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Uzun S, Gürhan N. The effect of motivational interviewing on quality of life and self-efficacy behaviors of individuals with chronic illness: A meta-analysis study. Public Health Nurs 2024. [PMID: 38856679 DOI: 10.1111/phn.13339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 04/25/2024] [Accepted: 04/30/2024] [Indexed: 06/11/2024]
Abstract
OBJECTIVE This study aims to reveal the effect of the motivational interviewing on the quality of life and self-efficacy behaviors of individuals with chronic diseases. MATERIAL-METHOD For this meta-analysis study, PubMed, Web of Science, EBSCOhost, Google Scholar, and YÖK Theses databases were searched in January-May 2021 without year limitation. As a result, 38 studies were included in the study: 23 for the quality of life variable, and 21 for the self-efficacy behaviors variable (in 6 studies, both variables were examined together). The data were synthesized with meta-analysis and narrative methods. The total sample size of the studies is 25,425. RESULTS This meta-analysis study showed that the motivational interviewing applied to individuals with chronic diseases changed their quality of life (SMD: 0.296, %95 CI: 0.054-0.537, Z = 2.402, p = .016, I2 = %95). The type of chronic disease, measurement tool, sample group, disease group, age range, and whether the motivational interviewer was a nurse or not changed the effect size of the motivational interviewing on the quality of life. The self-efficacy score average of the experimental group to which motivational interviewing was applied was statistically similar to that of the control group (SMD: 0.141, %95 CI: -0.065, 0.347; Z = 1.346, p = .178, I2 = %87). CONCLUSIONS As a result of the meta-analysis, it was determined that the use of motivational interviewing increased the quality of life level of individuals with chronic diseases. However, it is thought that more research is needed because some studies were conducted with small sample size and prepost test design. The results of the study may provide guidance on the interventions to be used in improving the quality of life of individuals with chronic diseases.
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Affiliation(s)
- Sevda Uzun
- Faculty of Health Sciences, Department of Psychiatric Nursing, Gumushane Univers℩ty, Gumushane, Turkey
| | - Nermin Gürhan
- Faculty of Health Sciences, Department of Psychiatric Nursing, Tokat Gaziosmanpasa University, Tokat, Turkey
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MacKean A, Godfrey E, Jones GD, Kedroff L, Sparks L, Jones GL. Effectiveness of remotely delivered motivational conversations on health outcomes in patients living with musculoskeletal conditions: A systematic review and meta-analysis. PATIENT EDUCATION AND COUNSELING 2024; 123:108204. [PMID: 38402714 DOI: 10.1016/j.pec.2024.108204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 02/09/2024] [Accepted: 02/10/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVE To evaluate the efficacy of remotely delivered motivational conversations on health outcomes in musculoskeletal populations. METHODS Four electronic databases (inception-March 2022) were searched and combined with grey literature. Randomised control trials (RCTs) evaluating the effect of remotely delivered motivational conversation-based interventions within musculoskeletal populations, using valid measures of pain, disability, quality of life (QoL), or self-efficacy were included. Overall quality was assessed using GRADE criteria. Meta-analyses were performed using random effects models with pooled effect sizes expressed as standardised mean differences ( ± 95%CIs). RESULTS Twelve RCTs were included. Meta-analyses revealed very-low to moderate quality evidence that remote interventions have a positive effect on pain and disability both immediately post intervention and at long-term follow-up compared to control, and have a positive effect on self-efficacy immediately post intervention. There was no effect on QoL immediately post intervention or at long-term follow up. CONCLUSION Remotely delivered motivation-based conversational interventions have a positive effect on pain, disability, and self-efficacy but not on QoL. PRACTICE IMPLICATIONS Motivational conversations, delivered remotely, may be effective in improving some health-related outcomes in MSK populations. However, higher quality evidence is needed to determine optimal intervention durations, and dosing frequencies using sufficient sample sizes and follow-up time frames.
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Affiliation(s)
- Alice MacKean
- Guy's and St Thomas' NHS Foundation Trust Physiotherapy Department, London, UK
| | - Emma Godfrey
- Department of Population Health Sciences, School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, Kings College London, London, UK; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Gareth D Jones
- Guy's and St Thomas' NHS Foundation Trust Physiotherapy Department, London, UK; Centre for Human and Applied Physiological Sciences (CHAPS), Faculty of Life Sciences & Medicine, King's College London, UK
| | - Louise Kedroff
- Physiotherapy Dept, Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Lucinda Sparks
- University College London Hospitals NHS Foundation Trust Physiotherapy Department, London, UK
| | - Gareth L Jones
- Guy's and St Thomas' NHS Foundation Trust Physiotherapy Department, London, UK.
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Stewart I, Welch C, An L, Resnicow K, Pennebaker J, Mihalcea R. Expressive Interviewing Agents to Support Health-Related Behavior Change: Randomized Controlled Study of COVID-19 Behaviors. JMIR Form Res 2023; 7:e40277. [PMID: 37074948 PMCID: PMC10395645 DOI: 10.2196/40277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 03/30/2023] [Accepted: 03/30/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Expressive writing and motivational interviewing are well-known approaches to help patients cope with stressful life events. Although these methods are often applied by human counselors, it is less well understood if an automated artificial intelligence approach can benefit patients. Providing an automated method would help expose a wider range of people to the possible benefits of motivational interviewing, with lower cost and more adaptability to sudden events like the COVID-19 pandemic. OBJECTIVE This study presents an automated writing system and evaluates possible outcomes among participants with respect to behavior related to the COVID-19 pandemic. METHODS We developed a rule-based dialogue system for "Expressive Interviewing" to elicit writing from participants on the subject of how COVID-19 has impacted their lives. The system prompts participants to describe their life experiences and emotions and provides topic-specific prompts in response to participants' use of topical keywords. In May 2021 and June 2021, we recruited participants (N=151) via Prolific to complete either the Expressive Interviewing task or a control task. We surveyed participants immediately before the intervention, immediately after the intervention, and again 2 weeks after the intervention. We measured participants' self-reported stress, general mental health, COVID-19-related health behavior, and social behavior. RESULTS Participants generally wrote long responses during the task (53.3 words per response). In aggregate, task participants experienced a significant decrease in stress in the short term (~23% decrease, P<.001) and a slight difference in social activity compared with the control group (P=.03). No significant differences in short-term or long-term outcomes were detected between participant subgroups (eg, male versus female participants) except for some within-condition differences by ethnicity (eg, higher social activity among African American people participating in Expressive Interviewing vs participants of other ethnicities). For short-term effects, participants showed different outcomes based on their writing. Using more anxiety-related words was correlated with a greater short-term decrease in stress (r=-0.264, P<.001), and using more positive emotion words was correlated with a more meaningful experience (r=0.243, P=.001). As for long-term effects, writing with more lexical diversity was correlated with an increase in social activity (r=0.266, P<.001). CONCLUSIONS Expressive Interviewing participants exhibited short-term, but not long-term, positive changes in mental health, and some linguistic metrics of writing style were correlated with positive change in behavior. Although there were no significant long-term effects observed, the positive short-term effects suggest that the Expressive Interviewing intervention could be used in cases in which a patient lacks access to traditional therapy and needs a short-term solution. TRIAL REGISTRATION Clincaltrials.gov NCT05949840; https://www.clinicaltrials.gov/study/NCT05949840.
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Affiliation(s)
- Ian Stewart
- School of Computer Science and Engineering, University of Michigan, Ann Arbor, MI, United States
| | - Charles Welch
- Department of Mathematics and Computer Science, University of Marburg, Marburg, Germany
| | - Lawrence An
- Center for Health Communications Research, University of Michigan, Ann Arbor, MI, United States
| | - Ken Resnicow
- School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - James Pennebaker
- Department of Psychology, University of Texas at Austin, Austin, TX, United States
| | - Rada Mihalcea
- School of Computer Science and Engineering, University of Michigan, Ann Arbor, MI, United States
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Huang X, Xu N, Wang Y, Sun Y, Guo A. The effects of motivational interviewing on hypertension management: A systematic review and meta-analysis. PATIENT EDUCATION AND COUNSELING 2023; 112:107760. [PMID: 37075650 DOI: 10.1016/j.pec.2023.107760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/17/2023] [Accepted: 04/14/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVE This systematic review aimed to examine the effects of motivational interviewing-based interventions on hypertension management. METHODS Six databases were searched from inception to 25 July, 2022 for randomized controlled trials involving adults diagnosed with hypertension and including motivational interviewing in the treatment interventions. RESULTS In total, 11 studies with 2121 participants were included. Compared with no or minimal additional intervention, motivational interviewing-based intervention showed greater reduction in systolic blood pressure (MD: -6.56, 95 % CI: -10.51, -2.62, P = 0.001) and diastolic blood pressure (MD: -3.75, 95 % CI: -4.92, -2.58, P < 0.001). Compared with the lower intensity intervention, motivational interviewing-based intervention produced statistically significant effect on reducing systolic blood pressure (MD: -2.72, 95 % CI: -5.34, -0.10, P = 0.040); while there was no significant effect on reducing diastolic blood pressure (MD: -0.47, 95 % CI: -2.21, 1.28, P = 0.600). Four out of six studies demonstrated medication adherence significantly improved following motivational interviewing-based intervention. Two studies included self-efficacy and quality of life, and inconsistent findings were observed. CONCLUSION Motivational interviewing could be effective in improving blood pressure control among patients with hypertension. Future studies with more rigorous study designs should be conducted to confirm the effects of motivational interviewing on medication adherence and psychological well-being. PRACTICE IMPLICATIONS Motivational interviewing could be applied as a promising intervention strategy among patients with hypertension.
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Affiliation(s)
- Xinghe Huang
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100144, China
| | - Nuo Xu
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100144, China
| | - Yuyu Wang
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100144, China
| | - Yixin Sun
- Department of Pharmacy, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Aimin Guo
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100144, China.
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Uzun S, Özmaya E. The effect of motivational interview conducted by nurses on quality of life: Meta-analysis. Perspect Psychiatr Care 2022; 58:2449-2459. [PMID: 35383938 DOI: 10.1111/ppc.13080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/12/2022] [Accepted: 03/23/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The aim of the study is to examine the effect of the motivational interviewing method conducted by nurses on the quality of life of patients with chronic diseases. DESIGN AND METHODS The studies examined in this meta-analysis study were obtained by scanning the PubMed, Web of Science, EBSCOhost, Google Scholar, and YÖK thesis databases between January and May 2021 without any year limitation. After the elimination, 16 studies were included in the study. The data were synthesized with meta-analysis and narrative methods. The total sample size of the studies was 14,425. FINDINGS This meta-analysis demonstrated that the motivational interviewing method applied by nurses in individuals with chronic diseases changed their quality of life (SMD: 0.258, 95% confidence interval: 0.076-0.441; Z = 2.775, p = 0.006, I2 = 89.97%). The variance between studies was statistically significant (p < 0.05) for the moderator of the measurement tools, the duration of the motivational interviews, and the country/continent of the studies were conducted (p < 0.05), suggesting that the measurement tools, the duration of the motivational interview, and the country/continent of the studies changed the effect size of the motivational interview method on the quality of life. PRACTICE IMPLICATIONS It has been concluded that the motivational interview method applied by nurses who are in a critical position in the protection and development of health improves the quality of life of individuals with chronic diseases.
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Affiliation(s)
- Sevda Uzun
- Department of Nursing, Faculty of Health Sciences, Gümüşhane University, Gümüşhane, Turkey
| | - Esma Özmaya
- Department of Health Care, Vocational School of Health Services, Karamanoğlu Mehmetbey University, Karaman, Turkey
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Alushi L, Alexander J, Jones J, Lafortune L. A Systematic Review on Physical Health Education Interventions for People with Parkinson's Disease: Content, Impact, and Implementation Considerations Across the Parkinson's Trajectory. JOURNAL OF PARKINSON'S DISEASE 2022; 12:1389-1407. [PMID: 35599500 DOI: 10.3233/jpd-223259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Educational interventions promoting the role of physical activity (PA) aim to address knowledge, poor exercise self-efficacy, and low outcome expectations, which are well-researched barriers to PA participation in healthy and in people with chronic conditions. However, little is known about the effectiveness of educational interventions in addressing these barriers in people with Parkinson's (PwP). OBJECTIVE To examine the content of education interventions that promote PA behavior in PwP, and to assess their effectiveness on physical and psychosocial outcomes. METHODS An electronic search (12/2021) of MEDLINE, EMBASE, CINAHL, PubMed PsycINFO, the Web of Science and the Cochrane Library was conducted from 1990 to 2021. Education interventions, alone or combined with other strategies, promoting PA in PwP were included. Quality was assessed using the Johanna Briggs Institute and National Institute of Health quality assessment tools. A narrative synthesis was performed. RESULTS Six studies were identified. Five interventions were comprised of education and exercise sessions. Improvement in physical and psychosocial outcomes were suggested but delineating the exact impact of education was impeded due to lack of assessment. CONCLUSION Few interventions exist that provide knowledge, and skills promoting PA participation, and fewer are addressed towards newly diagnosed PwP. There is lack of assessment over the effectiveness of education as a tool to facilitate PA participation in PwP. Lack of assessment poses the risk of potentially disregarding effective interventions or adopting ineffective approaches without the evidence. Education interventions can boost PA engagement by increasing factors such as exercise self-efficacy, but further interventions are required to assess this model of relationship.
