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心血管护理中护士简短动机性访谈的基于网络的电子学习平台评估:一项试点研究。

Evaluation of a Web-Based E-Learning Platform for Brief Motivational Interviewing by Nurses in Cardiovascular Care: A Pilot Study.

作者信息

Fontaine Guillaume, Cossette Sylvie, Heppell Sonia, Boyer Louise, Mailhot Tanya, Simard Marie-Josée, Tanguay Jean-Francois

机构信息

Montreal Heart Institute Research Center, Montréal, QC, Canada.

出版信息

J Med Internet Res. 2016 Aug 18;18(8):e224. doi: 10.2196/jmir.6298.

Abstract

BACKGROUND

Brief motivational interviewing (MI) can contribute to reductions in morbidity and mortality related to coronary artery disease, through health behavior change. Brief MI, unlike more intensive interventions, was proposed to meet the needs of clinicians with little spare time. While the provision of face-to-face brief MI training on a large scale is complicated, Web-based e-learning is promising because of the flexibility it offers.

OBJECTIVE

The primary objective of this pilot study was to examine the feasibility and acceptability of a Web-based e-learning platform for brief MI (MOTIV@CŒUR), which was evaluated by nurses in cardiovascular care. The secondary objective was to assess the preliminary effect of the training on nurses' perceived brief MI skills and self-reported clinical use of brief MI.

METHODS

We conducted a single-group, pre-post pilot study involving nurses working in a coronary care unit to evaluate MOTIV@CŒUR, which is a Web-based e-learning platform for brief MI, consisting of two sessions lasting 30 and 20 minutes. MOTIV@CŒUR covers 4 real-life clinical situations through role-modeling videos showing nurse-client interactions. A brief introduction to MI is followed by role playing, during which a nurse practitioner evaluates clients' motivation to change and intervenes according to the principles of brief MI. The clinical situations target smoking, medication adherence, physical activity, and diet. Nurses were asked to complete both Web-based training sessions asynchronously within 20 days, which allowed assessment of the feasibility of the intervention. Data regarding acceptability and preliminary effects (perceived skills in brief MI, and self-reported clinical use of conviction and confidence interventions) were self-assessed through Web-based questionnaires 30 days (±5 days) after the first session.

RESULTS

We enrolled 27 women and 4 men (mean age 37, SD 9 years) in March 2016. Of the 31 participants, 24 (77%, 95% CI 63%-91%) completed both sessions in ≤20 days. At 30 days, 28 of the 31 participants (90%) had completed at least one session. The training was rated as highly acceptable, with the highest scores observed for information quality (mean 6.26, SD 0.60; scale 0-7), perceived ease of use (mean 6.16, SD 0.78; scale 0-7), and system quality (mean 6.15, SD 0.58; scale 0-7). Posttraining scores for self-reported clinical use of confidence interventions were higher than pretraining scores (mean 34.72, SD 6.29 vs mean 31.48, SD 6.75, respectively; P=.03; scale 10-50). Other results were nonsignificant.

CONCLUSIONS

Brief MI training using a Web-based e-learning platform including role-modeling videos is both feasible and acceptable according to cardiovascular care nurses. Further research is required to evaluate the e-learning platform in a randomized controlled trial.

TRIAL REGISTRATION

International Standard Randomized Controlled Trial Number (ISRCTN): 16510888; http://www.isrctn.com/ISRCTN16510888 (Archived by WebCite at http://www.webcitation.org/6jf7dr7bx).

摘要

背景

简短动机性访谈(MI)可通过改变健康行为,有助于降低与冠状动脉疾病相关的发病率和死亡率。与更强化的干预措施不同,简短MI旨在满足闲暇时间很少的临床医生的需求。虽然大规模提供面对面的简短MI培训很复杂,但基于网络的电子学习因其提供的灵活性而颇具前景。

目的

本试点研究的主要目的是检验一个用于简短MI的基于网络的电子学习平台(MOTIV@CŒUR)的可行性和可接受性,该平台由心血管护理领域的护士进行评估。次要目的是评估该培训对护士所感知的简短MI技能以及自我报告的简短MI临床应用的初步效果。

方法

我们开展了一项单组前后测试点研究,纳入在冠心病监护病房工作的护士,以评估MOTIV@CŒUR,这是一个用于简短MI的基于网络的电子学习平台,由两节时长分别为30分钟和20分钟的课程组成。MOTIV@CŒUR通过展示护士与患者互动的示范视频涵盖4种现实临床情景。在对MI进行简短介绍后进行角色扮演,期间一名执业护士评估患者的改变动机,并根据简短MI的原则进行干预。临床情景涉及吸烟、药物依从性、体育活动和饮食。要求护士在20天内异步完成两节网络培训课程,这使得能够评估干预措施的可行性。在第一节课后30天(±5天),通过基于网络的问卷对关于可接受性和初步效果(所感知的简短MI技能,以及自我报告的信心干预和信念干预的临床应用)的数据进行自我评估。

结果

2016年3月,我们招募了27名女性和4名男性(平均年龄37岁,标准差9岁)。在31名参与者中,24名(77%,95%置信区间63%-91%)在≤20天内完成了两节课程。在30天时,31名参与者中的28名(90%)完成了至少一节课。该培训被评为高度可接受,在信息质量(平均6.26,标准差0.60;量表0-7)、感知易用性(平均6.16,标准差0.78;量表0-7)和系统质量(平均6.15,标准差0.58;量表0-7)方面得分最高。自我报告的信心干预临床应用的培训后得分高于培训前得分(分别为平均34.72,标准差6.29和平均31.48,标准差6.75;P = 0.03;量表10-50)。其他结果无统计学意义。

结论

根据心血管护理护士的评估,使用包括示范视频的基于网络的电子学习平台进行简短MI培训是可行且可接受的。需要进一步研究在随机对照试验中评估该电子学习平台。

试验注册

国际标准随机对照试验编号(ISRCTN):16510888;http://www.isrctn.com/ISRCTN16510888(由WebCite存档于http://www.webcitation.org/6jf7dr7bx)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc8f/5010651/a3fcde7a07e3/jmir_v18i8e224_fig1.jpg

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