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Enlund KB, Jönsson B, Abrahamsson KH, Pettersson A. Long-term effects of motivational interviewing vs. traditional counseling on dog owners' adherence to veterinary dental home care: a three-year follow-up study. Front Vet Sci 2024; 11:1296618. [PMID: 38596465 PMCID: PMC11002956 DOI: 10.3389/fvets.2024.1296618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 02/16/2024] [Indexed: 04/11/2024] Open
Abstract
Introduction Periodontal disease is one of the most common health issues in dogs. However, disease is largely preventable by eliminating dental plaque, best achieved by daily tooth brushing. Unfortunately, owner adherence is low to the recommendation of daily tooth brushing in dogs. Objective This study aimed to evaluate the impact of various communication strategies, traditional advice (TA) versus motivational interviewing (MI), and compare them to a control group receiving no additional communication (CG), on dog owners' performance of dental home care and the oral health of their dogs. Methods The study was conducted as a longitudinal clinical intervention study spanning 3 years, and involved 75 dog owners with young dogs who were randomly assigned to one of three groups: TA, MI, or CG. Intervention groups received annual telephone consultations based on their assigned methodology. A questionnaire was administered twice to all groups, and the dental health of the dogs was assessed at the study's conclusion. Result Tooth brushing frequency demonstrated a significant increase in the MI group compared to the CG group (p < 0.01), albeit with a relatively low occurrence of daily brushing among owners. Dental health assessment revealed a significantly lower plaque index in the MI group compared to the CG group (p < 0.05), and a lower calculus index in the TA group compared to the CG group (p < 0.01). No statistically significant differences were observed between the MI and TA groups in terms of dental health. Conclusion Regular veterinary communication appears to have a positive influence on dog owner adherence to veterinary recommendations concerning dental care in dogs. Communication with veterinarians (MI and traditional advice) improved owner knowledge, attitude, and decreased frequency of not brushing. Although dental health parameters improved, the effect size was small, suggesting the complexity of adherence. Personalized calls to dog owners offer potential for dental health improvement, warranting further comparison of MI with traditional advice.
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Affiliation(s)
- Karolina Brunius Enlund
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Birgitta Jönsson
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- The Public Dental Health Service Competence Centre of Northern Norway, Tromsø, Norway
| | - Kajsa H. Abrahamsson
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ann Pettersson
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
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2
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Morris ME, Thwaites C, Lui R, McPhail SM, Haines T, Kiegaldie D, Heng H, Shaw L, Hammond S, McKercher JP, Knight M, Carey LM, Gray R, Shorr R, Hill AM. Preventing hospital falls: feasibility of care workforce redesign to optimise patient falls education. Age Ageing 2024; 53:afad250. [PMID: 38275097 PMCID: PMC10811524 DOI: 10.1093/ageing/afad250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Indexed: 01/27/2024] Open
Abstract
OBJECTIVE To examine the feasibility of using allied health assistants to deliver patient falls prevention education within 48 h after hospital admission. DESIGN AND SETTING Feasibility study with hospital patients randomly allocated to usual care or usual care plus additional patient falls prevention education delivered by supervised allied health assistants using an evidence-based scripted conversation and educational pamphlet. PARTICIPANTS (i) allied health assistants and (ii) patients admitted to participating hospital wards over a 20-week period. OUTCOMES (i) feasibility of allied health assistant delivery of patient education; (ii) hospital falls per 1,000 bed days; (iii) injurious falls; (iv) number of falls requiring transfer to an acute medical facility. RESULTS 541 patients participated (median age 81 years); 270 control group and 271 experimental group. Allied health assistants (n = 12) delivered scripted education sessions to 254 patients in the experimental group, 97% within 24 h after admission. There were 32 falls in the control group and 22 in the experimental group. The falls rate was 8.07 falls per 1,000 bed days in the control group and 5.69 falls per 1,000 bed days for the experimental group (incidence rate ratio = 0.66 (95% CI 0.32, 1.36; P = 0.26)). There were 2.02 injurious falls per 1,000 bed days for the control group and 1.03 for the experimental group. Nine falls (7 control, 2 experimental) required transfer to an acute facility. No adverse events were attributable to the experimental group intervention. CONCLUSIONS It is feasible and of benefit to supplement usual care with patient education delivered by allied health assistants.