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Affiliation(s)
- Ledia Alushi
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - James Alexander
- Centre for Applied Health & Social Care Research, Kingston & St George's, University of London, London, UK
- Camden Neurology & Stroke Service, Central and North West London NHS Foundation Trust, London, UK
| | - Julie Jones
- School of Health Sciences, Robert Gordon University, Aberdeen, Scotland
| | - Louise Lafortune
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Cambridge Public Health, Interdisciplinary Research Centre, University of Cambridge, Cambridge, UK
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Harmanci P, Budak FK. The Effect of Psychoeducation Based on Motivational Interview Techniques on Medication Adherence, Hope, and Psychological Well-Being in Schizophrenia Patients. Clin Nurs Res 2021; 31:202-216. [PMID: 34596461 DOI: 10.1177/10547738211046438] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study was conducted to determine the effect of psychoeducation based on motivational interview techniques on medication adherence, hope, and psychological well-being in schizophrenia patients. There are many studies using Motivational Interviewing for individuals with schizophrenia. However, there are no studies on whether the concept of "adherence to treatment," which is clearly shown to be corrected with 6 to 8 weeks of motivational interviewing, will positively affect concepts such as "hope and well-being," which require longer interventions, in a shorter time. In this context, there are not enough studies in which motivational interviewing techniques are integrated into psychoeducational interventions that can be organized with more individuals. The study was conducted with a pretest-posttest control group design. The sample size of the study was determined as 150 schizophrenia patients including 75 in the experimental group and 75 in the control group based on power analysis. The researcher provided the patients in the experimental group with a six-session psychoeducation program based on motivational interview techniques. A "Descriptive Characteristics Form," the "Herth Hope Index," the "Morisky Medication Adherence Scale," and the "Psychological Well-Being Scale" were used to collect the data. In the study, psychoeducation based on motivational interview techniques created a statistically significant difference in the medication adherence, hope and psychological well-being levels of the patients in the experimental and control groups (p < .05). Psychoeducation based on motivational interview techniques provided for schizophrenia patients was found to be effective in enhancing their medication adherence, hope, and psychological well-being levels.
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The Impact of Motivational Interviewing on Self-care and Health-Related Quality of Life in Patients With Chronic Heart Failure. J Cardiovasc Nurs 2021; 37:456-464. [PMID: 34495916 DOI: 10.1097/jcn.0000000000000841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Self-care is an integral component of successful chronic heart failure (HF) management. Structured educational programs have already been shown to be effective in improving self-care, but some patients show resistance and little motivation for change. OBJECTIVE The objective of this study was to compare efficacy in improving self-care and health-related quality of life (HRQoL) for an educational intervention based on motivational interviewing (MI) compared with a conventional educational intervention. METHODS This experimental pretest-posttest study with an equivalent historical control group included 93 patients in the intervention group and 93 matched patients in the control group. Participants attended a first visit after HF hospitalization discharge and 6 to 7 follow-up visits during 6 months. The European Heart Failure Self-care Behavior scale and the Minnesota Living with Heart Failure Questionnaire were used to assess self-care and HRQoL, respectively. Data on mortality and hospital readmissions were collected as adverse events. RESULTS Self-care improved significantly more in the MI-based intervention group than in the control group (P = .005). Although both self-care and HRQoL improved in both groups over time (P < .05), there was no significant between-group difference in terms of HRQoL improvement over time (P = .13). CONCLUSIONS Our findings suggest that MI delivered by MI-trained nurses is effective in significantly improving self-care by patients with HF. Nonetheless, further studies are required to evaluate the impact of MI on other outcomes, such as HRQoL and adverse clinical events.
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Ghizzardi G, Arrigoni C, Dellafiore F, Vellone E, Caruso R. Efficacy of motivational interviewing on enhancing self-care behaviors among patients with chronic heart failure: a systematic review and meta-analysis of randomized controlled trials. Heart Fail Rev 2021; 27:1029-1041. [PMID: 33866487 DOI: 10.1007/s10741-021-10110-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/13/2021] [Indexed: 12/28/2022]
Abstract
Although motivational interviewing (MI) seems to be promising for enhancing self-care behaviors (i.e., daily disease management and responses to symptoms) in patients with heart failure (HF), no quantitative pooling of effect sizes has been described to summarize and test its efficacy on self-care. Given that self-care behaviors of patients with HF are essential to enhance pharmacological adherence and disease management and optimize clinical outcomes, we sought to perform a systematic review of randomized control trials (RCTs) regarding MI's efficacy on enhancing self-care behaviors among patients with HF, synthesizing MI effects on self-care through meta-analyses. Nine randomized controlled trials were included. MI showed moderate effects on enhancing self-care confidence (Hedge's g = 0.768; 95%CI = 0.326-1.210; P = 0.001) and self-care management (i.e., responses to symptoms) (Hedge's g = 0.744; 95%CI = 0.256-1.232; P = 0.003) and large effects on improving self-care maintenance (i.e., adherence to treatment and symptom monitoring) (Hedge's g = 0.873; 95%CI = 0.430-1.317; P < 0.001). No significant effects were found for enhancing the self-reported physical functioning (Hedge's g = -0.385; 95%CI = -1.063-0.294; P = 0.267) or the directly assessed physical functioning using the 6-min walking test (Hedge's g = -0.131; 95%CI = -0.981-0.720; P = 0.072). Although future research is still required to identify situation-specific indications regarding how MI should be implemented in relation to specific clinical conditions, this study showed that MI is an effective strategy to improve self-care in patients with HF.
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Affiliation(s)
- Greta Ghizzardi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Cristina Arrigoni
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
| | - Federica Dellafiore
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Rosario Caruso
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy.
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Poudel N, Kavookjian J, Scalese MJ. Motivational Interviewing as a Strategy to Impact Outcomes in Heart Failure Patients: A Systematic Review. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2021; 13:43-55. [PMID: 31502239 DOI: 10.1007/s40271-019-00387-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Heart failure (HF) hospitalization is an expensive healthcare utilization event. Motivational interviewing (MI) has been studied for effects on HF self-management behaviors. OBJECTIVE The objective of this systematic review was to conduct an exploration and report of evidence and gaps in the literature regarding the impact of MI on HF outcomes. DATA SOURCES A modified Cochrane systematic review was conducted via a literature search in the MEDLINE, CINAHL, Cochrane Collaborative Systematic Reviews, PsycINFO, Health Source: Nursing/Academic Edition, and Google Scholar databases. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS Randomized controlled trials (RCTs) or controlled experimental studies published in English from January 1990 to February 2019 that included adults (18 years and older) diagnosed with HF New York Heart Association (NYHA) class I, II, II, or IV were eligible for inclusion. Interventions evaluated were an MI-based face-to-face communication or telephone-based conversation provided by any healthcare provider type. STUDY APPRAISAL AND SYNTHESIS METHODS The Cochrane method for assessing risk of bias was used to analyze the methodological quality of retained studies. RESULTS Of 167 initial articles, nine were retained, describing eight unique studies (758 total patients, range 30-241; age range 58-79 years; attrition range 13-36%). The impact of MI was examined for general self-care behaviors (SCBs) (physical activity specifically), quality of life (QoL), and/or hospital readmission prevention. Eight of nine articles reported a positive impact of MI over advice-giving, seven being statistically significant. MI interventions used an initial face-to-face encounter with three to five follow-up telephone encounters. LIMITATIONS This systematic review had the following limitations: most retained studies included intervention activities conducted in hospital/clinic settings, which limits generalizability of the intervention in other care settings; intervention fidelity, blinding, selection, interventionist training, and random assignment were not clear in all studies; retained studies did not include potential covariates such as health literacy, patient age, and perception of disease/health risks; and some retained studies relied on patient self-report of outcomes, which may introduce recall or social desirability bias. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS MI demonstrated a positive effect on the SCB hospital readmission prevention factor and on QoL. MI delivered with greater frequency and over a longer duration may improve the immediate risk of hospital readmission as well as long-term outcomes through better medication adherence and SCBs. However, heterogeneity in the methods, design, intervention type, and structure challenged comparisons across studies and further research is warranted.
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Affiliation(s)
- Nabin Poudel
- Department of Health Outcomes Research and Policy, Harrison School of Pharmacy, Auburn University, 4306 Walker Building, Auburn, AL, 36849, USA
| | - Jan Kavookjian
- Department of Health Outcomes Research and Policy, Harrison School of Pharmacy, Auburn University, 4306 Walker Building, Auburn, AL, 36849, USA.
| | - Michael J Scalese
- Department of Pharmaceutical Services, Prisma Health Richland Hospital, 5 Medical Park Drive, Columbia, SC, 29203, USA
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Gilcharan Singh HK, Chee WSS, Hamdy O, Mechanick JI, Lee VKM, Barua A, Mohd Ali SZ, Hussein Z. Eating self-efficacy changes in individuals with type 2 diabetes following a structured lifestyle intervention based on the transcultural Diabetes Nutrition Algorithm (tDNA): A secondary analysis of a randomized controlled trial. PLoS One 2020; 15:e0242487. [PMID: 33253259 PMCID: PMC7703935 DOI: 10.1371/journal.pone.0242487] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 11/03/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Eating self-efficacy behavior is an important predictor of successful lifestyle intervention. This secondary analysis evaluated the changes in eating self-efficacy behavior in patients with type 2 diabetes (T2D) and overweight/obesity following structured lifestyle intervention based on the Malaysian customized transcultural Diabetes Nutrition Algorithm (tDNA). METHODS Patients with T2D and overweight/obesity (n = 230) were randomized either into the tDNA group which included a structured low-calorie meal plan using normal foods, incorporation of diabetes-specific meal replacements, and an exercise prescription or usual T2D care (UC) for 6 months. Patients in the tDNA group also received either counseling with motivational interviewing (tDNA-MI) or conventional counseling (tDNA-CC). The UC group received standard dietary and exercise advice using conventional counseling. Eating self-efficacy was assessed using a locally validated Weight Efficacy Lifestyle (WEL) questionnaire. All patients were followed up for additional 6 months' post-intervention. RESULTS There was a significant change in WEL scores with intervention over one-year [Group X Time effect: F = 51.4, df = (3.4, 318.7), p<0.001]. Compared to baseline, WEL scores improved in both the tDNA groups with significantly higher improvement in the tDNA-MI group compared to the tDNA-CC and UC groups at 6 months (tDNA-MI: 25.4±2.1 vs. tDNA-CC: 12.9±2.8 vs. UC: -6.9±1.9, p<0.001). At 12 months' follow-up, both the tDNA groups maintained improvement in the WEL scores, with significantly higher scores in the tDNA-MI group than tDNA-CC group, and the UC group had decreased WEL scores (tDNA-MI: 28.9±3.1 vs. tDNA-CC: 11.6±3.6 vs. UC: -13.2±2.1, p<0.001). Patients in the tDNA-MI group with greater weight loss and hemoglobin A1C reduction also had a higher eating self-efficacy, with a similar trend observed in comparative groups. CONCLUSION Eating self-efficacy improved in patients with T2D and overweight/obesity who maintained their weight loss and glycemic control following a structured lifestyle intervention based on the Malaysian customized tDNA and the improvement was further enhanced with motivational interviewing. CLINICAL TRIAL This randomized clinical trial was registered under National Medical Research Registry, Ministry of Health Malaysia with registration number: NMRR-14-1042-19455 and also under ClinicalTrials.gov with registration number: NCT03881540.
