Article

Effect of “motivational interviewing” on quality of care measures in screen detected type 2 diabetes patients: a one-year follow-up of an RCT, ADDITION Denmark

Department General Practice and Research Unit of General Medical Practice, Institute of Public Health University of Aarhus, Denmark.
Scandinavian journal of primary health care (Impact Factor: 1.61). 02/2011; 29(2):92-8. DOI: 10.3109/02813432.2011.554271
Source: PubMed

ABSTRACT OBJECTIVE. "Motivational interviewing" (MI) has shown to be broadly applicable in the management of behavioural problems and diseases. Only a few studies have evaluated the effect of MI on type 2 diabetes treatment and none has explored the effect of MI on target-driven intensive treatment. METHODS. Patients were cluster-randomized by GPs, who were randomized to training in MI or not. Both groups received training in target-driven intensive treatment of type 2 diabetes. The intervention consisted of a 1½-day residential course in MI with half-day follow-up twice during the first year. Blood samples, case record forms, national registry files, and validated questionnaires from patients were obtained. RESULTS. After one year significantly improved metabolic status measured by HbA1c (p < 0.01) was achieved in both groups. There was no difference between groups. Medication adherence was close to 100% within both treatment groups. GPs in the intervention group did not use more than an average of 1.7 out of three possible MI consultations. CONCLUSION. The study found no effect of MI on metabolic status or on adherence of medication in people with screen detected type 2 diabetes. However, there was a significantly improved metabolic status and excellent medication adherence after one year within both study groups. An explanation may be that GPs in the control group may have taken up core elements of MI, and that GPs trained in MI used less than two out of three planned MI consultations. The five-year follow-up of this study will reveal whether MI has an effect over a longer period.

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    • "The evidence pertaining to the use of MI is growing and it is currently implemented within different behavioural domains and patient categories as above mentioned (Angus and Kagan, 2009; Brody, 2009; Rubak et al., 2009; Bjerregaard et al., 2011). Motivational interviewing integrates well with other clinical practices (Rubak et al., 2011) and can be used when time is constrained (Rubak et al., 2006). Shorter hospital stays and better communication between HCPs and their patients require a clear and understandable approach (Nørgaard and Andreasen, 2012) The majority of training courses in MI last one to three days and are conducted in workshop formats (Rubak et al., 2006; Lindhardt et al., 2014; Brobeck et al., 2011). "
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    ABSTRACT: Objective To explore and describe how healthcare professionals in the Southern Region of Denmark experienced motivational interviewing as a communication method when working with pregnant women with obesity. Design A qualitative, descriptive study based on face-to-face interviews with eleven obstetric healthcare professionals working in a perinatal setting. Methods A thematic descriptive method was applied to semi-structured interviews. The healthcare professional's experiences were recorded verbatim during individual semi-structured qualitative interviews, transcribed, and analysed using a descriptive analysis methodology. Results Motivational interviewing was found to be a useful method when communicating with obese pregnant women. The method made the healthcare professionals more aware of their own communication style both when encountering pregnant women and in their interaction with colleagues. However, most of the healthcare professionals emphasized that time was crucial and they had to be dedicated to the motivational interviewing method. The healthcare professionals further stated that it enabled them to become more professional in their daily work and made some of them feel less “burned out”, “powerless” and “stressed” as they felt they had a communication method in handling difficult workloads. Conclusion Healthcare professionals experienced motivational interviewing to be a useful method when working perinatally. The motivational interviewing method permitted heightened awareness of the healthcare professionals communication method with the patients and increased their ability to handle a difficult workload. Overall, lack of time restricted the use of the motivational interviewing method on a daily basis
    Midwifery 04/2015; · 1.71 Impact Factor
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    • "The evidence pertaining to the use of MI is growing and it is currently implemented within different behavioural domains and patient categories as above mentioned (Angus and Kagan, 2009; Brody, 2009; Rubak et al., 2009; Bjerregaard et al., 2011). Motivational interviewing integrates well with other clinical practices (Rubak et al., 2011) and can be used when time is constrained (Rubak et al., 2006). Shorter hospital stays and better communication between HCPs and their patients require a clear and understandable approach (Nørgaard and Andreasen, 2012) The majority of training courses in MI last one to three days and are conducted in workshop formats (Rubak et al., 2006; Lindhardt et al., 2014; Brobeck et al., 2011). "
    [Show abstract] [Hide abstract]
    ABSTRACT: to explore and describe how healthcare professionals in the Southern Region of Denmark experienced motivational interviewing as a communication method when working with pregnant women with obesity. a qualitative, descriptive study based on face-to-face interviews with 11 obstetric healthcare professionals working in a perinatal setting. a thematic descriptive method was applied to semi-structured interviews. The healthcare professional׳s experiences were recorded verbatim during individual semi-structured qualitative interviews, transcribed, and analysed using a descriptive analysis methodology. motivational interviewing was found to be a useful method when communicating with obese pregnant women. The method made the healthcare professionals more aware of their own communication style both when encountering pregnant women and in their interaction with colleagues. However, most of the healthcare professionals emphasised that time was crucial and they had to be dedicated to the motivational interviewing method. The healthcare professionals further stated that it enabled them to become more professional in their daily work and made some of them feel less 'burned out', 'powerless' and 'stressed' as they felt they had a communication method in handling difficult workloads. healthcare professionals experienced motivational interviewing to be a useful method when working perinatally. The motivational interviewing method permitted heightened awareness of the healthcare professionals communication method with the patients and increased their ability to handle a difficult workload. Overall, lack of time restricted the use of the motivational interviewing method on a daily basis. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Midwifery 04/2015; 31(7). DOI:10.1016/j.midw.2015.03.010 · 1.71 Impact Factor
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    • "They use this method to help the patient talk through his/her motivational issues and decide on strategies to change behaviour (Miller and Rollnick, 2002). Research also shows that diabetic patients of providers and diabetes educators trained in MI have improved health outcomes when compared to traditional care (Rubak et al., 2011). MI is a method of communication the provider and the sta® use when they interact with the patient as part of the process of creating the key content captured by the SCP. "
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    ABSTRACT: A transformation in the way in which primary care is delivered is underway in the US. Across the country primary care practices are grappling with how to change from the traditional physician-directed model to a more patient-centered collaborative style as part of the effort to curb the rise of chronic disease. To date, few tools or techniques exist to help the individual primary care provider make this difficult and complex transformation. One such tool that has arisen is the shared care plan (SCP). As defined in the Taking Action for Learning and Knowledge Management to improve Diabetes Mellitus (TALK/DM) study (a NIDDK funded pilot project to implement SCPs in primary care), the SCP of primary care becomes the product of collaboration between the practice and the patients. The SCP is created by combining knowledge management (KM) techniques and motivational interviewing (MI) health counselling methods to form a new knowledge object. This paper focuses on this aspect of the TALK/DM study and takes a case study approach to explore how one primary care practice is implementing the SCP as knowledge object (both a paper document and an electronic record in the EMR system) in its organisation. This study adds nuance and insight into how knowledge objects such as the SCP can serve as a tool for collaboration in primary care.
    Journal of Information & Knowledge Management 12/2013; DOI:10.1142/S0219649213500408
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