动机性访谈：一种在医学实践中应用的循证方法。
Motivational Interviewing: An Evidence-Based Approach for Use in Medical Practice.
机构信息
Lübeck University, Department of Psychiatry and Psychotherapy, Lübeck.
出版信息
Dtsch Arztebl Int. 2021 Feb 19;118(7):109-115. doi: 10.3238/arztebl.m2021.0014.
BACKGROUND
Motivational factors in health-relevant modes of behavior are an important matter in medical practice. Motivational interviewing (MI) is a technique that has been specifically developed to help motivate ambivalent patients to change their behav - ior.
METHODS
This review is based on pertinent publications retrieved by a selective search in the PubMed, Cochrane, and Web of Science databases. Special attention was paid to systematic reviews and meta-analyses concerning the efficacy of MI in the medical care of various target groups. The present review focuses on the relevance of MI for patients with highly prevalent disorders.
RESULTS
Meta-analyses reveal statistically significant mean intervention effects of MI in medical care with respect to a variety of health-relevant modes of behavior, in comparison to standard treatment and no treatment in the control groups (odds ratio [OR]: 1.55; 95% confidence interval: [1.40; 1.71]). Statistically significant effect sizes were reported for substance consumption, physical activity, dental hygiene, body weight, treatment adherence, willingness to change behavior, and mortality; effects on healthpromoting behavior were mixed. Studies of the factors that contribute to the efficacy of MI suggest that it exerts its effects largely through the selective reinforcement of statements made by the patients themselves about potential changes in their behavior.
CONCLUSION
MI has been found useful for strengthening the motivation for behavioral change in patients with various behavioral - ly influenced health problems and for promoting treatment adherence. It can be used to optimize medical interventions. Further research is needed with respect to its specific mechanisms of action, its efficacy in reinforcing health-promoting modes of be - havior, differential indications for different patient groups, and the cost-efficiency of the technique across the spectrum of disorders in which it is used.
背景
与健康相关的行为模式中的激励因素是医疗实践中的一个重要问题。动机访谈（MI）是一种专门开发的技术，旨在帮助犹豫不决的患者改变行为。
方法
本综述基于通过在 PubMed、Cochrane 和 Web of Science 数据库中进行选择性搜索检索到的相关出版物。特别关注关于 MI 在各种目标群体的医疗保健中的疗效的系统评价和荟萃分析。本综述重点关注 MI 对高患病率障碍患者的相关性。
结果
荟萃分析显示，与对照组中的标准治疗和无治疗相比，MI 在医疗保健方面对各种与健康相关的行为模式具有统计学上显著的平均干预效果（优势比 [OR]：1.55；95%置信区间：[1.40；1.71]）。报告了关于物质消费、体育活动、口腔卫生、体重、治疗依从性、改变行为的意愿和死亡率的统计学上显著的效应大小；对促进健康行为的影响则存在差异。对促成 MI 疗效的因素的研究表明，它主要通过选择性强化患者自己关于行为潜在变化的陈述来发挥作用。
结论
MI 已被证明可用于增强各种受行为影响的健康问题患者改变行为的动机，并促进治疗依从性。它可用于优化医疗干预措施。需要进一步研究其具体作用机制、在强化促进健康行为模式方面的疗效、不同患者群体的不同适应证、以及在其使用的各种疾病谱中的技术的成本效益。
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