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Affiliation(s)
- Harvinder Kaur Gilcharan Singh
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
| | - Winnie Siew Swee Chee
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
| | - Osama Hamdy
- Division of Endocrinology, Diabetes and Metabolism, Joslin Diabetes Center, Harvard Medical School, Boston, United States of America
| | - Jeffrey Ian Mechanick
- Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - Verna Kar Mun Lee
- Department of Family Medicine, School of Medicine, International Medical University, Kuala Lumpur, Malaysia
| | - Ankur Barua
- Department of Community Medicine, School of Medicine, International Medical University, Kuala Lumpur, Malaysia
| | - Siti Zubaidah Mohd Ali
- Department of Non-Communicable Diseases, Klinik Kesihatan Seremban, Negeri Sembilan, Malaysia
| | - Zanariah Hussein
- Department of Medicine, Hospital Putrajaya, Pusat Pentadbiran Kerajaan Persekutuan, Putrajaya, Malaysia
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Piotrowicz E, Mierzyńska A, Banach M, Jaworska I, Pencina M, Kowalik I, Pluta S, Szalewska D, Opolski G, Zaręba W, Glowczynska R, Irzmański R, Orzechowski P, Kalarus Z, Piotrowicz R. Quality of life in heart failure patients undergoing hybrid comprehensive telerehabilitation versus usual care - results of the Telerehabilitation in Heart Failure Patients (TELEREH-HF) Randomized Clinical Trial. Arch Med Sci 2020; 17:1599-1612. [PMID: 34900039 PMCID: PMC8641512 DOI: 10.5114/aoms.2020.98350] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 07/31/2020] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Hybrid comprehensive telerehabilitation (HCTR) consisting of telecare (with psychological telesupport), telerehabilitation and remote monitoring of implantable devices might be an innovative option improving heart failure (HF) patients' quality of life (QoL) and emotional health. The aim of the study was to investigate the influence of HCTR on various facets of QoL in HF patients in comparison with usual care (UC) alone. MATERIAL AND METHODS The present analysis formed part of a multicenter, randomized trial that enrolled 850 HF patients (NYHA I-III, LVEF ≤ 40%). Patients were randomized 1 : 1 to HCTR plus UC or UC only. Patients underwent either an HCTR program or UC with observation. The psychological intervention in the HCTR group included supportive psychological counseling via mobile phone. The Medical Outcome Survey Short Form 36 Questionnaire was used to assess QoL. Measurements were made before and after a 9-week intervention (HCTR group)/observation (UC group). RESULTS After the intervention, the HCTR group showed significant improvement in overall QoL, physical domain (PD) of QoL, and 4 areas of QoL (physical functioning (PhF), role functioning related to physical state (RF), general health (GH), vitality (VI)). A significant positive change in QoL in the UC group was observed only in VI and social functioning. There were also significant differences in QoL after 9-week intervention/observation between the two groups. The results showed greater improvement in HCTR for overall QoL (p = 0.009), PD of QoL (p = 0.0003) and three specific areas of QoL: PhF (p = 0.001), RF (p = 0.003), bodily pain (BP) (p = 0.015). CONCLUSIONS In comparison to UC, HCTR resulted in improvement in overall QoL, PD of QoL and 3 specific areas of QoL: PhF, RF and BP.
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Affiliation(s)
- Ewa Piotrowicz
- Telecardiology Center, National Institute of Cardiology, Warsaw, Poland
| | - Anna Mierzyńska
- Department of Coronary Artery Disease and Cardiac Rehabilitation, National Institute of Cardiology, Warsaw, Poland
| | - Maciej Banach
- Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
| | - Izabela Jaworska
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice; Silesian Centre for Heart Diseases, Zabrze, Poland
- Palliative Medicine Department, St. Camillus Hospital, Tarnowskie Gory, Poland
| | - Michał Pencina
- Duke University’s School of Medicine, Durham, United States of America
| | | | | | - Dominika Szalewska
- Department of Rehabilitation Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Grzegorz Opolski
- 1 Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Wojciech Zaręba
- University of Rochester Medical Center, Rochester, NY, United States of America
| | - Renata Glowczynska
- 1 Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Robert Irzmański
- Department of Internal Medicine and Cardiac Rehabilitation, Medical University of Lodz, Lodz, Poland
| | - Piotr Orzechowski
- Telecardiology Center, National Institute of Cardiology, Warsaw, Poland
| | | | - Ryszard Piotrowicz
- Department of Coronary Artery Disease and Cardiac Rehabilitation, National Institute of Cardiology, Warsaw, Poland
- Warsaw Academy of Medicine Rehabilitation, Warsaw, Poland
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Kyriakou M, Middleton N, Ktisti S, Philippou K, Lambrinou E. Supportive Care Interventions to Promote Health-Related Quality of Life in Patients Living With Heart Failure: A Systematic Review and Meta-Analysis. Heart Lung Circ 2020; 29:1633-1647. [PMID: 32723688 DOI: 10.1016/j.hlc.2020.04.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 03/29/2020] [Accepted: 04/26/2020] [Indexed: 10/23/2022]
Abstract
Supportive care (physical, psychosocial, and spiritual) may be beneficial as a coping resource in the care of patients with heart failure (HF). Nurses may provide individualised supportive care to offer positive emotional support, enhance the patients' knowledge of self-management, and meet the physical and psychosocial needs of patients with HF. The aim of this study was to examine the potential effectiveness of supportive care interventions in improving the health- related quality of life (HRQoL) of patients with HF. Related outcomes of depression and anxiety were also examined. A systematic search of PubMed, CINAHL, and the Cochrane Library was performed to locate randomised controlled trials (RCTs) that implemented any supportive care interventions in patients with HF published in the English language. Identified articles were further screened for additional studies. Ten (10) RCTs were selected for the meta-analysis. Effect sizes were estimated between the comparison groups over the overall follow-up period, and presented along with confidence intervals (CIs). Statistical heterogeneity for each comparison was estimated using Q (chi square test) and I2 statistics with 95% CIs. Statistical heterogeneity was observed in all study variables (i.e., HRQoL and dimensions). There was a positive, but not statistically significant, effect of social support on HRQoL (mean difference [MD], 5.31; 95% CI, -8.93 to 19.55 [p=0.46]). The results of the two dimensions suggested a positive and statistically significant effect of the supportive care interventions (physical: MD, 7.90; 95% CI, 11.31-4.50 [p=0.00]; emotional dimension: MD, 4.10; 95% CI, 6.14-2.06; [p=0.00]). The findings of the current study highlight the need to incorporate supportive care to meet the needs of patients with HF. Patients with HF have care needs that change continuously and rapidly, and there is a need of a continuous process in order to address the holistic needs of patients with HF at all times and not just in a cardiology department or an acute care setting. Patients with HF have multiple needs, which remain unmet. Supportive care is a holistic, ongoing approach that may be effective in identifying and meeting the care needs of patients with HF along with the patient. This review includes all interventions provided in individuals with HF, giving clinicians the opportunity to choose the most suitable ones in improving the clinical outcomes of their patients with HF.
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Affiliation(s)
- Martha Kyriakou
- Nicosia General Hospital, Nicosia, Cyprus; Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus.
| | - Nicos Middleton
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | | | - Katerina Philippou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Ekaterini Lambrinou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
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Akinrolie O, Barclay R, Strachan S, Gupta A, Jasper US, Jumbo SU, Askin N, Rabbani R, Zarychanski R, Abou-Setta AM. The effect of motivational interviewing on physical activity level among older adults: a systematic review and meta-analysis. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2020. [DOI: 10.1080/02703181.2020.1725217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Olayinka Akinrolie
- Applied Health Sciences Program, Faculty of Graduate Studies, University of Manitoba, Winnipeg, Canada
| | - Ruth Barclay
- Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Canada
| | - Shaelyn Strachan
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, Canada
| | - Akanksha Gupta
- Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Canada
| | - Unyime S. Jasper
- Adelaide Geriatrics Training and Research with Aged Care (G-TRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
- National Health and Medical Research Council Centre of Research Excellence, Frailty Trans-Disciplinary Research to Achieve Healthy Ageing, University of Adelaide, Adelaide, Australia
| | - Samuel U. Jumbo
- Faculty of Health and Rehabilitation Science, Western University, London, Ontario, Canada
| | - Nicole Askin
- Neil John Maclean Health Sciences Library, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Rasheda Rabbani
- George & Fay Yee Center for Healthcare Innovation, University of Manitoba/Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ryan Zarychanski
- George & Fay Yee Center for Healthcare Innovation, University of Manitoba/Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ahmed M. Abou-Setta
- George & Fay Yee Center for Healthcare Innovation, University of Manitoba/Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada
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Rey-Barth S, Eychenne C, Rolland C, Pinsault N, Bosson JL. Use of a smart electrically assisted bicycle (VELIS) in the health field -Proof of concept. Med Eng Phys 2020; 81:125-129. [PMID: 32473841 DOI: 10.1016/j.medengphy.2020.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 12/19/2019] [Accepted: 04/05/2020] [Indexed: 11/27/2022]
Abstract
Physical activity (PA) is highly recommended in the management of most chronic diseases. For these patients, the smart electric bicycle can be effective to improve adherence to this behavior. The E-bike used in this study (called VELIS) has an innovative onboard technology that allows for subject monitoring and the engine power is designed to adapt to the user's abilities. A prerequisite for the use of the VELIS with patients is to initially carry out a pilot study on healthy subjects. The objective was to evaluate the impact of the customizable settings on physiological parameters and to ensure this prototype's efficiency and safety of use. Twelve healthy participants with various profiles (physical condition, used to cycling or not) were included. They have completed four times a 14 km itinerary with various settings of the VELIS. We recorded GPS data, heart rate and perceived exertion. Based on exercise intensity, we confirm that riding an E-bike should be considered as a physical activity. Safety of the participants is ensured by the engine brake. Recordings show that it took between 1 and 3 min for the novice to become familiar with the VELIS and to get optimal assistance. The main finding of this pilot study confirms that VELIS is an easy to use and secure tool to make PA approachable, whatever the level of training in healthy subjects.
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Affiliation(s)
- S Rey-Barth
- Univ. Grenoble Alpes, CNRS, TIMC-IMAG, 38000 Grenoble, France.
| | - C Eychenne
- Univ. Grenoble Alpes, CNRS, TIMC-IMAG, 38000 Grenoble, France
| | - C Rolland
- Univ. Grenoble Alpes, CNRS, TIMC-IMAG, 38000 Grenoble, France
| | - N Pinsault
- Univ. Grenoble Alpes, CNRS, TIMC-IMAG, 38000 Grenoble, France
| | - J L Bosson
- Univ. Grenoble Alpes, CNRS, TIMC-IMAG, 38000 Grenoble, France
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Taş F, Seviğ EÜ, Güngörmüş Z. The effect of Transtheoretical Model based motivational interviewing on smokeless tobacco cessation in high school students. JOURNAL OF SUBSTANCE USE 2020. [DOI: 10.1080/14659891.2020.1760372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Filiz Taş
- Kahramanmaraş School of Health Sciences, Nursing Department, Sütçü İmam University, Kahramanmaraş, Turkey
| | | | - Zeynep Güngörmüş
- Faculty of Health Sciences, Gaziantep University, Gazıantep, Turkey
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Sadasivam RS, Kamberi A, DeLaughter K, Phillips B, Williams JH, Cutrona SL, Ray MN, Gilbert GH, Houston TK. Secure Asynchronous Communication Between Smokers and Tobacco Treatment Specialists: Secondary Analysis of a Web-Assisted Tobacco Intervention in the QUIT-PRIMO and National Dental PBRN Networks. J Med Internet Res 2020; 22:e13289. [PMID: 32374266 PMCID: PMC7240437 DOI: 10.2196/13289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 05/24/2019] [Accepted: 01/28/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Within a web-assisted tobacco intervention, we provided a function for smokers to asynchronously communicate with a trained tobacco treatment specialist (TTS). Previous studies have not attempted to isolate the effect of asynchronous counseling on smoking cessation. OBJECTIVE This study aimed to conduct a semiquantitative analysis of TTS-smoker communication and evaluate its association with smoking cessation. METHODS We conducted a secondary analysis of data on secure asynchronous communication between trained TTSs and a cohort of smokers during a 6-month period. Smokers were able to select their preferred TTS and message them using a secure web-based form. To evaluate whether the TTS used evidence-based practices, we coded messages using the Motivational Interviewing Self-Evaluation Checklist and Smoking Cessation Counseling (SCC) Scale. We assessed the content of messages initiated by the smokers by creating topical content codes. At 6 months, we assessed the association between smoking cessation and the amount of TTS use and created a multivariable model adjusting for demographic characteristics and smoking characteristics at baseline. RESULTS Of the 725 smokers offered asynchronous counseling support, 33.8% (245/725) messaged the TTS at least once. A total of 1082 messages (TTSs: 565; smokers 517) were exchanged between the smokers and TTSs. The majority of motivational interviewing codes were those that supported client strengths (280/517, 54.1%) and promoted engagement (280/517, 54.1%). SCC code analysis showed that the TTS provided assistance to smokers if they were willing to quit (247/517, 47.8%) and helped smokers prepare to quit (206/517, 39.8%) and anticipate barriers (197/517, 38.1%). The majority of smokers' messages discussed motivations to quit (234/565, 41.4%) and current and past treatments (talking about their previous use of nicotine replacement therapy and medications; 201/565, 35.6%). The majority of TTS messages used behavioral strategies (233/517, 45.1%), offered advice on treatments (189/517, 36.5%), and highlighted motivations to quit (171/517, 33.1%). There was no association between the amount of TTS use and cessation. In the multivariable model, after adjusting for gender, age, race, education, readiness at baseline, number of cigarettes smoked per day at baseline, and the selected TTS, smokers messaging the TTS one or two times had a smoking cessation odds ratio (OR) of 0.8 (95% CI 0.4-1.4), and those that messaged the TTS more than two times had a smoking cessation OR of 1.0 (95% CI 0.4-2.3). CONCLUSIONS Our study demonstrated the feasibility of using asynchronous counseling to deliver evidence-based counseling. Low participant engagement or a lack of power could be potential explanations for the nonassociation with smoking cessation. Future trials should explore approaches to increase participant engagement and test asynchronous counseling in combination with other approaches for improving the rates of smoking cessation.
