School of Medicine, University of Nottingham, Nottingham, United Kingdom.
School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom.
PLoS One. 2024 Feb 8;19(2):e0295180. doi: 10.1371/journal.pone.0295180. eCollection 2024.
Patients with diabetic foot ulcers have poor adherence to treatment recommendations. However, the most effective way to support adherence in this population is unknown. This study aimed to assess the preliminary effectiveness of a motivation communication training programme for healthcare professionals working with these patients, using theory and evidence-based strategies.A proof-of-concept study using a non-randomised, controlled before-and-after design. Six podiatrists took part in the motivation communication training programme. Pre-training, observation was undertaken to examine the communication style currently used by podiatrists in routine consultations. Patients' (n = 25) perceptions of podiatrist autonomy support, self-determination for limiting weight-bearing activity and average daily step count were also assessed. Post training, observations and patient measures were repeated with a different group of patients (n = 24). Observations indicated that podiatrists exhibited a more need-supportive communication style (e.g., taking time to understand patients' perspectives) after undergoing the training programme. Patients in the post-training group reported higher levels of autonomy support, while self-determination to limit weight-bearing activity remained unchanged. Although the post-training group had a lower average daily step count, the difference was not statistically significant. This is the first study to investigate implementation of motivation communication strategies in routine consultations with patients with diabetic foot ulcers. Results suggest that training can enhance healthcare professionals' motivation communication skills with potential for addressing adherence issues, however, a larger cluster randomised controlled trial is necessary to confirm this.
糖尿病足溃疡患者对治疗建议的依从性较差。然而，支持该人群依从性的最有效方法尚不清楚。本研究旨在评估针对治疗这些患者的医疗保健专业人员的动机沟通培训计划的初步效果，该计划使用理论和基于证据的策略。
一项使用非随机、对照前后设计的概念验证研究。六名足病医生参加了动机沟通培训计划。在培训前，进行了观察，以检查足病医生在常规咨询中当前使用的沟通方式。还评估了患者（n=25）对足病医生自主支持、限制承重活动的自我决定和平均每日步数的看法。在培训后，对不同组的患者（n=24）重复进行观察和患者测量。观察表明，足病医生在接受培训计划后表现出更具需求支持的沟通方式（例如，花时间了解患者的观点）。后训练组的患者报告了更高水平的自主支持，而限制承重活动的自我决定则保持不变。尽管后训练组的平均每日步数较低，但差异无统计学意义。这是第一项研究调查动机沟通策略在糖尿病足溃疡患者常规咨询中的实施情况。结果表明，培训可以增强医疗保健专业人员的动机沟通技能，有可能解决依从性问题，但需要更大规模的集群随机对照试验来证实这一点。