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Affiliation(s)
- Meg E Morris
- Academic and Research Collaborative in Health (ARCH), and Care Economy Research Institute (CERI), La Trobe University, Melbourne, VIC, Australia
- Victorian Rehabilitation Centre, Healthscope, Glen Waverley, Melbourne, VIC, Australia
| | - Claire Thwaites
- Academic and Research Collaborative in Health (ARCH), and Care Economy Research Institute (CERI), La Trobe University, Melbourne, VIC, Australia
- Victorian Rehabilitation Centre, Healthscope, Glen Waverley, Melbourne, VIC, Australia
| | - Rosalie Lui
- Victorian Rehabilitation Centre, Healthscope, Glen Waverley, Melbourne, VIC, Australia
| | - Steven M McPhail
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
- Digital Health and Informatics Directorate, Metro South Health, Brisbane, QLD, Australia
| | - Terry Haines
- School of Primary and Allied Health Care, Monash University, Melbourne, VIC, Australia
| | - Debra Kiegaldie
- Faculty of Health Sciences & Community Studies, Holmesglen Institute, Melbourne, VIC, Australia
- Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
| | - Hazel Heng
- Northern Health Academic and Research Collaborative in Health (ARCH), La Trobe University, Melbourne, VIC, Australia
- Northern Health, Epping, VIC, Australia
| | - Louise Shaw
- Academic and Research Collaborative in Health (ARCH), and Care Economy Research Institute (CERI), La Trobe University, Melbourne, VIC, Australia
- Centre for Digital Transformation of Health, University of Melbourne, Melbourne, VIC, Australia
| | - Susan Hammond
- Victorian Rehabilitation Centre, Healthscope, Glen Waverley, Melbourne, VIC, Australia
| | - Jonathan P McKercher
- Academic and Research Collaborative in Health (ARCH), and Care Economy Research Institute (CERI), La Trobe University, Melbourne, VIC, Australia
| | - Matthew Knight
- Victorian Rehabilitation Centre, Healthscope, Glen Waverley, Melbourne, VIC, Australia
| | - Leeanne M Carey
- Occupational Therapy, Department of Community and Clinical Health, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Melbourne, VIC, Australia
| | - Richard Gray
- School of Nursing and Midwifery, La Trobe University, Melbourne, VIC, Australia
| | - Ron Shorr
- Department of Epidemiology, University of Florida, Gainesville, FL, USA
| | - Anne-Marie Hill
- School of Allied Health, Western Australian Centre for Health & Ageing, The University of Western Australia, Perth, WA, Australia
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3
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Lutaud R, Mitilian E, Forte J, Gentile G, Reynaud R, Truffet C, Bellanger T. Motivational interviewing for the management of child and adolescent obesity: a systematic literature review. BJGP Open 2023; 7:BJGPO.2022.0145. [PMID: 37402547 PMCID: PMC11176675 DOI: 10.3399/bjgpo.2022.0145] [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: 10/03/2022] [Revised: 03/17/2023] [Accepted: 05/02/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Among children or adolescents with obesity, 40-70.5% will remain obese as adults according to their paediatric body mass index (BMI). The recommended management involves changes in their nutritional habits (diet, physical activity, and sedentary lifestyle). Motivational interviewing (MI), a patient-centred consultation, has proven its worth in many fields where acting on behaviours is essential. AIM To investigate the use and outcomes of MI in the management of children and adolescents who are overweight and obese. DESIGN & SETTING A systematic review evaluated MI in the management of children and adolescents who are overweight and obese. METHOD PubMed, Web of Science, Cochrane Library, and CISMeF were searched between January 2022 and March 2022 for following terms: 'motivational interviewing', 'overweight or obesity', 'children or adolescent' to identify randomised controlled trials (RCTs). Inclusion criteria were interventions involving MI in children or adolescents who were commonly (polygenically) overweight or obese. Exclusion criteria were: studies before 1991; and articles not written in English or French. The first stage of the selection process was carried out by reading the titles and abstracts. A second stage was carried out by reading the complete studies. A secondary inclusion of articles was carried out following the reading of bibliographic references, mainly from systematic reviews and meta-analyses. The data were summarised in synthetic tables based on the Population, Intervention, Comparison, Outcomes, and Study (PICOS) tool. RESULTS From 444 articles the review identified 26 RCTs. Statistically significant results were found for all criteria (anthropometric and behavourial) in both children and adolescents. Quality of life and depression scores were also improved. Parental presence in the interview appeared to be essential for children, whereas for adolescents, the supportive involvement of parents outside of the interviews seemed more appropriate. The frequency and duration of the interventions played a major role in obtaining results, as did the number of people involved, and the diversity of the places where they are taken care of. CONCLUSION MI seems promising for children and adolescents with overweight or obesity, within the framework of a comprehensive, multiprofessional, family management, carried out over a long period with regular consultations.