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Affiliation(s)
| | - Ariana Kamberi
- University of Massachusetts Medical School, Worcester, MA, United States
| | - Kathryn DeLaughter
- Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, United States
| | - Barrett Phillips
- Veterans Affairs Central Western Massachusetts Healthcare System, Leeds, MA, United States
| | | | - Sarah L Cutrona
- University of Massachusetts Medical School, Worcester, MA, United States
| | - Midge N Ray
- University of Alabama at Birmingham, Birmingham, AL, United States
| | - Gregg H Gilbert
- University of Alabama at Birmingham, Birmingham, AL, United States
| | - Thomas K Houston
- University of Massachusetts Medical School, Worcester, MA, United States
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Engelen MM, van Dulmen S, Nijhuis-van der Sanden MWG, Adriaansen MJM, Vermeulen H, Bredie SJH, van Gaal BGI. Self-management support in cardiovascular consultations by advanced practice nurses trained in motivational interviewing: An observational study. PATIENT EDUCATION AND COUNSELING 2020; 103:159-164. [PMID: 31362901 DOI: 10.1016/j.pec.2019.07.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 03/14/2019] [Accepted: 07/15/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE This observational study explores advanced practice nurses' (APN) performance in secondary prevention and self-management support in patients with cardiovascular disease. METHODS Real-life consultations in three outpatient clinics were recorded on audio and analysed. First, discussed (sub)categories were determined using five categories of self-management: symptom management, treatment, biomedical cardiovascular risk factors, psychosocial consequences, and lifestyle changes. Second, the extent in which motivational interviewing aspects were applied was determined using the Behaviour Change Counselling Index (BECCI). RESULTS In total, 49 consultations performed by five female APNs were analysed. Physical topics were discussed in 98% and psychological subthemes in 41% of the consultations. Although not all components of motivational interviewing were applied, talking about current behaviour and behaviours that should change were discussed, and information was provided. Especially setting targets and exchanging ideas on how to reach behavioural goals were applied to a small extent. CONCLUSION Well-trained APNs in the current study do not carry out motivational interviewing in a structural and complete manner according to BECCI and do not discuss all self-management categories. PRACTICE IMPLICATIONS Psychological topics should be more integrated in providing self-management support by APNs and the application of motivational interviewing should be enhanced by regularly and repeated training.
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Affiliation(s)
- Marscha M Engelen
- Radboud university medical center, Radboud Institute for Health Science, IQ healthcare, Nijmegen, The Netherlands; HAN University of Applied Science, Faculty of Health and Social Studies, Institute of Nursing, Nijmegen, The Netherlands.
| | - Sandra van Dulmen
- Radboud university medical center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Nijmegen, The Netherlands; NIVEL (Netherlands institute for health services research), Utrecht, The Netherlands; Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | | | - Marian J M Adriaansen
- HAN University of Applied Science, Faculty of Health and Social Studies, Institute of Nursing, Nijmegen, The Netherlands
| | - Hester Vermeulen
- Radboud university medical center, Radboud Institute for Health Science, IQ healthcare, Nijmegen, The Netherlands
| | - Sebastian J H Bredie
- Radboud university medical center, Department of Internal Medicine, Nijmegen, The Netherlands
| | - Betsie G I van Gaal
- Radboud university medical center, Radboud Institute for Health Science, IQ healthcare, Nijmegen, The Netherlands; HAN University of Applied Science, Faculty of Health and Social Studies, Institute of Nursing, Nijmegen, The Netherlands
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Klompstra L, Jaarsma T, Strömberg A. Self-efficacy Mediates the Relationship Between Motivation and Physical Activity in Patients With Heart Failure. J Cardiovasc Nurs 2019; 33:211-216. [PMID: 29189427 PMCID: PMC5908261 DOI: 10.1097/jcn.0000000000000456] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Motivation is necessary in patients with heart failure (HF) who are attempting to become more physically active but may not be sufficient to initiate physical activity. Self-efficacy might explain the relationship between motivation and physical activity. OBJECTIVE The aim of this study was to examine the role of exercise self-efficacy in the relationship between exercise motivation and physical activity in patients with HF. METHODS A total of 100 stable patients with HF (88% in New York Heart Association class II/III; mean age, 67 ± 13 years; 62% men) were studied. Self-efficacy was measured with the Exercise Self-Efficacy Scale; motivation, with the Exercise Motivation Index; and physical activity, with a self-report questionnaire. Logistic regression analyses were made to examine the mediation effect of exercise self-efficacy on the relationship between exercise motivation and physical activity. RESULTS Forty-two percent of the 100 patients reported engaging in less than 60 minutes per week of physical activity. Motivation predicted physical activity (b = 0.58, P < .05), but after controlling for self-efficacy, the relationship between motivation and physical activity was no longer significant (b = 0.76, P = .06), indicating full mediation. CONCLUSION Motivation to be physically active is important but not sufficient. In addition to a high level of motivation to be physically active, it is important that patients with HF have a high degree of self-efficacy.
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Affiliation(s)
- Leonie Klompstra
- Leonie Klompstra, PhD Post-doctoral Researcher, Division of Nursing, Department of Social and Welfare Studies, Linköping University, Sweden. Tiny Jaarsma, PhD, RN Professor, Division of Nursing, Department of Social and Welfare Studies, Linköping University, Sweden. Anna Strömberg, PhD, RN Professor, Division of Nursing, Department of Medical and Health Sciences, and Department of Cardiology, Linköping University, Sweden; and Program in Nursing Science, University of California Irvine
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Amo-Setién FJ, Abajas-Bustillo R, Torres-Manrique B, Martín-Melón R, Sarabia-Cobo C, Molina-Mula J, Ortego-Mate C. Characteristics of nursing interventions that improve the quality of life of people with chronic diseases. A systematic review with meta-analysis. PLoS One 2019; 14:e0218903. [PMID: 31233569 PMCID: PMC6590814 DOI: 10.1371/journal.pone.0218903] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 06/11/2019] [Indexed: 02/05/2023] Open
Abstract
PURPOSE The objective of this systematic review was to determine the characteristics of the interventions conducted by nurses that attempt to improve the health related quality of life (HRQoL) of people over 18 years of age with chronic diseases. METHODS This systematic review with meta-analysis summarizes 24 studies, conducted in 10 countries, that evaluated HRQoL through the Short-Form Health Survey (SF). Five databases were accessed to find the available studies from December 31st, 2000 to May 22sd, 2017. Selected studies were coded according to the characteristics of the sample and the intervention. A model of random effects was adopted for the overall estimation and to explain the heterogeneity. RESULTS Twenty-four studies were included in the systematic review and meta-analysis providing a sample of 4324 chronic patients aged 63.4 years. Among the 8 subscales and two summary measures that comprise the SF-36, only an overall significant effect size (ES) index was found in the Mental Health Component summary score (ES = 0.14; 95% CI:0.03 - 0.26; I2 = 44.6, p = 0.042) and the Mental Health subscale. This improvement on HRQoL was associated to interventions on "Case Management" and "Treatments and Procedures", which were based on a theory, were of shorter duration, and had a follow-up period. CONCLUSIONS Interventions targeting people with chronic diseases resulted in a slight increase in the HRQoL that was not always significant, which suggests that there is a need for their continuous improvement.
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Affiliation(s)
| | | | | | | | - Carmen Sarabia-Cobo
- Faculty of Nursing, University of Cantabria, IDIVAL Nursing Group, Santander, Spain
| | - Jesús Molina-Mula
- Nursing and Physiotherapy Department, University of Illes Balears, Palma, Spain
| | - Carmen Ortego-Mate
- Faculty of Nursing, University of Cantabria, IDIVAL Nursing Group, Santander, Spain
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Amo-Setién FJ, Abajas-Bustillo R, Torres-Manrique B, Martín-Melón R, Sarabia-Cobo C, Molina-Mula J, Ortego-Mate C. Characteristics of nursing interventions that improve the quality of life of people with chronic diseases. A systematic review with meta-analysis. PLoS One 2019. [DOI: https://doi.org/10.1371/journal.pone.0218903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Stallings DT, Kraenzle Schneider J. Motivational Interviewing and Fat Consumption in Older Adults: A Meta-Analysis. J Gerontol Nurs 2018; 44:33-43. [PMID: 30208189 DOI: 10.3928/00989134-20180817-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Accepted: 07/23/2018] [Indexed: 12/24/2022]
Abstract
Diets high in fat increase the risks for obesity and chronic diseases, even for older adults, the largest growing population in the United States. In the current study, a meta-analysis was performed to examine the effects of motivational interviewing (MI) dietary interventions on fat consumption in older adults. Electronic databases, journals, and unpublished literature were searched. Six primary studies were retrieved, providing seven comparisons between intervention and control groups and a total of 1,351 participants. MI had a moderate effect on fat intake in older adults (effect size = 0.354, p < 0.01). Studies with indicators of higher design quality showed greater MI effects. Nurses and providers can incorporate MI into health education and counseling to improve older adults' dietary health behaviors. [Journal of Gerontological Nursing, 44(11), 33-43.].
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Meaning-making and quality of life in heart failure interventions: a systematic review. Qual Life Res 2018; 28:557-565. [DOI: 10.1007/s11136-018-1993-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2018] [Indexed: 10/28/2022]
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Vakilian K, Molavi S, Zamani AR, Goodarzi M. Effect of Motivational Interviewing on Using Intrauterine Device in Women at High Risk for Pregnancy. Open Access Maced J Med Sci 2018; 6:1306-1309. [PMID: 30087742 PMCID: PMC6062271 DOI: 10.3889/oamjms.2018.166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 06/09/2018] [Accepted: 06/10/2018] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Reproductive health programs help women live healthier. Family planning consultation is an important component of reproductive health. A good family planning consultation can increase the use of effective birth control methods and improve the life quality of people, specifically of those at high risk. One of the most effective birth control techniques is an intrauterine device (IUD). AIM This study was done to investigate the effect of motivational interviewing (MI) on the use of IUD in women at high risk for pregnancy. METHODS This random educational trial was conducted in Isfahan on 44 women at high risk for pregnancy in 2015. Subjects were selected through random sampling. First, written informed consent of all samples was gathered, and then the intervention was made in five 45-minute motivational interviewing sessions by the researcher. For this study, a questionnaire was created to measure knowledge, attitude, acceptance, and performance. All the subjects filled this instrument prior and one month after the intervention. Data were then analysed using SPSS 20. The employed statistical tests included dependent t-test, independent t-test, Mann-Whitney, Fischer's exact test, and McNemar's test. RESULTS Results suggested that MI significantly improved the use of IUD in the intervention group (p < 0.001). Also, the mean knowledge (p < 0.001) and attitude (p < 0.001) scores significantly increased in the intervention group. CONCLUSION Due to the role of MI in increasing the use of IUD, embedding this type of consultation in specific programs for changing health behaviours during pregnancy can be beneficial.
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Affiliation(s)
- Katayoon Vakilian
- Arak University of Medical Sciences, Arak School of Nursing and Midwifery, Arak, Iran
| | - Sajedeh Molavi
- Arak University of Medical Sciences, Arak School of Nursing and Midwifery, Arak, Iran
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Carvalho KMD, Silva CRDT, Figueiredo MDLF, Nogueira LT, Andrade EMLR. Intervenções educativas para promoção da saúde do idoso: revisão integrativa. ACTA PAUL ENFERM 2018. [DOI: 10.1590/1982-0194201800062] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo: Identificar na literatura a produção cientifica sobre as intervenções educativas utilizadas por enfermeiros na promoção da saúde do idoso. Métodos: Revisão integrativa de literatura realizada nas bases de dados LILACS, MEDLINE, CINAHL e Web of Science, entre 2007 e 2017, em português, inglês e espanhol, utilizando os descritores: “aged”; “aging”; “aged, 80 and over”; “health services for the aged”; “nursing”; “clinical trial”; “technology/ED”; “educational technology”; (health education AND technology”); “health promotion”, combinados por meio dos operadores booleanos “AND” e “OR”. Resultados: Foram incluídos 22 estudos. As intervenções educativas utilizadas por enfermeiros na promoção da saúde do idoso foram: orientações pedagógicas durante a consulta de enfermagem (50%), acompanhamento domiciliar (27,8%), aconselhamento com dinâmicas motivacionais (11,1%) e sessões educativas com estratégias lúdicas (11,1%). Conclusão: O Enfermeiro desempenha papel fundamental na promoção da saúde por coordenar o plano de cuidados pelo vínculo que estabelece com os usuários, familiares e cuidadores a partir de ações educativas capazes de modificar atitudes e proporcionar saúde. As ações educativas promoveram saúde por oportunizar a maior adoção de hábitos saudáveis, acompanhamento terapêutico e bem estar.
