Mental Health Service (116B), San Francisco VAHCS, San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA.
Mental Health Service (116B), San Francisco VAHCS, San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA.
Patient Educ Couns. 2025 Jan;130:108421. doi: 10.1016/j.pec.2024.108421. Epub 2024 Sep 12.
OBJECTIVES: Motivational Interviewing (MI), a client-centered approach that seeks to evoke and resolve ambivalence, and health education (HE), which provides health information and advice, may both provide some benefit to unmotivated smokers. In HE, it is possible that client language reflective of new learning, or "learning talk" (LT), and rejection of health advice, or "rejection talk," (RT), may uniquely reflect intent of subsequent behavior change. METHODS: This project utilized MI and HE sessions from two randomized clinical trials (RCTs), one in a low-income, diverse community civilian sample of 255 unmotivated smokers, and the other in a sample of Veterans with mental illness who were unmotivated smokers (n = 55). Mixed methods approaches were utilized to reliably code sessions using the Motivational Interviewing Skill Code 2.5 (MISC 2.5) and a refined Learning Talk coding system. RESULTS: Reliability of LT and RT codes ranged from fair to excellent (ICCs from 0.43-0.93). CONCLUSION: LT appears to be a unique construct and its impact on post-session changes in smoking is warranted. PRACTICE IMPLICATIONS: This system can be used in a study to code existing interventions for smokers using both MI and HE techniques and relate in-session client LT to subsequent smoking behaviors.
目的：动机性访谈（MI）是一种以客户为中心的方法，旨在唤起并解决矛盾心理，而健康教育（HE）则提供健康信息和建议，这两者都可能对缺乏动机的吸烟者有所帮助。在健康教育中，客户反映新学习的语言，即“学习谈话”（LT），以及对健康建议的拒绝，即“拒绝谈话”（RT），可能独特地反映了后续行为改变的意图。
方法：本项目利用了来自两项随机临床试验（RCT）的 MI 和 HE 会议，一项是在一个低收入、多样化的平民社区中，有 255 名缺乏动机的吸烟者参加；另一项是在一个有心理健康问题且缺乏动机的吸烟者的退伍军人样本中进行的（n=55）。采用混合方法，使用动机性访谈技能编码系统 2.5（MISC 2.5）和经过改进的学习谈话编码系统，可靠地对会议进行编码。
结果：LT 和 RT 编码的可靠性从一般到极好（ICC 从 0.43 到 0.93）。
结论：LT 似乎是一个独特的结构，其对会话后吸烟行为变化的影响是合理的。
实践意义：该系统可用于一项研究，对使用 MI 和 HE 技术的吸烟者的现有干预措施进行编码，并将会话中的客户 LT 与随后的吸烟行为联系起来。
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