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Affiliation(s)
- Romain Lutaud
- Département Universitaire de Médecine Générale, Faculté des Sciences Médicales et Paramédicales, Aix-Marseille Université, France
- CNRS, EFS, ADES, Aix-Marseille Université, Marseille, France
| | - Eva Mitilian
- Département Universitaire de Médecine Générale, Faculté des Sciences Médicales et Paramédicales, Aix-Marseille Université, France
| | - Jenny Forte
- Département Universitaire de Médecine Générale, Faculté des Sciences Médicales et Paramédicales, Aix-Marseille Université, France
| | - Gaetan Gentile
- Département Universitaire de Médecine Générale, Faculté des Sciences Médicales et Paramédicales, Aix-Marseille Université, France
- Aix Marseille Université, Institut des Neurosciences des Systèmes, INSERM, France
| | - Rachel Reynaud
- Aix Marseille Université, Faculté des Sciences Médicales et Paramédicales, Service de Pediatrie Multidisciplinaire CHU Timone Enfants, APHM, France
| | - Camille Truffet
- Département Universitaire de Médecine Générale, Faculté des Sciences Médicales et Paramédicales, Aix-Marseille Université, France
| | - Thibault Bellanger
- Département Universitaire de Médecine Générale, Faculté des Sciences Médicales et Paramédicales, Aix-Marseille Université, France
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Miranda Quezada IP, Pérez-Salgado D, Dorantes Pineda CM, Ortiz-Hernández L. [Evaluation of a program led by community workers to promote cardiometabolic health in adults in a highly marginalized Mexican municipality]. NUTR HOSP 2023. [PMID: 37154072 DOI: 10.20960/nh.04289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
OBJECTIVE to evaluate the impact of a group program of nutrition education implemented by community workers on food consumption, physical activity and cardiometabolic risk. MATERIAL AND METHODS a randomized trial by conglomerates was performed. The intervention group (n = 246) participated in a program of nine group sessions of nutrition education delivered by community workers and focused on giving healthy habits options and evocation of motivations. The control group (n = 183) received printed information on healthy eating and physical activity. At the beginning of the study and after one year of follow-up, anthropometric measurements of blood pressure, heart rate, lipid profile and glucose were assessed. A questionnaire was applied to collect sociodemographic data, food consumption and physical activity. RESULTS in multilevel regression models it was observed that the intervention group reported an increase in the frequency of consumption of fruits, vegetables and legumes, increased body mass index and its probability of increasing recreational physical activity was higher; in addition, it reduced its consumption of sweetened cereals, and decreased the probability of hyperglycemia compared to the control group. Resting heart rate increased in both groups, but the increase was lower in the intervention group. CONCLUSIONS nutrition education guided by community workers can have positive effects on cardiometabolic risk, so it would be an alternative to traditional education focused on providing information.