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Hopelessness and cognitive impairment are risk markers for mortality in systolic heart failure patients. J Psychosom Res 2018; 109:12-18. [PMID: 29773147 DOI: 10.1016/j.jpsychores.2018.03.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 03/15/2018] [Accepted: 03/17/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Depression exacerbates the burden of heart failure and independently predicts mortality. The aim of this study was to investigate which specific symptoms of depression predict all-cause mortality in systolic heart failure patients. METHODS Consecutive outpatients with heart failure and impaired left ventricular ejection fraction (LVEF), attending an Australian metropolitan heart function clinic between 2001 and 2011, were enrolled. The Cardiac Depression Scale (CDS) was completed as a component of usual care. Baseline clinical characteristics were drawn from hospital databases. The primary end-point was all-cause mortality, obtained from the Australian National Death Index. RESULTS A total of 324 patients (68.5% male) were included (mean age at enrolment = 66.8 ± 14.36 years), with a median follow-up time of 6.7 years (95% CI 5.97-7.39) and a mortality rate of 50% by the census date. Mean LVEF = 31.0 ± 11.31%, with 25% having NYHA functional class of III or IV. Factor analysis of the CDS extracted six symptom dimensions: Hopelessness, Cognitive Impairment, Anhedonia/Mood, Irritability, Worry, and Sleep Disturbance. Cox regression analyses identified Hopelessness (HR 1.024, 95% CI 1.004-1.045, p = .018) and Cognitive Impairment (HR 1.048, 95% CI 1.005-1.093, p = .028) as independent risk markers of all-cause mortality, following adjustment of known prognostic clinical factors. CONCLUSION Hopelessness and cognitive impairment are stronger risk markers for all-cause mortality than other symptoms of depression in systolic heart failure. These data will allow more specific risk assessment and potentially new targets for more effective treatment and management of depression in this population.
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Motivational interviewing to improve the self-care behaviors for patients with chronic heart failure: A randomized controlled trial. Int J Nurs Sci 2018; 5:213-217. [PMID: 31406827 PMCID: PMC6626221 DOI: 10.1016/j.ijnss.2018.04.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 01/21/2018] [Accepted: 04/23/2018] [Indexed: 11/23/2022] Open
Abstract
Objectives This study aimed to investigate the effect of motivational interviewing on the self-care behaviours in patients with chronic heart failure. Methods Sixty-two hospitalized patients with chronic heart failure were recruited in this study from April 2014 to April 2015 from a hospital. Twenty-nine patients were in the intervention group, and 33 patients were in the control group. Patients in the intervention group received four sessions of motivational interviewing, whereas those in the control group received traditional health education. At 2, 4, and 8 weeks post-discharge, the intervention group underwent telephone follow-up based on motivational interviewing, whereas the control group underwent routine telephone follow-up. Primary outcome was measured using the Self-care of Heart Failure Index at baseline and at 2 months post-discharge. Results Before intervention, the self-care behaviours scores were 79.00 ± 48.80 in the intervention group and 88.68 ± 29.26in the control group. No statistically significant differences were found between two groups in scores for each subscale and total scale (P > 0.05). After intervention, the scores of self-care behaviours in the two groups were both improved at 155.13 ± 35.65 for the intervention group and 115.44 ± 22.82 for the control group with statistically significance (P < 0.01). The score of self-care behaviours increased by 76.13 point in the intervention group on average, whereas 26.76 point in the control group. There was significant difference between increases in scores of self-care behaviours in two groups (P < 0.01). Conclusions The self-care behaviours of patients with chronic heart failure could be improved effectively through motivational interviewing.
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McCarthy MM, Dickson VV, Katz SD, Chyun DA. An Exercise Counseling Intervention in Minority Adults With Heart Failure. Rehabil Nurs 2018; 42:146-156. [PMID: 26956804 DOI: 10.1002/rnj.265] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE The primary aim of this study was to assess the feasibility of an exercise counseling intervention for adults of diverse race/ethnicity with heart failure (HF) and to assess its potential for improving overall physical activity, functional capacity, and HF self-care. DESIGN This study was a quasi-experimental, prospective, longitudinal cohort design. METHODS Twenty adults were enrolled and completed the 6-minute walk and standardized instruments, followed by exercise counseling using motivational interviewing. Each received an accelerometer, hand weights, and a diary to record self-care behaviors. Participants were followed via phone for 12 weeks to collect step-counts, review symptoms, and plan the following week's step goal. FINDINGS Results indicate that this intervention was feasible for most participants and resulted in improvements in physical activity, functional capacity, and self-care behaviors. CONCLUSION/CLINICAL RELEVANCE Brief exercise counseling may be an appropriate option to improve outcomes for stable patients with HF and may be tailored to fit different settings.
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Affiliation(s)
- Margaret M McCarthy
- 1 College of Nursing, New York University, New York, NY, USA2 Heart Failure Program, New York University, Langone Medical Center, New York, NY, USA
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Boisvert S, Proulx-Belhumeur A, Gonçalves N, Doré M, Francoeur J, Gallani MC. An integrative literature review on nursing interventions aimed at increasing self-care among heart failure patients. Rev Lat Am Enfermagem 2017; 23:753-68. [PMID: 26444179 PMCID: PMC4623739 DOI: 10.1590/0104-1169.0370.2612] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to analyze and summarize knowledge concerning critical components of interventions that have been proposed and implemented by nurses with the aim of optimizing self-care by heart failure patients. METHODS PubMed and CINAHL were the electronic databases used to search full peer-reviewed papers, presenting descriptions of nursing interventions directed to patients or to patients and their families and designed to optimize self-care. Forty-two studies were included in the final sample (n=4,799 patients). RESULTS this review pointed to a variety and complexity of nursing interventions. As self-care encompasses several behaviors, interventions targeted an average of 3.6 behaviors. Educational/counselling activities were combined or not with cognitive behavioral strategies, but only about half of the studies used a theoretical background to guide interventions. Clinical assessment and management were frequently associated with self-care interventions, which varied in number of sessions (1 to 30); length of follow-up (2 weeks to 12 months) and endpoints. CONCLUSIONS these findings may be useful to inform nurses about further research in self-care interventions in order to propose the comparison of different modalities of intervention, the use of theoretical background and the establishment of endpoints to evaluate their effectiveness.
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Affiliation(s)
- Sophie Boisvert
- Faculté des sciences infirmières, Université Laval, Québec, QC, CA
| | | | - Natalia Gonçalves
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, BR
| | - Michel Doré
- Faculté des sciences infirmières, Université Laval, Québec, QC, CA
| | - Julie Francoeur
- Institut universitaire de cardiologie et pneumologie de Québec, Québec, QC, CA
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Klompstra L, Jaarsma T, Mårtensson J, Strömberg A. Exergaming Through the Eyes of Patients with Heart Failure: A Qualitative Content Analysis Study. Games Health J 2017; 6:152-158. [DOI: 10.1089/g4h.2016.0087] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Leonie Klompstra
- Division of Nursing, Department of Social and Welfare Studies, Linköping University, Linköping, Sweden
| | - Tiny Jaarsma
- Division of Nursing, Department of Social and Welfare Studies, Linköping University, Linköping, Sweden
| | - Jan Mårtensson
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Anna Strömberg
- Division of Nursing, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Department of Cardiology, Program in Nursing Science, University of California Irvine, Irvine, California
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Richards SH, Anderson L, Jenkinson CE, Whalley B, Rees K, Davies P, Bennett P, Liu Z, West R, Thompson DR, Taylor RS. Psychological interventions for coronary heart disease. Cochrane Database Syst Rev 2017; 4:CD002902. [PMID: 28452408 PMCID: PMC6478177 DOI: 10.1002/14651858.cd002902.pub4] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Coronary heart disease (CHD) is the most common cause of death globally, although mortality rates are falling. Psychological symptoms are prevalent for people with CHD, and many psychological treatments are offered following cardiac events or procedures with the aim of improving health and outcomes. This is an update of a Cochrane systematic review previously published in 2011. OBJECTIVES To assess the effectiveness of psychological interventions (alone or with cardiac rehabilitation) compared with usual care (including cardiac rehabilitation where available) for people with CHD on total mortality and cardiac mortality; cardiac morbidity; and participant-reported psychological outcomes of levels of depression, anxiety, and stress; and to explore potential study-level predictors of the effectiveness of psychological interventions in this population. SEARCH METHODS We updated the previous Cochrane Review searches by searching the following databases on 27 April 2016: CENTRAL in the Cochrane Library, MEDLINE (Ovid), Embase (Ovid), PsycINFO (Ovid), and CINAHL (EBSCO). SELECTION CRITERIA We included randomised controlled trials (RCTs) of psychological interventions compared to usual care, administered by trained staff, and delivered to adults with a specific diagnosis of CHD. We selected only studies estimating the independent effect of the psychological component, and with a minimum follow-up of six months. The study population comprised of adults after: a myocardial infarction (MI), a revascularisation procedure (coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI)), and adults with angina or angiographically defined coronary artery disease (CAD). RCTs had to report at least one of the following outcomes: mortality (total- or cardiac-related); cardiac morbidity (MI, revascularisation procedures); or participant-reported levels of depression, anxiety, or stress. DATA COLLECTION AND ANALYSIS Two review authors independently screened titles and abstracts of all references for eligibility. A lead review author extracted study data, which a second review author checked. We contacted study authors to obtain missing information. MAIN RESULTS This review included 35 studies which randomised 10,703 people with CHD (14 trials and 2577 participants added to this update). The population included mainly men (median 77.0%) and people post-MI (mean 65.7%) or after undergoing a revascularisation procedure (mean 27.4%). The mean age of participants within trials ranged from 53 to 67 years. Overall trial reporting was poor, with around a half omitting descriptions of randomisation sequence generation, allocation concealment procedures, or the blinding of outcome assessments. The length of follow-up ranged from six months to 10.7 years (median 12 months). Most studies (23/35) evaluated multifactorial interventions, which included therapies with multiple therapeutic components. Ten studies examined psychological interventions targeted at people with a confirmed psychopathology at baseline and two trials recruited people with a psychopathology or another selecting criterion (or both). Of the remaining 23 trials, nine studies recruited unselected participants from cardiac populations reporting some level of psychopathology (3.8% to 53% with depressive symptoms, 32% to 53% with anxiety), 10 studies did not report these characteristics, and only three studies excluded people with psychopathology.Moderate quality evidence showed no risk reduction for total mortality (risk ratio (RR) 0.90, 95% confidence interval (CI) 0.77 to 1.05; participants = 7776; studies = 23) or revascularisation procedures (RR 0.94, 95% CI 0.81 to 1.11) with psychological therapies compared to usual care. Low quality evidence found no risk reduction for non-fatal MI (RR 0.82, 95% CI 0.64 to 1.05), although there was a 21% reduction in cardiac mortality (RR 0.79, 95% CI 0.63 to 0.98). There was also low or very low quality evidence that psychological interventions improved participant-reported levels of depressive symptoms (standardised mean difference (SMD) -0.27, 95% CI -0.39 to -0.15; GRADE = low), anxiety (SMD -0.24, 95% CI -0.38 to -0.09; GRADE = low), and stress (SMD -0.56, 95% CI -0.88 to -0.24; GRADE = very low).There was substantial statistical heterogeneity for all psychological outcomes but not clinical outcomes, and there was evidence of small-study bias for one clinical outcome (cardiac mortality: Egger test P = 0.04) and one psychological outcome (anxiety: Egger test P = 0.012). Meta-regression exploring a limited number of intervention characteristics found no significant predictors of intervention effects for total mortality and cardiac mortality. For depression, psychological interventions combined with adjunct pharmacology (where deemed appropriate) for an underlying psychological disorder appeared to be more effective than interventions that did not (β = -0.51, P = 0.003). For anxiety, interventions recruiting participants with an underlying psychological disorder appeared more effective than those delivered to unselected populations (β = -0.28, P = 0.03). AUTHORS' CONCLUSIONS This updated Cochrane Review found that for people with CHD, there was no evidence that psychological treatments had an effect on total mortality, the risk of revascularisation procedures, or on the rate of non-fatal MI, although the rate of cardiac mortality was reduced and psychological symptoms (depression, anxiety, or stress) were alleviated; however, the GRADE assessments suggest considerable uncertainty surrounding these effects. Considerable uncertainty also remains regarding the people who would benefit most from treatment (i.e. people with or without psychological disorders at baseline) and the specific components of successful interventions. Future large-scale trials testing the effectiveness of psychological therapies are required due to the uncertainty within the evidence. Future trials would benefit from testing the impact of specific (rather than multifactorial) psychological interventions for participants with CHD, and testing the targeting of interventions on different populations (i.e. people with CHD, with or without psychopathologies).
