机性访谈完整性准则3.1.1对录音会话进行分析。

结果

没有一名护士在任何动机性访谈会话的所有部分都达到初级熟练水平,两名护士在任何部分或会话中都未达到初级熟练水平。大多数护士达到的特定言语行为/总结分数是做出比简单反思更复杂的内容。在“开放式问题百分比”方面达到初级熟练水平/能力的总结分数是最少有人达到的。

结论

在与患者讨论生活方式改变的录音会话中,初级保健护士在动机性访谈的所有方面都未达到初级熟练水平/能力。这表明需要改进,因此在动机性访谈的临床实践中需要额外的培训、反馈和监督。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3581/4513379/7ac9b840fb5e/12875_2015_304_Fig1_HTML.jpg

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