儿科医生视角下的动机性访谈：对照顾患有慢性疾病青少年的医生进行为期 2 天的培训后的评估。

Motivational interviewing from the paediatricians' perspective: assessments after a 2-day training for physicians caring for adolescents with chronic medical conditions (CMCs).

机构信息

University Hospital Düsseldorf, Düsseldorf, Germany.

Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany.

出版信息

BMC Pediatr. 2024 May 22;24(1):355. doi: 10.1186/s12887-024-04794-z.

DOI:10.1186/s12887-024-04794-z

PMID:38778341

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11110176/

Abstract

BACKGROUND

Counselling adolescents with chronic medical conditions (CMCs) can be challenging regarding suitable interviewing skills and clinicians' attitudes toward the patient. Successful communication can be a key element of treatment. Motivational Interviewing (MI) is broadly applicable in managing behavioural problems and diseases by increasing patient motivation for lifestyle changes. However, data concerning the applicability, feasibility and implementation of MI sessions in everyday practice are missing from the physicians' point of view.

METHOD

The present study was conducted as a mixed methods design. Twenty paediatricians were randomized to a 2-day MI course followed by MI consultations. Data were collected through a questionnaire one year after MI training. Factors for effective training and possible barriers to successful use of MI were examined.

RESULTS

Completed questionnaires were returned by 19 of 20 paediatricians. The paediatricians' experiences with MI demonstrate that MI is regarded as a valuable tool when working with adolescents with CMCs. 95% of all respondents reported that they found MI education necessary for their clinical work and were using it also outside the COACH-MI study context. 73.7% percent saw potential to strengthen the connection to their patients by using MI. The doctors were already using more MI conversation techniques after a 2-day MI course. Obstacles were seen in the short training, the lack of time and missing undisturbed environment (interruptions by telephone, staff, etc.) during clinical flow.

CONCLUSIONS

MI techniques are not yet a regular part of medical training. However, a 2-day MI course was rated effective and provided a lasting impact by physicians caring for children and adolescents with chronic medical conditions (CMCs), although booster sessions should be offered regularly.

TRIAL REGISTRATION

The study was registered in the German Clinical Trials Register (DRKS00014043) on 26/04/2018.

摘要

背景

对患有慢性疾病（CMC）的青少年进行咨询可能会面临一些挑战，比如需要掌握适当的访谈技巧和临床医生对患者的态度。成功的沟通可能是治疗的关键要素。动机式访谈（MI）在通过增加患者对生活方式改变的动机来管理行为问题和疾病方面具有广泛的适用性。然而，从医生的角度来看，关于 MI 课程在日常实践中的适用性、可行性和实施情况的数据是缺失的。

方法

本研究采用混合方法设计进行。20 名儿科医生被随机分为 2 天的 MI 课程组和 MI 咨询组。在 MI 培训一年后，通过问卷调查收集数据。研究检查了有效的培训因素和成功使用 MI 的可能障碍。

结果

20 名儿科医生中有 19 名完成了问卷。儿科医生对 MI 的经验表明，MI 在与患有 CMC 的青少年合作时被视为一种有价值的工具。所有受访者中有 95%表示他们认为 MI 教育对他们的临床工作是必要的，并且在 COACH-MI 研究之外也在使用它。73.7%的人认为通过使用 MI 有可能加强与患者的联系。在参加了为期两天的 MI 课程后，医生们已经在使用更多的 MI 对话技巧。他们认为培训时间短、缺乏时间以及在临床工作中没有不受干扰的环境（电话、工作人员等的干扰）是障碍。