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Affiliation(s)
- Suzanne H Richards
- Leeds Institute of Health Sciences, University of Leeds, Charles Thackrah Building, 101 Clarendon Road, Leeds, UK, LS2 9LJ
- Primary Care, University of Exeter Medical School, St Luke's Campus, Magdalen Road, Exeter, Devon, UK, EX1 2LU
| | - Lindsey Anderson
- Institute of Health Research, University of Exeter Medical School, Veysey Building, Salmon Pool Lane, Exeter, UK, EX2 4SG
| | - Caroline E Jenkinson
- Primary Care, University of Exeter Medical School, St Luke's Campus, Magdalen Road, Exeter, Devon, UK, EX1 2LU
| | - Ben Whalley
- School of Psychology, University of Plymouth, Plymouth, UK
| | - Karen Rees
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK, CV4 7AL
| | - Philippa Davies
- School of Social and Community Medicine, University of Bristol, Canynge Hall, Bristol, UK, BS8 2PS
| | - Paul Bennett
- Department of Psychology, University of Swansea, Singleton Park, Swansea, UK, SA2 8PP
| | - Zulian Liu
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Robert West
- Wales Heart Research Institute, Cardiff University, Heath Park, Cardiff, UK, CF14 4XN
| | - David R Thompson
- Department of Psychiatry, University of Melbourne, St Vincent's Hospital, Melbourne, Victoria, Australia, VIC 3000
| | - Rod S Taylor
- Institute of Health Research, University of Exeter Medical School, Veysey Building, Salmon Pool Lane, Exeter, UK, EX2 4SG
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Mirkarimi K, Kabir MJ, Honarvar MR, Ozouni-Davaji RB, Eri M. Effect of Motivational Interviewing on Weight Efficacy Lifestyle among Women with Overweight and Obesity: A Randomized Controlled Trial. IRANIAN JOURNAL OF MEDICAL SCIENCES 2017; 42:187-193. [PMID: 28360445 PMCID: PMC5366367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/29/2022]
Abstract
Obesity and overweight have become increasingly a major public health problem across the world. This study aimed at exploring the effects of motivational interviewing on weight efficacy lifestyle among women with obesity and overweight. A single-blind randomized clinical trial study was conducted on 100 overweight and obese women who attended a nutrition clinic. The samples were selected based on the clinical records and assigned into two groups, namely motivational interviewing arm (50 samples) and nutrition education arm (50 samples). Data were collected using a standard validated questionnaire entitled "weight efficacy lifestyle". The intervention was designed according to five motivation sessions and four nutrition education programs, such that the participants of the nutrition education arm were also provided with the nutrition pamphlets related to weight control. Data were finally analyzed using the SPSS statistical software by performing the independent t-test, chi-square, LSD and repeated measures ANOVA tests. P<0.05 were considered statistically significant. The mean age of women was 39.9±9.1 and 36.3±8.9 years in the control and motivational interviewing arms, respectively. Compared with the control group, the score of the motivational interviewing group was statistically significant in terms of weight efficacy lifestyle P=0.0001) and all subscales including social pressure (P=0.0001), physical discomfort (P=0.005), food accessibility (P=0.0001), positive and entertainment activities (P=0.0001), as well as negative emotions (P=0.003). Motivational interviewing appeared to be effective in increasing weight efficacy lifestyle among women with overweight and obesity. TRIAL REGISTRATION NUMBER IRCT2014051817736N1.
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Affiliation(s)
- Kamal Mirkarimi
- Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mohammad Javad Kabir
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Honarvar
- Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran,Correspondence: Mohammad Reza Honarvar, M-Phil; No 19, Shaghayegh Apartment, 3rd Sima alley, 57 Edalat street, Gorgan, Golestan province, Iran Tel: +98 17 32160330 Fax: +98 17 32160330
| | - Rahman Berdi Ozouni-Davaji
- Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Maryam Eri
- Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran
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Vellone E, Paturzo M, D'Agostino F, Petruzzo A, Masci S, Ausili D, Rebora P, Alvaro R, Riegel B. MOTIVATional intErviewing to improve self-care in Heart Failure patients (MOTIVATE-HF): Study protocol of a three-arm multicenter randomized controlled trial. Contemp Clin Trials 2017; 55:34-38. [PMID: 28185994 DOI: 10.1016/j.cct.2017.02.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Revised: 02/03/2017] [Accepted: 02/04/2017] [Indexed: 10/20/2022]
Abstract
AIMS Heart Failure (HF) self-care improves patient outcomes but trials designed to improve HF self-care have shown inconsistent results. Interventions may be more effective in improving self-care if they mobilize support from providers, promote self-efficacy, increase understanding of HF, increase the family involvement, and are individualized. All of these elements are emphasized in motivational interviewing (MI); few trials have been conducted using MI in HF patients and rarely have caregivers been involved in MI interventions. The aim of this study will be to evaluate if MI improves self-care maintenance in HF patients, and to determine if MI improves the following secondary outcomes: a) in HF patients: self-care management, self-care confidence, symptom perception, quality of life, anxiety/depression, cognition, sleep quality, mutuality with caregiver, hospitalizations, use of emergency services, and mortality; b) in caregivers: caregiver contribution to self-care, quality of life, anxiety/depression, sleep, mutuality with patient, preparedness, and social support. METHODS A three-arm randomized controlled trial will be conducted in a sample of 240 HF patients and caregivers. Patients and caregivers will be randomized to the following arms: 1) MI intervention to patients only; 2) MI intervention to patients and caregivers; 3) standard of care to patients and caregivers. The primary outcome will be measured in patients 3months after enrollment. Primary and secondary outcomes also will be evaluated 6, 9 and 12months after enrollment. CONCLUSION This study will contribute to understand if MI provided to patients and caregivers can improve self-care. Because HF is rising in prevalence, findings can be useful to reduce the burden of the disease.
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Affiliation(s)
- Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
| | - Marco Paturzo
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Fabio D'Agostino
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Antonio Petruzzo
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Stefano Masci
- School of Counselling, University of Rome Tor Vergata, Rome, Italy
| | - Davide Ausili
- Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
| | - Paola Rebora
- Centre of Biostatistics for Clinical Epidemiology, Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Barbara Riegel
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
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Riegel B, Dickson VV, Garcia LE, Masterson Creber R, Streur M. Mechanisms of change in self-care in adults with heart failure receiving a tailored, motivational interviewing intervention. PATIENT EDUCATION AND COUNSELING 2017; 100:283-288. [PMID: 27599712 PMCID: PMC5318245 DOI: 10.1016/j.pec.2016.08.030] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 08/16/2016] [Accepted: 08/29/2016] [Indexed: 06/06/2023]
Abstract
UNLABELLED Self-care is challenging but we previously demonstrated that motivational interviewing (MI) was effective in improving heart failure (HF) self-care. OBJECTIVE To identify the mechanisms of intervention effectiveness by elucidating the MI techniques used and the relationship between the techniques and changes in self-care. METHODS Audiotaped sessions (first and subsequent sessions) from 8 participants were transcribed verbatim and coded to evaluate changes in self-care. Using a sequential mixed method design, quantitative and qualitative self-care data were triangulated; congruence was 97%. The MI techniques used and mechanisms of intervention effectiveness were identified from the qualitative data. RESULTS Three MI techniques used were related to improved self-care: 1) reflection and reframing, 2) genuine empathy, affirmation, and humor, and 2) individualized problem solving. These techniques stimulated openness to goal setting, positive self-talk, perceived ability to overcome barriers, and change talk. The mechanisms by which the techniques achieved the desired outcomes were the development of discrepancy and self-efficacy, which are consistent with the principles of MI. CONCLUSION This study contributes to clarifying the mechanism by which MI facilitates behavioral change. PRACTICE IMPLICATIONS Using MI to discuss self-care can help to overcome barriers and engage HF patients in goal setting for behavior change.
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Affiliation(s)
- Barbara Riegel
- Edith Clemmer Steinbright Professor of Gerontology School of Nursing, University of Pennsylvania, Philadelphia, PA, USA.
| | | | | | | | - Megan Streur
- Post-doctoral Fellow School of Nursing, University of Washington Seattle, WA, USA
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Shoemaker MJ, Oberholtzer NL, Jongekrijg LE, Bowen TE, Cartwright K, Hanson K, Serba D, Dickinson MG, Kowalk A. Exercise- and Psychosocial-Based Interventions to Improve Daily Activity in Heart Failure: A Pilot Study. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2016. [DOI: 10.1177/1084822316683660] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In individuals with heart failure (HF), low daily activity is associated with a poorer prognosis. The purpose of this pilot study was to investigate the effects of two home-based interventions on the primary HF-related outcome of daily activity and secondary outcomes of exercise tolerance, HF-related health status, and lower extremity functional strength in 16 patients with HF and implanted Medtronic implantable cardioverter defibrillator and cardiac resynchronization devices using a single-blind, randomized controlled pilot trial. Interventions were either daily activity feedback and encouragement or health coaching and home-based exercise. There were no significant differences in primary or secondary outcomes either between or within groups. Three subjects in each treatment group improved in two or more secondary outcomes, and only one improved in daily activity. Although the present pilot study incorporated both exercise and psychosocial components in the intervention, there was no effect on daily activity, perhaps because readiness for behavioral change was not accounted for either in group stratification/allocation or inclusion criteria.
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Affiliation(s)
| | | | | | | | | | - Kim Hanson
- Grand Valley State University, Grand Rapids, MI, USA
| | - Deb Serba
- Grand Valley State University, Grand Rapids, MI, USA
| | - Michael G. Dickinson
- Frederik Meijer Heart and Vascular Institute, Spectrum Health, Grand Rapids, MI, USA
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Schneider JK, Wong-Anuchit C, Stallings D, Krieger MM. Motivational Interviewing and Fruit/Vegetable Consumption in Older Adults. Clin Nurs Res 2016; 26:731-746. [PMID: 29092634 DOI: 10.1177/1054773816673634] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Evidence supports the relationship between fruit and vegetable consumption (FVC) and risk reduction for several illness conditions, even for older adults. Thus, we examined the effects of motivational interviewing (MI) on FVC in adults with a mean age ≥60. We chose MI because of its growing popularity as an effective behavior change strategy and because the person-centered MI principles are a good fit for older adults. We searched 10 electronic databases, several journals, and unpublished and fugitive literature. We retrieved seven primary studies, providing nine comparisons, with 1,978 participants. The overall MI effect size (ES) was .221 ( p = .002). When the percentage of women was greater, ES was lower; when interventionists had more training, ES was higher; and when sessions were longer, ES was stronger. Future researchers might test longer sessions with trained interventionists and examine gender differences. Practitioners should be well trained and offer sessions that are 30 to 40 min in length.
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Krabbenborg MA, Boersma SN, van der Veld WM, Vollebergh WA, Wolf JR. Self-determination in relation to quality of life in homeless young adults: Direct and indirect effects through psychological distress and social support. JOURNAL OF POSITIVE PSYCHOLOGY 2016. [DOI: 10.1080/17439760.2016.1163404] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Masterson Creber R, Patey M, Lee CS, Kuan A, Jurgens C, Riegel B. Motivational interviewing to improve self-care for patients with chronic heart failure: MITI-HF randomized controlled trial. PATIENT EDUCATION AND COUNSELING 2016; 99:256-64. [PMID: 26358533 PMCID: PMC4733398 DOI: 10.1016/j.pec.2015.08.031] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 08/07/2015] [Accepted: 08/27/2015] [Indexed: 05/15/2023]
Abstract
OBJECTIVE The purpose of this study was to test the efficacy of a tailored motivational interviewing (MI) intervention versus usual care for improving HF self-care behaviors, physical HF symptoms and quality of life. METHODS This is a single-center, randomized controlled trial. Participants were enrolled in the hospital. Immediately after discharge, those in the intervention group received a single home visit and 3-4 follow-up phone calls by a nurse over 90 days. RESULTS A total of 67 participants completed the study (mean age 62±12.8 years), of which 54% were African American, 30% were female, 84% had class III/IV symptoms, and 63% were educated at a high school level or less. There were no differences between the groups in self-care maintenance, self-care confidence, physical HF symptoms, or quality of life at 90 days. CONCLUSION Patients who received the MI intervention had significant and clinically meaningful improvements in HF self-care maintenance over 90 days that exceeded that of usual care. PRACTICE IMPLICATIONS These data support the use of a nurse-led MI intervention for improving HF self-care. Identifying methods to improve HF self-care may lead to improved clinical outcomes.
