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为医疗服务提供者配备将行为改变咨询成功融入实践的原则、知识和技能:一个初级卫生保健框架。

Equipping providers with principles, knowledge and skills to successfully integrate behaviour change counselling into practice: a primary healthcare framework.

作者信息

Vallis M, Lee-Baggley D, Sampalli T, Ryer A, Ryan-Carson S, Kumanan K, Edwards L

机构信息

Primary Care, Nova Scotia Health Authority & Dalhousie University, Halifax, Canada.

Primary Care, Nova Scotia Health Authority & Dalhousie University, Halifax, Canada.

出版信息

Public Health. 2018 Jan;154:70-78. doi: 10.1016/j.puhe.2017.10.022. Epub 2017 Dec 22.

DOI:10.1016/j.puhe.2017.10.022
PMID:29216495
Abstract

OBJECTIVES

There is an urgent need for healthcare providers and healthcare systems to support productive interactions with patients that promote sustained health behaviour change in order to improve patient and population health outcomes. Behaviour change theories and interventions have been developed and evaluated in experimental contexts; however, most healthcare providers have little training, and therefore low confidence in, behaviour change counselling. Particularly important is how to integrate theory and method to support healthcare providers to engage in behaviour change counselling competently. In this article, we describe a general training model developed from theory, evidence, experience and stakeholder engagement. This model will set the stage for future evaluation research on training needed to achieve competency, sustainability of competency, as well as effectiveness/cost-effectiveness of training in supporting behaviour change.

DESIGN AND METHODS

A framework to support competency based training in behaviour change counselling is described in this article. This framework is designed to be integrative, sustainable, scalable and capable of being evaluated in follow-up studies.

RESULTS AND DISCUSSION

Effective training in behaviour change counselling is critical to meet the current and future healthcare needs of patients living with, or at risk of, chronic diseases. Increasing competency in establishing change-based relationships, assessing and promoting readiness to change, implementing behaviour modification and addressing psychosocial issues will be value added to the healthcare system.

摘要

目标

医疗服务提供者和医疗系统迫切需要支持与患者进行有效的互动,以促进持续的健康行为改变,从而改善患者和人群的健康状况。行为改变理论和干预措施已在实验环境中得到开发和评估;然而,大多数医疗服务提供者几乎没有接受过行为改变咨询方面的培训,因此对此信心不足。特别重要的是如何整合理论和方法,以支持医疗服务提供者胜任行为改变咨询工作。在本文中,我们描述了一种基于理论、证据、经验和利益相关者参与而开发的通用培训模型。该模型将为未来关于实现胜任能力所需培训、胜任能力的可持续性以及培训在支持行为改变方面的有效性/成本效益的评估研究奠定基础。

设计与方法

本文描述了一个支持行为改变咨询中基于胜任能力培训的框架。该框架旨在具有综合性、可持续性、可扩展性,并能够在后续研究中进行评估。

结果与讨论

有效的行为改变咨询培训对于满足慢性病患者或有慢性病风险患者当前和未来的医疗需求至关重要。提高在建立基于改变的关系、评估和促进改变意愿、实施行为改变以及解决心理社会问题方面的能力,将为医疗系统增添价值。

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