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动机性访谈对心力衰竭患者自我护理的影响:一项随机临床试验。

Effect of motivational interviewing on self-care of people with heart failure: a randomized clinical trial.

机构信息

Universidade Federal Fluminense, Escola de Enfermagem Aurora de Afonso Costa, Departamento de Enfermagem Médico Cirúrgica, Niterói, RJ, Brasil.

Universidad de la Republica Uruguay, Facultad de Medicina, Hospital de Clinicas Manuel Quintela, Montevidéo, Uruguay.

出版信息

Rev Esc Enferm USP. 2020 Nov 6;54:e03634. doi: 10.1590/S1980-220X2019013703634. eCollection 2020.

Abstract

OBJECTIVE

To analyze the effect of motivational interviewing on self-care for people with chronic heart failure.

METHOD

A multicenter randomized clinical trial, which divided people into an intervention group (n=59) and a control group (n=59), followed for 60 days in centers of Brazil and Uruguay. The intervention group received three consultations per motivational interviewing, with an interval of 30 days, and the control group maintained conventional follow-up in specialized clinics. The data were assessed using the Self-Care of Heart Failure Index 6.2, before and after intervention in each of the centers. They were analyzed using the mean, median, t-test, correlation analysis using the Spearman coefficient and effect of the intervention by Cohen's d.

RESULTS

One hundred and eighteen people completed the study. In view of the assessment of the effect of the motivational interviewing on self-care, compared to conventional follow-up, a medium effect on maintenance and management (Cohen's d=0.6723; 0.5086) and high on self-care confidence (Cohen's d=0.9877).

CONCLUSION

Motivational interviewing was effective in improving self-care in patients with heart failure, being a feasible strategy to be implemented in specialized clinics. Brazilian Registry of Clinical Trials (Registro Brasileiro de Ensaios Clínicos): RBR-6fp5qt.

摘要

目的

分析动机性访谈对慢性心力衰竭患者自我护理的影响。

方法

一项多中心随机临床试验,将参与者分为干预组(n=59)和对照组(n=59),在巴西和乌拉圭的中心进行为期 60 天的随访。干预组接受三次动机性访谈咨询,间隔 30 天,对照组在专门诊所进行常规随访。在每个中心,使用心力衰竭自我护理量表 6.2 评估干预前后的数据。采用均值、中位数、t 检验、Spearman 系数相关分析和 Cohen's d 进行干预效果分析。

结果

共有 118 人完成了研究。从动机性访谈对自我护理的干预效果评估来看,与常规随访相比,在维持和管理方面具有中等效应(Cohen's d=0.6723;0.5086),在自我护理信心方面具有高度效应(Cohen's d=0.9877)。

结论

动机性访谈可有效改善心力衰竭患者的自我护理,是在专门诊所实施的一种可行策略。巴西临床试验注册(Registro Brasileiro de Ensaios Clínicos):RBR-6fp5qt。

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