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Affiliation(s)
| | - Megan Patey
- MSN, WHNP-BC, RN School of Nursing, University of Pennsylvania, School of Nursing, Philadelphia, PA, USA
| | - Christopher S Lee
- RN, FAHA, FAAN School of Nursing, Oregon Health & Sciences University, School of Nursing, Portland, OR, USA
| | - Amy Kuan
- BSN, RN School of Nursing, University of Pennsylvania, School of Nursing, Philadelphia, PA, USA
| | - Corrine Jurgens
- RN, FAAN School of Nursing, Stony Brook University, School of Nursing, Stony Brook, NY, USA
| | - Barbara Riegel
- RN, FAHA, FAAN School of Nursing, University of Pennsylvania, School of Nursing, Philadelphia, PA, USA
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Riegel B, Masterson Creber R, Hill J, Chittams J, Hoke L. Effectiveness of Motivational Interviewing in Decreasing Hospital Readmission in Adults With Heart Failure and Multimorbidity. Clin Nurs Res 2016; 25:362-77. [PMID: 26743119 DOI: 10.1177/1054773815623252] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Hospitalizations are common in heart failure (HF). Multimorbidity, defined as ≥2 comorbid conditions, drives many readmissions. The purpose of this pilot study was to test the effectiveness of motivational interviewing (MI) in decreasing these hospital readmissions. We enrolled 100 hospitalized HF patients into a randomized controlled trial, randomizing in a 2:1 ratio: intervention (n = 70) and control (n = 30). The intervention group received MI tailored to reports of self-care during one home visit and three to four follow-up phone calls. After 3 months, 34 participants had at least one hospital readmission. The proportion of patients readmitted for a condition unrelated to HF was lower in the intervention (7.1%) compared with the control group (30%, p = .003). Significant predictors of a non-HF readmission were intervention group, age, diabetes, and hemoglobin. Together, these variables explained 35% of the variance in multimorbidity readmissions. These preliminary results are promising in suggesting that MI may be an effective method of decreasing multimorbidity hospital readmissions in HF patients.
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Affiliation(s)
- Barbara Riegel
- University of Pennsylvania School of Nursing, Philadelphia, USA
| | | | - Julia Hill
- University of Pennsylvania School of Nursing, Philadelphia, USA
| | - Jesse Chittams
- University of Pennsylvania School of Nursing, Philadelphia, USA
| | - Linda Hoke
- Hospital of the University of Pennsylvania, Philadelphia, USA
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Gooding AL, Choi J, Fiszdon JM, Wilkins K, Kirwin PD, van Dyck CH, Devanand D, Bell MD, Rivera Mindt M. Comparing three methods of computerised cognitive training for older adults with subclinical cognitive decline. Neuropsychol Rehabil 2015; 26:810-21. [PMID: 26674122 DOI: 10.1080/09602011.2015.1118389] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Cognitive rehabilitation for mild cognitive impairment (MCI) and early Alzheimer's disease is readily available to the geriatric population. Initial evidence suggests that techniques incorporating motivational strategies to enhance treatment engagement may provide more benefit than computerised training alone. Seventy four adults with subclinical cognitive decline were randomly assigned to computerised cognitive training (CCT), Cognitive Vitality Training (CVT), or an Active Control Group (ACG), and underwent neuropsychological evaluations at baseline and four-month follow-up. Significant differences were found in changes in performance on the Modified Mini Mental State Examination (mMMSE) and measures of verbal learning and memory across treatment groups. Experimental groups showed greater preservation of functioning on the mMMSE than the ACG group, the CVT group performed better than the ACG group on one measure of verbal learning and both measures of verbal memory, and the CCT group performed better than the ACG group on one measure of verbal learning and one measure of verbal memory. There were no significant group differences between the CVT and CCT groups on measures of verbal learning or memory. It was concluded that computerised cognitive training may offer the most benefit when incorporated into a therapeutic milieu rather than administered alone, although both appear superior to more generic forms of cognitive stimulation.
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Affiliation(s)
- Amanda L Gooding
- a Department of Neurology , Columbia University Medical Center , New York , NY , USA
| | - Jimmy Choi
- b Olin Neuropsychiatry Research Center , Hartford Hospital/The Institute of Living , Hartford , CT , USA
| | - Joanna M Fiszdon
- c Department of Psychiatry , Yale University School of Medicine , New Haven , CT , USA.,d VA Connecticut Healthcare System , West Haven , CT , USA
| | - Kirsten Wilkins
- c Department of Psychiatry , Yale University School of Medicine , New Haven , CT , USA.,d VA Connecticut Healthcare System , West Haven , CT , USA
| | - Paul D Kirwin
- c Department of Psychiatry , Yale University School of Medicine , New Haven , CT , USA.,d VA Connecticut Healthcare System , West Haven , CT , USA
| | - Christopher H van Dyck
- c Department of Psychiatry , Yale University School of Medicine , New Haven , CT , USA.,e Department of Psychiatry , Yale Alzheimer's Disease Research Unit , New Haven , CT , USA
| | - Davangere Devanand
- f Columbia Psychiatry , New York State Psychiatric Institute at Columbia University Medical Center , New York , NY , USA
| | - Morris D Bell
- c Department of Psychiatry , Yale University School of Medicine , New Haven , CT , USA.,d VA Connecticut Healthcare System , West Haven , CT , USA
| | - Monica Rivera Mindt
- g Department of Psychology , Fordham University , Bronx , NY , USA.,h Departments of Pathology & Psychiatry , Mount Sinai School of Medicine , New York , NY , USA
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Barker-Collo S, Krishnamurthi R, Witt E, Feigin V, Jones A, McPherson K, Starkey N, Parag V, Jiang Y, Barber PA, Rush E, Bennett D, Aroll B. Improving Adherence to Secondary Stroke Prevention Strategies Through Motivational Interviewing: Randomized Controlled Trial. Stroke 2015; 46:3451-8. [PMID: 26508749 DOI: 10.1161/strokeaha.115.011003] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 09/18/2015] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND PURPOSE Stroke recurrence rates are high (20%-25%) and have not declined over past 3 decades. This study tested effectiveness of motivational interviewing (MI) for reducing stroke recurrence, measured by improving adherence to recommended medication and lifestyle changes compared with usual care. METHODS Single-blind, prospective phase III randomized controlled trial of 386 people with stroke assigned to either MI treatment (4 sessions at 28 days, 3, 6, and 9 months post stroke) or usual care; with outcomes assessed at 28 days, 3, 6, 9, and 12 months post stroke. Primary outcomes were change in systolic blood pressure and low-density lipoprotein cholesterol levels as indicators of adherence at 12 months. Secondary outcomes included self-reported adherence, new stroke, or coronary heart disease events (both fatal and nonfatal); quality of life (Short Form-36); and mood (Hospital Anxiety and Depression Scale). RESULTS MI did not significantly change measures of blood pressure (mean difference in change, -0.2.35 [95% confidence interval, -6.16 to 1.47]) or cholesterol (mean difference in change, -0.0.12 [95% confidence interval, -0.30 to 0.06]). However, it had positive effects on self-reported medication adherence at 6 months (1.979; 95% confidence interval, 0.98-3.98; P=0.0557) and 9 months (4.295; 95% confidence interval, 1.56-11.84; P=0.0049) post stroke. Improvement across other measures was also observed, but the differences between MI and usual care groups were not statistically significant. CONCLUSIONS MI improved self-reported medication adherence. All other effects were nonsignificant, though in the direction of a treatment effect. Further study is required to determine whether MI leads to improvement in other important areas of functioning (eg, caregiver burden). CLINICAL TRIAL REGISTRATION URL: http://www.anzctr.org.au. Unique identifier: ACTRN-12610000715077.
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Affiliation(s)
- Suzanne Barker-Collo
- From the School of Psychology (S.B.-C.), National Institute for Health innovation, School of Population Health (V.P., Y.J.), Department of Neurology, Centre for Brain Research (P.A.B.), and General Practice and Primary Healthcare, School of Population Health (B.A.), University of Auckland, Auckland, New Zealand; National Institute for Stroke and Applied Neurosciences (R.K., E.W., V.F., A.J.) and Centre for Physical Activity and Nutrition (E.R.), AUT University, Auckland, New Zealand; Health Research Council New Zealand, Auckland, New Zealand (K.M.); Department of Psychology, Waikato University, Hamilton, New Zealand (N.S.); and Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, United Kingdom (D.B.).
| | - Rita Krishnamurthi
- From the School of Psychology (S.B.-C.), National Institute for Health innovation, School of Population Health (V.P., Y.J.), Department of Neurology, Centre for Brain Research (P.A.B.), and General Practice and Primary Healthcare, School of Population Health (B.A.), University of Auckland, Auckland, New Zealand; National Institute for Stroke and Applied Neurosciences (R.K., E.W., V.F., A.J.) and Centre for Physical Activity and Nutrition (E.R.), AUT University, Auckland, New Zealand; Health Research Council New Zealand, Auckland, New Zealand (K.M.); Department of Psychology, Waikato University, Hamilton, New Zealand (N.S.); and Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, United Kingdom (D.B.)
| | - Emma Witt
- From the School of Psychology (S.B.-C.), National Institute for Health innovation, School of Population Health (V.P., Y.J.), Department of Neurology, Centre for Brain Research (P.A.B.), and General Practice and Primary Healthcare, School of Population Health (B.A.), University of Auckland, Auckland, New Zealand; National Institute for Stroke and Applied Neurosciences (R.K., E.W., V.F., A.J.) and Centre for Physical Activity and Nutrition (E.R.), AUT University, Auckland, New Zealand; Health Research Council New Zealand, Auckland, New Zealand (K.M.); Department of Psychology, Waikato University, Hamilton, New Zealand (N.S.); and Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, United Kingdom (D.B.)
| | - Valery Feigin
- From the School of Psychology (S.B.-C.), National Institute for Health innovation, School of Population Health (V.P., Y.J.), Department of Neurology, Centre for Brain Research (P.A.B.), and General Practice and Primary Healthcare, School of Population Health (B.A.), University of Auckland, Auckland, New Zealand; National Institute for Stroke and Applied Neurosciences (R.K., E.W., V.F., A.J.) and Centre for Physical Activity and Nutrition (E.R.), AUT University, Auckland, New Zealand; Health Research Council New Zealand, Auckland, New Zealand (K.M.); Department of Psychology, Waikato University, Hamilton, New Zealand (N.S.); and Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, United Kingdom (D.B.)
| | - Amy Jones
- From the School of Psychology (S.B.-C.), National Institute for Health innovation, School of Population Health (V.P., Y.J.), Department of Neurology, Centre for Brain Research (P.A.B.), and General Practice and Primary Healthcare, School of Population Health (B.A.), University of Auckland, Auckland, New Zealand; National Institute for Stroke and Applied Neurosciences (R.K., E.W., V.F., A.J.) and Centre for Physical Activity and Nutrition (E.R.), AUT University, Auckland, New Zealand; Health Research Council New Zealand, Auckland, New Zealand (K.M.); Department of Psychology, Waikato University, Hamilton, New Zealand (N.S.); and Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, United Kingdom (D.B.)
| | - Kathryn McPherson
- From the School of Psychology (S.B.-C.), National Institute for Health innovation, School of Population Health (V.P., Y.J.), Department of Neurology, Centre for Brain Research (P.A.B.), and General Practice and Primary Healthcare, School of Population Health (B.A.), University of Auckland, Auckland, New Zealand; National Institute for Stroke and Applied Neurosciences (R.K., E.W., V.F., A.J.) and Centre for Physical Activity and Nutrition (E.R.), AUT University, Auckland, New Zealand; Health Research Council New Zealand, Auckland, New Zealand (K.M.); Department of Psychology, Waikato University, Hamilton, New Zealand (N.S.); and Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, United Kingdom (D.B.)
| | - Nicola Starkey
- From the School of Psychology (S.B.-C.), National Institute for Health innovation, School of Population Health (V.P., Y.J.), Department of Neurology, Centre for Brain Research (P.A.B.), and General Practice and Primary Healthcare, School of Population Health (B.A.), University of Auckland, Auckland, New Zealand; National Institute for Stroke and Applied Neurosciences (R.K., E.W., V.F., A.J.) and Centre for Physical Activity and Nutrition (E.R.), AUT University, Auckland, New Zealand; Health Research Council New Zealand, Auckland, New Zealand (K.M.); Department of Psychology, Waikato University, Hamilton, New Zealand (N.S.); and Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, United Kingdom (D.B.)
| | - Varsha Parag
- From the School of Psychology (S.B.-C.), National Institute for Health innovation, School of Population Health (V.P., Y.J.), Department of Neurology, Centre for Brain Research (P.A.B.), and General Practice and Primary Healthcare, School of Population Health (B.A.), University of Auckland, Auckland, New Zealand; National Institute for Stroke and Applied Neurosciences (R.K., E.W., V.F., A.J.) and Centre for Physical Activity and Nutrition (E.R.), AUT University, Auckland, New Zealand; Health Research Council New Zealand, Auckland, New Zealand (K.M.); Department of Psychology, Waikato University, Hamilton, New Zealand (N.S.); and Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, United Kingdom (D.B.)
| | - Yannan Jiang
- From the School of Psychology (S.B.-C.), National Institute for Health innovation, School of Population Health (V.P., Y.J.), Department of Neurology, Centre for Brain Research (P.A.B.), and General Practice and Primary Healthcare, School of Population Health (B.A.), University of Auckland, Auckland, New Zealand; National Institute for Stroke and Applied Neurosciences (R.K., E.W., V.F., A.J.) and Centre for Physical Activity and Nutrition (E.R.), AUT University, Auckland, New Zealand; Health Research Council New Zealand, Auckland, New Zealand (K.M.); Department of Psychology, Waikato University, Hamilton, New Zealand (N.S.); and Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, United Kingdom (D.B.)
