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培养护士的动机性访谈技巧,以促进冠心病患者的健康生活方式。

Developing nurses' skills in motivational interviewing to promote a healthy lifestyle in patients with coronary artery disease.

作者信息

Dobber Jos, Latour Corine, Snaterse Marjolein, van Meijel Berno, Ter Riet Gerben, Scholte Op Reimer Wilma, Peters Ron

机构信息

1 ACHIEVE, Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Science, The Netherlands.

2 Inholland University of Applied Sciences, Amsterdam, The Netherlands.

出版信息

Eur J Cardiovasc Nurs. 2019 Jan;18(1):28-37. doi: 10.1177/1474515118784102. Epub 2018 Jun 15.

Abstract

BACKGROUND

If nurses have the communication skills and the time, they can play an important role in increasing the intrinsic motivation of patients with coronary artery disease (CAD) to change their lifestyle. Motivational Interviewing (Mo-Int) can be used to further support this role. However, few nurses are sufficiently proficient in applying Mo-Int skills. Increasing these complex communication skills may contribute significantly to achieve lifestyle changes in CAD patients.

AIMS

The aim of this study was to evaluate the coaching of nurses to skilfully use Mo-Int in a secondary prevention programme for CAD patients.

METHODS

The design was a before-after study of a learning strategy as a follow-up on a short Mo-Int workshop. At (on average) four-monthly intervals, the nurses received, three times, feedback and coaching by telephone and email on their use of Mo-Int skills in audio-recorded conversations on lifestyle change with CAD patients. The Mo-Int consistency of the nurses' communication skills was scored using the Motivational Interviewing Target Scheme 2.1 (range 0-32).

RESULTS

Of the 24 nurses, 13 completed all audio recordings. The mean change in Mo-Int consistency of these completers between the first and the last audio recording was 6.4 (95% confidence interval 3.2 to 9.5). This change indicates an improvement from 'a small part of Motivational Interviewing practice' to 'a mainly sufficient degree of Motivational Interviewing practice'.

CONCLUSION

A one-year follow-up on a Mo-Int workshop with feedback and coaching improves Mo-Int skills of nurses. Healthcare professionals should be aware of the importance of a follow-up on training in complex communication skills, to develop and preserve competency.

摘要

背景

如果护士具备沟通技巧和时间,他们在提高冠心病(CAD)患者改变生活方式的内在动力方面可以发挥重要作用。动机性访谈(Mo-Int)可用于进一步支持这一作用。然而,很少有护士能够充分熟练地应用动机性访谈技巧。提高这些复杂的沟通技巧可能对实现CAD患者的生活方式改变有显著贡献。

目的

本研究的目的是评估在CAD患者二级预防计划中对护士进行培训,使其熟练使用动机性访谈的情况。

方法

该设计是一项关于学习策略的前后对照研究,作为对短期动机性访谈工作坊的后续跟进。护士们(平均)每隔四个月会收到三次通过电话和电子邮件给予的关于他们在与CAD患者进行生活方式改变的录音对话中使用动机性访谈技巧的反馈和指导。使用动机性访谈目标方案2.1对护士沟通技巧的动机性访谈一致性进行评分(范围为0-32)。

结果

24名护士中,13名完成了所有录音。这些完成者在第一次和最后一次录音之间动机性访谈一致性的平均变化为6.4(95%置信区间3.2至9.5)。这一变化表明从“动机性访谈实践的一小部分”提升到了“动机性访谈实践的主要充分程度”。

结论

对动机性访谈工作坊进行为期一年的随访,并给予反馈和指导,可提高护士的动机性访谈技巧。医疗保健专业人员应意识到对复杂沟通技巧培训进行随访以发展和保持能力的重要性。

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