Thepwongsa Isaraporn, Muthukumar Radhakrishnan, Kessomboon Pattapong
Department of Community Medicine, Faculty of Medicine, Khon Kaen University, Thailand.
Graduate School, Khon Kaen University, Thailand.
Fam Pract. 2017 Aug 1;34(4):376-383. doi: 10.1093/fampra/cmx045.
Motivational interviewing (MI) is an effective tool to help clinicians with facilitating behavioural changes in many diseases and conditions. However, different forms of MI are required in different health care settings and for different clinicians. Although general practitioners (GPs) play a major role in Type 2 diabetes management, the effects of MI delivered by GPs intended to change the behaviours of their Type 2 diabetes patients and GP outcomes, defined as GP knowledge, satisfaction and practice behaviours, have not been systematically reviewed.
An electronic search was conducted through Cochrane Library, Scopus, ProQuest, Wiley Online Library, Ovid MEDLINE, PubMed, CINAHL, MEDLINE Complete and Google Scholar from the earliest date of each database to 2017. Reference lists from each article obtained were reviewed. Measured changes in GP satisfaction, knowledge, and practice behaviours, and patient outcomes were recorded.
Eight out of 1882 studies met the criteria for inclusion. Six studies examined the effects of MI on Type 2 diabetes patient outcomes, only one of which examined its effects on GP outcomes. Two-thirds of the studies (4/6) found a significant improvement in at least one of the following patient outcomes: total cholesterol, low-density lipoproteins, fasting blood glucose, HbA1c, body mass index, blood pressure, waist circumference and physical activity. The effects of MI on GP outcomes yielded mixed results.
Few studies have examined evidence for the effectiveness of MI delivered by GPs to Type 2 diabetes patients. Evidence to support the effectiveness of MI on GP and patient outcomes is weak. Further quality studies are needed to examine the effects of MI on GP and patient outcomes.
动机性访谈（MI）是一种有效的工具，可帮助临床医生促进许多疾病和病症中的行为改变。然而，在不同的医疗保健环境中以及针对不同的临床医生，需要采用不同形式的动机性访谈。尽管全科医生（GP）在2型糖尿病管理中发挥着主要作用，但全科医生进行的旨在改变其2型糖尿病患者行为的动机性访谈的效果以及全科医生的结果（定义为全科医生的知识、满意度和实践行为）尚未得到系统评价。
通过Cochrane图书馆、Scopus、ProQuest、Wiley在线图书馆、Ovid MEDLINE、PubMed、CINAHL、MEDLINE Complete和谷歌学术搜索从每个数据库的最早日期到2017年的文献。对获取的每篇文章的参考文献列表进行了审查。记录了全科医生满意度、知识和实践行为以及患者结果的测量变化。
1882项研究中有8项符合纳入标准。6项研究考察了动机性访谈对2型糖尿病患者结果的影响，其中只有1项考察了其对全科医生结果的影响。三分之二的研究（4/6）发现至少以下一项患者结果有显著改善：总胆固醇、低密度脂蛋白、空腹血糖、糖化血红蛋白、体重指数、血压、腰围和身体活动。动机性访谈对全科医生结果的影响产生了混合结果。
很少有研究考察全科医生对2型糖尿病患者进行动机性访谈有效性的证据。支持动机性访谈对全科医生和患者结果有效性的证据薄弱。需要进一步的高质量研究来考察动机性访谈对全科医生和患者结果的影响。