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Jongebloed-Westra M, Bode C, Bente BE, de Jonge JM, ten Klooster PM, Koffijberg H, Exterkate SH, van Netten JJ, van Gemert-Pijnen JEWC. Attitudes and experiences towards the application of motivational interviewing by podiatrists working with people with diabetes at high-risk of developing foot ulcers: a mixed-methods study. J Foot Ankle Res 2022; 15:62. [PMID: 35986419 PMCID: PMC9388362 DOI: 10.1186/s13047-022-00567-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 08/08/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Podiatrists are key professionals in promoting adequate foot self-care for people with diabetes at high-risk of developing foot ulcers. However, merely informing patients about the advantages of foot self-care is insufficient to realise behavioural change. Motivational interviewing (MI) is a promising person-centred communication style that could help to create a working alliance between healthcare providers and patient to improve foot self-care. This study aims to observe and analyse the application of MI in consultations carried out by MI-trained and non-MI-trained podiatrists with their patients, and explore podiatrists’ attitudes and experiences towards MI.
Methods
Eighteen podiatrists (median age: 28.5 years, 10 female and 8 male) followed a three-day basic training in MI and 4 podiatrists (median age: 38.5 years, 4 female) were not trained in MI. To observe and rate the MI-fidelity in daily clinical practice, audio recordings from the MI-trained and non-MI-trained podiatrists were scored with the Motivational Interviewing Treatment Integrity code. Individual, semi-structed, in-depth interviews were conducted with the MI-trained podiatrists to explore their attitudes towards and experiences with MI. These data sources were triangulated to describe the effect of training podiatrists in MI for their clinical practice.
Results
The MI-trained podiatrists scored significantly higher than the non-MI-trained podiatrists on two of four global MI-related communication skills (empathy, p = 0.008 and change talk, p = 0.008), on one of five core MI-adherent behaviours (affirmation, p = 0.041) and on one of the other behaviour counts (simple reflections, p = 0.008). The podiatrists mainly reported their attitudes and experiences regarding partnership and cultivating change talk, during the interviews. In addition, they also mentioned facilitators and barriers to using MI and indicated whether they experienced MI as having added value.
Conclusions
The MI-trained podiatrists used the principles of MI at a solid beginner proficiency level in their clinical practice in comparison to the non-MI-trained podiatrists, who did not reach this level. This achievement is in accordance with the basic MI-training they received. This multi-method study reveals that podiatrists can be effectively trained in applying MI in daily clinical practice.
Trial registration
Netherlands Trial Register NL7710. Registered: 6 May 2019.
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Jafar TH, Tan NC, Shirore RM, Allen JC, Finkelstein EA, Hwang SW, Koong AYL, Moey PKS, Kang GCY, Goh CWT, Subramanian RC, Thiagarajah AG, Ramakrishnan C, Lim CW, Liu J. Integration of a multicomponent intervention for hypertension into primary healthcare services in Singapore-A cluster randomized controlled trial. PLoS Med 2022; 19:e1004026. [PMID: 35696440 PMCID: PMC9239484 DOI: 10.1371/journal.pmed.1004026] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 06/28/2022] [Accepted: 05/20/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Despite availability of clinical practice guidelines for hypertension management, blood pressure (BP) control remains sub-optimal (<30%) even in high-income countries. This study aims to assess the effectiveness of a potentially scalable multicomponent intervention integrated into primary care system compared to usual care on BP control. METHODS AND FINDINGS A cluster-randomized controlled trial was conducted in 8 government clinics in Singapore. The trial enrolled 916 patients aged ≥40 years with uncontrolled hypertension (systolic BP (SBP) ≥140 mmHg or diastolic BP (DBP) ≥90 mmHg). Multicomponent intervention consisted of physician training in risk-based treatment of hypertension, subsidized losartan-HCTZ single-pill combination (SPC) medications, nurse training in motivational