Chahal Nita, Rush Janet, Manlhiot Cedric, Boydell Katherine M, Jelen Ahlexxi, McCrindle Brian W
Labatt Family Heart Centre, Department of Paediatrics, University of Toronto, The Hospital for Sick Children, Toronto, ON, Canada.
Faculty of Health Sciences, School of Nursing, McMaster University, Hamilton, ON, Canada.
SAGE Open Med. 2017 May 15;5:2050312117707152. doi: 10.1177/2050312117707152. eCollection 2017.
Lifestyle management for dyslipidemic adolescents often occurs in the context of family-centered care, which necessitates adaptation of counseling strategies.
To determine the effectiveness of motivational interviewing for lifestyle behavior change for dyslipidemic adolescents in a dyad with a parent versus alone.
A total number of 32 adolescents were randomized 1:1 to receive a series of motivational interviewing sessions either together with a parent or alone for a 6-month intervention, with both quantitative and qualitative assessment of outcomes.
Both groups were similar at baseline. Following the intervention, there were no significant differences between groups in physical, laboratory, lifestyle or psychosocial measures, except for a reduction in dietary fats/sugars (p = 0.02) and in screen time (p = 0.02) in the alone group. When both groups were combined, significant reductions at 6 months were noted for body mass index (p < 0.001), waist circumference (p < 0.001), total cholesterol (p < 0.001), low-density lipoprotein cholesterol (p < 0.001), triglycerides (p = 0.01), non-high-density lipoprotein cholesterol (p < 0.001), fasting insulin (p = 0.01), and homeostatic model (p = 0.02). Reduced screen time and increased fruit and vegetable intake were also noted for both groups combined. These changes were also reflected in self-efficacy (p = 0.004), self-esteem (p = 0.03), and improvement in quality of life measures. Interview data provided insights into the utility and acceptability of the motivational interviewing intervention.
Motivational interviewing was an efficient strategy for inspiring healthy lifestyle and physiological changes among adolescents in both groups. Family centered pediatric approaches should consider the autonomy and individual preferences of the adolescent prior to counseling.
血脂异常青少年的生活方式管理通常在以家庭为中心的护理背景下进行，这就需要调整咨询策略。
确定动机性访谈对血脂异常青少年与父母一起或单独进行生活方式行为改变的有效性。
总共32名青少年按1:1随机分组，接受一系列动机性访谈，一组与父母一起，另一组单独进行，为期6个月的干预，并对结果进行定量和定性评估。
两组在基线时相似。干预后，除单独组的膳食脂肪/糖摄入量减少（p = 0.02）和屏幕使用时间减少（p = 0.02）外，两组在身体、实验室、生活方式或心理社会指标方面无显著差异。当两组合并时，6个月时体重指数（p < 0.001）、腰围（p < 0.001）、总胆固醇（p < 0.001）、低密度脂蛋白胆固醇（p < 0.001）、甘油三酯（p = 0.01）、非高密度脂蛋白胆固醇（p < 0.001）、空腹胰岛素（p = 0.01）和稳态模型（p = 0.02）均有显著降低。两组合并后还发现屏幕使用时间减少，水果和蔬菜摄入量增加。这些变化也反映在自我效能感（p = 0.004）、自尊（p = 0.03）和生活质量指标的改善上。访谈数据提供了关于动机性访谈干预的效用和可接受性的见解。
动机性访谈是激发两组青少年健康生活方式和生理变化的有效策略。以家庭为中心的儿科方法在咨询前应考虑青少年的自主性和个人偏好。
