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指导患者应对复杂性:为患有多种疾病的患者提供动机性访谈。

Guiding patients through complexity: Motivational interviewing for patients with multimorbidity.

机构信息

BA (Hons), MPsych (Clinical), MAPS, Clinical Psychologist and Manager, Psychology Department, Ballarat Health Services, Vic; Motivational Interviewing Network of Trainers; PhD candidate, Department of General Practice, University of Melbourne, Carlton, Vic.

MBBS, MGPP, MMed, MD, FRACGP, FASPM, general practitioner and Associate Professor, Department of Rural Health, University of Melbourne, Ballarat, Vic @.

出版信息

Aust J Gen Pract. 2018 Jan-Feb;47(1-2):8-13. doi: 10.31128/AFP-08-17-4325.

Abstract

BACKGROUND

Multimorbidity is an increasing and complex issue in Australian general practice. General practitioners (GPs) face the challenge of navigating multiple potential intervention pathways. Emerging guidelines for multimorbidity recommend patient-centred care and addressing the lifestyle factors of the patient. Motivational interviewing is a patient-centred approach that is focused on behavioural change and effective across a range of lifestyle factors.

OBJECTIVE

The aim of this article is to provide a practical introduction to motivational interviewing skills that may be helpful in working with patients who have multimorbidity. Key skills discussed in this article include agenda setting, giving advice, responding to resistance, and asking questions to evoke a patient’s own motivation for change.

DISCUSSION

GPs are ideally placed to assist patients with multimorbidity to navigate recommendations and identify which recommendations will work. Navigating complexity is at the heart of general practice, and multimorbidity demands more than an ‘assess-and-advise’ model of care. Motivational interviewing provides a promising and readily applicable framework to empower patients living with multimorbidity.

摘要

背景

多病共存是澳大利亚全科医学中日益复杂的问题。全科医生(GP)面临着多种潜在干预途径的挑战。新兴的多病共存指南建议以患者为中心的护理,并解决患者的生活方式因素。动机性访谈是一种以患者为中心的方法,专注于行为改变,并在一系列生活方式因素方面都具有有效性。

目的

本文旨在提供有关动机性访谈技巧的实用介绍,这些技巧可能有助于与患有多病共存的患者合作。本文讨论的关键技能包括设定议程、提供建议、应对阻力以及提问以唤起患者自身改变的动机。

讨论

全科医生最适合帮助多病共存的患者了解建议并确定哪些建议有效。驾驭复杂性是全科医学的核心,而多病共存需要的不仅仅是“评估和建议”的护理模式。动机性访谈为赋权患有多病共存的患者提供了一个有前途且易于应用的框架。

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