conversations (MCs), and telephone follow-ups. Usual care (controls) comprised of routine care in the clinics, no MC or telephone follow-ups, and no subsidy on SPCs. The primary outcome was mean SBP at 24 months' post-baseline. Four clinics (447 patients) were randomized to intervention and 4 (469) to usual care. Patient enrolment commenced in January 2017, and follow-up was during December 2018 to September 2020. Analysis used intention-to-treat principles. The primary outcome was SBP at 24 months. BP at baseline, 12 and 24 months was modeled at the patient level in a likelihood-based, linear mixed model repeated measures analysis with treatment group, follow-up, treatment group × follow-up interaction as fixed effects, and random cluster (clinic) effects. A total of 766 (83.6%) patients completed 2-year follow-up. A total of 63 (14.1%) and 87 (18.6%) patients in intervention and in usual care, respectively, were lost to follow-up. At 24 months, the adjusted mean SBP was significantly lower in the intervention group compared to usual care (-3.3 mmHg; 95% CI: -6.34, -0.32; p = 0.03). The intervention led to higher BP control (odds ratio 1.51; 95% CI: 1.10, 2.09; p = 0.01), lower odds of high (>20%) 10-year cardiovascular risk score (OR 0.67; 95% CI: 0.47, 0.97; p = 0.03), and lower mean log albuminuria (-0.22; 95% CI: -0.41, -0.02; p = 0.03). Mean DBP, mortality rates, and serious adverse events including hospitalizations were not different between groups. The main limitation was no masking in the trial. CONCLUSIONS A multicomponent intervention consisting of physicians trained in risk-based treatment, subsidized SPC medications, nurse-delivered motivational conversation, and telephone follow-ups improved BP control and lowered cardiovascular risk. Wide-scale implementation of a multicomponent intervention such as the one in our trial is likely to reduce hypertension-related morbidity and mortality globally. TRIAL REGISTRATION Trial Registration: Clinicaltrials.gov NCT02972619.
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Affiliation(s)
- Tazeen Hasan Jafar
- Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore
- Department of Renal Medicine, Singapore General Hospital, Singapore
- Duke Global Health Institute, Durham, North Carolina, United States of America
- * E-mail:
| | | | | | - John Carson Allen
- Center for Quantitative Medicine, Office of Research, Duke-NUS Medical School, Singapore
| | | | | | | | | | | | | | | | | | | | - Ching Wee Lim
- Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore
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Cordingley L, Nelson PA, Davies L, Ashcroft D, Bundy C, Chew-Graham C, Chisholm A, Elvidge J, Hamilton M, Hilton R, Kane K, Keyworth C, Littlewood A, Lovell K, Lunt M, McAteer H, Ntais D, Parisi R, Pearce C, Rutter M, Symmons D, Young H, Griffiths CEM. Identifying and managing psoriasis-associated comorbidities: the IMPACT research programme. PROGRAMME GRANTS FOR APPLIED RESEARCH 2022. [DOI: 10.3310/lvuq5853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background
Psoriasis is a common, lifelong inflammatory skin disease, the severity of which can range from limited disease involving a small body surface area to extensive skin involvement. It is associated with high levels of physical and psychosocial disability and a range of comorbidities, including cardiovascular disease, and it is currently incurable.
Objectives
To (1) confirm which patients with psoriasis are at highest risk of developing additional long-term conditions and identify service use and costs to patient, (2) apply knowledge about risk of comorbid disease to the development of targeted screening services to reduce risk of further disease, (3) learn how patients with psoriasis cope with their condition and about their views of service provision, (4) identify the barriers to provision of best care for patients with psoriasis and (5) develop patient self-management resources and staff training packages to improve the lives of people with psoriasis.
Design
Mixed methods including two systematic reviews, one population cohort study, one primary care screening study, one discrete choice study, four qualitative studies and three mixed-methodology studies.
Setting
Primary care, secondary care and online surveys.
Participants
People with psoriasis and health-care professionals who manage patients with psoriasis.
