Matthieu Monica M, Oliver Ciara M, Hernandez Gissa I, McCullough Jane Ann, Adkins David A, Mallory Mary J, Taylor Laura D, Jensen Jamie L, Garner Kimberly K
US Department of Veterans Affairs Medical Center, Central Arkansas Veterans Healthcare System, HSR&D Center of Innovation: Center for Mental Healthcare & Outcomes Research, Little Rock, AR, USA; Saint Louis University, School of Social Work, Saint Louis, MO, USA.
US Department of Veterans Affairs Medical Center, Central Arkansas Veterans Healthcare System, HSR&D Center of Innovation: Center for Mental Healthcare & Outcomes Research, Little Rock, AR, USA.
Patient Educ Couns. 2024 Mar;120:108116. doi: 10.1016/j.pec.2023.108116. Epub 2023 Dec 14.
Advance Care Planning (ACP) via Group Visits (ACP-GV) is an innovative patient-centered intervention used in the United States Department of Veterans Affairs (VA) healthcare system. The goal of ACP-GV is to spread ACP to veterans and caregivers in medically underserved rural areas. Veterans, caregivers and those they trust participate in a group led by clinicians in Veterans Health Administration healthcare and/or community-based settings. To learn how to facilitate ACP-GV, clinicians attend ACP-GV training. The training teaches the ACP-GV group model and the theoretical components of Motivational Interviewing (MI) (Rollnick & Miller, 1995), which are used to empower participants to have conversations about their healthcare values and preferences. Therefore, the aim is to describe the specific MI techniques utilized by group facilitators in the innovative ACP-GV intervention.
We provide exemplars for how group facilitators apply the MI techniques to the group discussion with participants. Lastly, we provide a scripted case example of a coded MI-concordant session of ACP-GV delivered with veterans in a healthcare setting that can be used in future training and education for clinicians interested in facilitating ACP using a group modality.
MI is a key aspect of delivering ACP-GV, a high-quality, patient-centered intervention for veterans, caregivers and those they trust.
通过小组访视进行的预先护理计划（ACP-GV）是美国退伍军人事务部（VA）医疗系统中采用的一种以患者为中心的创新干预措施。ACP-GV的目标是将预先护理计划推广到医疗服务不足的农村地区的退伍军人及其护理人员。退伍军人、护理人员以及他们信任的人在退伍军人健康管理局医疗保健和/或社区环境中，参与由临床医生带领的小组活动。为了学习如何推动ACP-GV，临床医生参加ACP-GV培训。该培训讲授ACP-GV小组模式以及动机性访谈（MI）（Rollnick & Miller，1995）的理论组成部分，这些内容用于使参与者有能力就其医疗保健价值观和偏好进行对话。因此，目的是描述创新的ACP-GV干预措施中小组 facilitators 使用的特定MI技巧。
我们提供了小组facilitators如何将MI技巧应用于与参与者的小组讨论的示例。最后，我们提供了一个在医疗环境中与退伍军人进行的编码为MI一致的ACP-GV会议的脚本案例示例，可用于未来对有兴趣通过小组方式推动ACP的临床医生的培训和教育。
MI是实施ACP-GV的关键方面，ACP-GV是一种为退伍军人、护理人员以及他们信任的人提供的高质量、以患者为中心的干预措施。