| | - P Alan Barber
- From the School of Psychology (S.B.-C.), National Institute for Health innovation, School of Population Health (V.P., Y.J.), Department of Neurology, Centre for Brain Research (P.A.B.), and General Practice and Primary Healthcare, School of Population Health (B.A.), University of Auckland, Auckland, New Zealand; National Institute for Stroke and Applied Neurosciences (R.K., E.W., V.F., A.J.) and Centre for Physical Activity and Nutrition (E.R.), AUT University, Auckland, New Zealand; Health Research Council New Zealand, Auckland, New Zealand (K.M.); Department of Psychology, Waikato University, Hamilton, New Zealand (N.S.); and Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, United Kingdom (D.B.)
| | - Elaine Rush
- From the School of Psychology (S.B.-C.), National Institute for Health innovation, School of Population Health (V.P., Y.J.), Department of Neurology, Centre for Brain Research (P.A.B.), and General Practice and Primary Healthcare, School of Population Health (B.A.), University of Auckland, Auckland, New Zealand; National Institute for Stroke and Applied Neurosciences (R.K., E.W., V.F., A.J.) and Centre for Physical Activity and Nutrition (E.R.), AUT University, Auckland, New Zealand; Health Research Council New Zealand, Auckland, New Zealand (K.M.); Department of Psychology, Waikato University, Hamilton, New Zealand (N.S.); and Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, United Kingdom (D.B.)
| | - Derrick Bennett
- From the School of Psychology (S.B.-C.), National Institute for Health innovation, School of Population Health (V.P., Y.J.), Department of Neurology, Centre for Brain Research (P.A.B.), and General Practice and Primary Healthcare, School of Population Health (B.A.), University of Auckland, Auckland, New Zealand; National Institute for Stroke and Applied Neurosciences (R.K., E.W., V.F., A.J.) and Centre for Physical Activity and Nutrition (E.R.), AUT University, Auckland, New Zealand; Health Research Council New Zealand, Auckland, New Zealand (K.M.); Department of Psychology, Waikato University, Hamilton, New Zealand (N.S.); and Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, United Kingdom (D.B.)
| | - Bruce Aroll
- From the School of Psychology (S.B.-C.), National Institute for Health innovation, School of Population Health (V.P., Y.J.), Department of Neurology, Centre for Brain Research (P.A.B.), and General Practice and Primary Healthcare, School of Population Health (B.A.), University of Auckland, Auckland, New Zealand; National Institute for Stroke and Applied Neurosciences (R.K., E.W., V.F., A.J.) and Centre for Physical Activity and Nutrition (E.R.), AUT University, Auckland, New Zealand; Health Research Council New Zealand, Auckland, New Zealand (K.M.); Department of Psychology, Waikato University, Hamilton, New Zealand (N.S.); and Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, United Kingdom (D.B.)
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Navidian A, Rostami Z, Rozbehani N. Effect of motivational group interviewing-based safety education on Workers' safety behaviors in glass manufacturing. BMC Public Health 2015; 15:929. [PMID: 26386556 PMCID: PMC4575785 DOI: 10.1186/s12889-015-2246-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 09/07/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Worker safety education using models that identify and reinforce factors affecting behavior is essential. The present study aimed to determine the effect of safety education based on motivational interviewing on awareness of, attitudes toward, and engagement in worker safety in the glass production industry in Hamedan, Iran, in 2014. METHODS This was a quasi-experimental interventional study including a total of 70 production line workers at glass production facilities in Hamedan. The workers were randomly assigned to either an intervention or a control group, with 35 workers in each group. Participants in the control group received four one-hour safety education sessions, in the form of traditional lectures. Those in the intervention group received four educational sessions based on motivational group interviewing, which were conducted in four groups of eight to ten participants each. The instruments used included a researcher-developed questionnaire with checklists addressing safety awareness, and attitude and performance, which were completed before and 12 weeks after the intervention. The data were analyzed using descriptive statistics, independent and paired t-tests, and chi-squared tests. RESULTS Having obtained the differences in scores before and after the intervention, we determined mean changes in the scores of awareness, attitude, and use of personal protective equipment among workers who underwent motivational group interviewing (3.74 ± 2.16, 1.71 ± 3.16, and 3.2 ± 1.92, respectively, p < 0.05). These scores were significantly greater than those of control workers who underwent traditional educational sessions (1.28 ± 1.93, 1.1 ± 3.07, and 0.2 ± 1.26, respectively). CONCLUSIONS Our findings revealed that incorporation of motivational interviewing principles into safety education programs had the positive effect of enhancing workers' knowledge, attitude, and, particularly, implementation of safe behaviors. The application of this advisory approach is recommended to increase workplace safety and minimize occupational hazards in the work environment.
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Affiliation(s)
- Ali Navidian
- Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
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Zhang KM, Dindoff K, Arnold JMO, Lane J, Swartzman LC. What matters to patients with heart failure? The influence of non-health-related goals on patient adherence to self-care management. PATIENT EDUCATION AND COUNSELING 2015; 98:927-934. [PMID: 25979423 DOI: 10.1016/j.pec.2015.04.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 04/02/2015] [Accepted: 04/19/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To describe the life goals of heart failure (HF) patients and to determine whether adherence is influenced by the extent to which these priorities are perceived as compatible with HF self-care regimens. METHOD Forty HF outpatients identified their top-five life goals and indicated the compatibility of HF self-care regimens (diet, exercise, weighing) with these priorities. HF knowledge, self-efficacy and reported adherence were also assessed. RESULTS Patients valued autonomy and social relationships as much as physical health. However, the rated importance of these domains did not predict adherence. Adherence positively correlated with the extent to which the regimen, specifically exercise, was considered compatible with life goals (r=.34, p<.05). Exercise adherence also correlated with illness severity and self-efficacy (rs=-.42 and .36, p<.05, respectively). The perceived compatibility of physical activity with personal goals predicted 11% of the variance in exercise adherence above and beyond that accounted for by illness severity and self-efficacy (FΔ (1, 36)=7.11, p<.05). CONCLUSIONS Patients' goals outside of the illness management context influence self-care practices. PRACTICE IMPLICATIONS Exploring patients' broad life goals may increase opportunities to resolve ambivalence and enhance motivation for self-care adherence.
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Affiliation(s)
- Karen M Zhang
- Department of Psychology, University of Western Ontario, London, ON, Canada.
| | - Kathleen Dindoff
- School of Language & Liberal Studies, Fanshawe College, London, ON, Canada
| | - J Malcolm O Arnold
- Division of Cardiology, London Health Sciences Centre, London, ON, Canada
| | - Jeanine Lane
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - Leora C Swartzman
- Department of Psychology, University of Western Ontario, London, ON, Canada
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Sturt J, Dennick K, Hessler D, Hunter BM, Oliver J, Fisher L. Effective interventions for reducing diabetes distress: systematic review and meta-analysis. ACTA ACUST UNITED AC 2015. [DOI: 10.1179/2057332415y.0000000004] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Training Healthcare Providers in Motivational Communication for Promoting Physical Activity and Exercise in Cardiometabolic Health Settings: Do We Know What We Are Doing? CURRENT CARDIOVASCULAR RISK REPORTS 2015. [DOI: 10.1007/s12170-015-0457-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Pietrabissa G, Ceccarini M, Borrello M, Manzoni GM, Titon A, Nibbio F, Montano M, Bertone G, Gondoni L, Castelnuovo G. Enhancing behavioral change with motivational interviewing: a case study in a Cardiac Rehabilitation Unit. Front Psychol 2015; 6:298. [PMID: 25852614 PMCID: PMC4364083 DOI: 10.3389/fpsyg.2015.00298] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 03/02/2015] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Psychological interventions in cardiac rehabilitation programs appear relevant in as much they significantly contribute to achieve the goals of rehabilitation, to reduce the risk of relapses and to improve patients' adherence to therapy. To this aim, motivational interviewing (MI) has shown promising results in improving motivation to change and individuals' confidence in their ability to do so. OBJECTIVE The purpose of this article is to integrate theory with practice by describing a three-session case scenario. It illustrates how MI's skills and strategies can be used to enhance heart-healthy habits. MI may be synergistic with other treatment approaches and it is used here in conjunction with brief strategic therapy. CONCLUSION By the use of MI principles and techniques, the patient reported an increase in his motivation and ability to change, developing a post discharge plan that incorporates self-care behaviors. CLINICAL IMPLICATIONS MI may be effective in motivating and facilitating health behavior change among obese patients suffering from heart failure.
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Affiliation(s)
- Giada Pietrabissa
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Saint Joseph Hospital, VerbaniaItaly
- Department of Psychology, Catholic University of Milan, MilanItaly
| | - Martina Ceccarini
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Saint Joseph Hospital, VerbaniaItaly
- Faculty of Psychology, University of Bergamo, BergamoItaly
| | - Maria Borrello
- Faculty of Psychology, University of Bergamo, BergamoItaly
| | - Gian Mauro Manzoni
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Saint Joseph Hospital, VerbaniaItaly
- Department of Psychology, Catholic University of Milan, MilanItaly
| | - Annamaria Titon
- Cardiac Rehabilitation Unit, Istituto Auxologico Italiano IRCCS, Saint Joseph Hospital, VerbaniaItaly
| | - Ferruccio Nibbio
- Cardiac Rehabilitation Unit, Istituto Auxologico Italiano IRCCS, Saint Joseph Hospital, VerbaniaItaly
| | - Mariella Montano
- Cardiac Rehabilitation Unit, Istituto Auxologico Italiano IRCCS, Saint Joseph Hospital, VerbaniaItaly
| | - Gianandrea Bertone
- Cardiac Rehabilitation Unit, Istituto Auxologico Italiano IRCCS, Saint Joseph Hospital, VerbaniaItaly
| | - Luca Gondoni
- Cardiac Rehabilitation Unit, Istituto Auxologico Italiano IRCCS, Saint Joseph Hospital, VerbaniaItaly
| | - Gianluca Castelnuovo
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Saint Joseph Hospital, VerbaniaItaly
- Department of Psychology, Catholic University of Milan, MilanItaly
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American Association of Heart Failure Nurses Position Paper on Educating Patients with Heart Failure. Heart Lung 2015; 44:173-7. [DOI: 10.1016/j.hrtlng.2015.01.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Wang D, Li XY, Zhang LN, Zhou L, Zhang KJ. WITHDRAWN: Effects of motivational interviewing on lifestyle modification and diabetes prevention in adults with pre-diabetes. Diabetes Res Clin Pract 2015:S0168-8227(15)00082-0. [PMID: 25748829 DOI: 10.1016/j.diabres.2015.01.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 11/12/2014] [Accepted: 01/29/2015] [Indexed: 11/25/2022]
Abstract
This article has been withdrawn at the request of the editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.
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Affiliation(s)
- Dan Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xiu-Yun Li
- West Mofan Road Community Health Service Center, Nanjing, China
| | - Li-Na Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Ling Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China.
| | - Kai-Jin Zhang
- School of Public Health, Southeast University, Nanjing, China.
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Masterson Creber R, Patey M, Dickson VV, DeCesaris M, Riegel B. Motivational Interviewing Tailored Interventions for Heart Failure (MITI-HF): study design and methods. Contemp Clin Trials 2015; 41:62-8. [PMID: 25559913 DOI: 10.1016/j.cct.2014.12.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 12/22/2014] [Accepted: 12/24/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Lack of engagement in self-care is common among patients needing to follow a complex treatment regimen, especially patients with heart failure who are affected by comorbidity, disability and side effects of poly-pharmacy. The purpose of Motivational Interviewing Tailored Interventions for Heart Failure (MITI-HF) is to test the feasibility and comparative efficacy of an MI intervention on self-care, acute heart failure physical symptoms and quality of life. METHODS We are conducting a brief, nurse-led motivational interviewing randomized controlled trial to address behavioral and motivational issues related to heart failure self-care. Participants in the intervention group receive home and phone-based motivational interviewing sessions over 90-days and those in the control group receive care as usual. Participants in both groups receive patient education materials. The primary study outcome is change in self-care maintenance from baseline to 90-days. CONCLUSION This article presents the study design, methods, plans for statistical analysis and descriptive characteristics of the study sample for MITI-HF. Study findings will contribute to the literature on the efficacy of motivational interviewing to promote heart failure self-care. PRACTICAL IMPLICATIONS We anticipate that using an MI approach can help patients with heart failure focus on their internal motivation to change in a non-confrontational, patient-centered and collaborative way. It also affirms their ability to practice competent self-care relevant to their personal health goals.
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Affiliation(s)
| | - Megan Patey
- University of Pennsylvania, School of Nursing, United States
| | | | | | - Barbara Riegel
- University of Pennsylvania, School of Nursing, United States
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