Results
Prevalence rates for psoriasis vary by geographical location. Incidence in the UK was estimated to be between 1.30% and 2.60%. Knowledge about the cost-effectiveness of therapies is limited because high-quality clinical comparisons of interventions have not been done or involve short-term follow-up. After adjusting for known cardiovascular risk factors, psoriasis (including severe forms) was not found to be an independent risk factor for major cardiovascular events; however, co-occurrence of inflammatory arthritis was a risk factor. Traditional risk factors were high in patients with psoriasis. Large numbers of patients with suboptimal management of known risk factors were found by screening patients in primary care. Risk information was seldom discussed with patients as part of screening consultations, meaning that a traditional screening approach may not be effective in reducing comorbidities associated with psoriasis. Gaps in training of health-care practitioners to manage psoriasis effectively were identified, including knowledge about risk factors for comorbidities and methods of facilitating behavioural change. Theory-based, high-design-quality patient materials broadened patient understanding of psoriasis and self-management. A 1-day training course based on motivational interviewing principles was effective in increasing practitioner knowledge and changing consultation styles. The primary economic analysis indicated a high level of uncertainty. Sensitivity analysis indicated some situations when the interventions may be cost-effective. The interventions need to be assessed for long-term (cost-)effectiveness.
Limitations
The duration of patient follow-up in the study of cardiovascular disease was relatively short; as a result, future studies with longer follow-up are recommended.
Conclusions
Recognition of the nature of the psoriasis and its impact, knowledge of best practice and guideline use are all limited in those most likely to provide care for the majority of patients. Patients and practitioners are likely to benefit from the provision of appropriate support and/or training that broadens understanding of psoriasis as a complex condition and incorporates support for appropriate health behaviour change. Both interventions were feasible and acceptable to patients and practitioners. Cost-effectiveness remains to be explored.
Future work
Patient support materials have been created for patients and NHS providers. A 1-day training programme with training materials for dermatologists, specialist nurses and primary care practitioners has been designed. Spin-off research projects include a national study of responses to psoriasis therapy and a global study of the prevalence and incidence of psoriasis. A new clinical service is being developed locally based on the key findings of the Identification and Management of Psoriasis Associated ComorbidiTy (IMPACT) programme.
Funding
This project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full in Programme Grants for Applied Research; Vol. 10, No. 3. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Lis Cordingley
- Division of Musculoskeletal and Dermatological Sciences, University of Manchester, Manchester, UK
| | - Pauline A Nelson
- Dermatology Research Centre, University of Manchester, Manchester, UK
| | - Linda Davies
- Centre for Health Economics, University of Manchester, Manchester, UK
| | - Darren Ashcroft
- Centre for Pharmacoepidemiology and Drug Safety, University of Manchester, Manchester, UK
| | - Christine Bundy
- Dermatology Research Centre, University of Manchester, Manchester, UK
| | | | - Anna Chisholm
- Dermatology Research Centre, University of Manchester, Manchester, UK
| | - Jamie Elvidge
- Centre for Health Economics, University of Manchester, Manchester, UK
| | - Matthew Hamilton
- Centre for Health Economics, University of Manchester, Manchester, UK
| | - Rachel Hilton
- Bridgewater Community Healthcare NHS Foundation Trust, Wigan, UK
| | - Karen Kane
- Dermatology Research Centre, University of Manchester, Manchester, UK
| | | | - Alison Littlewood
- Dermatology Research Centre, University of Manchester, Manchester, UK
| | - Karina Lovell
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
| | - Mark Lunt
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, University of Manchester, Manchester, UK
| | | | - Dionysios Ntais
- Centre for Health Economics, University of Manchester, Manchester, UK
| | - Rosa Parisi
- Centre for Pharmacoepidemiology and Drug Safety, University of Manchester, Manchester, UK
| | - Christina Pearce
- Dermatology Research Centre, University of Manchester, Manchester, UK
| | - Martin Rutter
- Manchester Diabetes Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Deborah Symmons
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, University of Manchester, Manchester, UK
| | - Helen Young
- Dermatology Research Centre, University of Manchester, Manchester, UK
- Salford Royal NHS Foundation Trust, