Pócs Dávid, Hamvai Csaba, Kelemen Oguz
Magatartástudományi Intézet, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Hajnóczy u 13. 1/3, 6722.
Orv Hetil. 2017 Aug;158(34):1331-1337. doi: 10.1556/650.2017.30825.
Public health data show that early mortality in Hungary could be prevented by smoking cessation, reduced alcohol consumption, regular exercise, healthy diet and increased adherence. Doctor-patient encounters often highlight these aspects of health behavior. There is evidence that health behavior change is driven by internal motivation rather than external influence. This finding has led to the concept of motivational interview, which is a person-centered, goal-oriented approach to counselling. The doctor asks targeted questions to elicit the patient's motivations, strengths, internal resources, and to focus the interview around these. The quality and quantity of the patient's change talk is related to better outcomes. In addition, the interview allows the patient to express ambivalent feelings and doubts about the change. The doctor should use various communication strategies to resolve this ambivalence. Furthermore, establishing a good doctor-patient relationship is the cornerstone of the motivational interview. An optimal relationship can evoke change talk and reduce the patient's resistance, which can also result in a better outcome. The goal of the motivational interview is to focus on the 'why' to change health behavior rather than the 'how', and to utilize internal motivation instead of persuasion. This is the reason why motivational interview has become a widely-accepted evidence based approach. Orv Hetil. 2017; 158(34): 1331-1337.
公共卫生数据表明，匈牙利的早期死亡率可通过戒烟、减少酒精摄入、定期锻炼、健康饮食和提高依从性来预防。医患交流常常会突出健康行为的这些方面。有证据表明，健康行为的改变是由内在动机而非外部影响驱动的。这一发现催生了动机性访谈的概念，它是一种以患者为中心、目标导向的咨询方法。医生会提出针对性问题，以引出患者的动机、优势、内在资源，并围绕这些展开访谈。患者改变谈话的质量和数量与更好的结果相关。此外，访谈让患者能够表达对改变的矛盾情绪和疑虑。医生应运用各种沟通策略来解决这种矛盾心理。此外，建立良好的医患关系是动机性访谈的基石。最佳的关系能够引发改变谈话并降低患者的抵触情绪，这也能带来更好的结果。动机性访谈的目标是关注改变健康行为的“原因”而非“方式”，并利用内在动机而非说服手段。这就是动机性访谈已成为一种广泛接受的循证方法的原因。《匈牙利医学周报》。2017年；158(34): 1331 - 1337。
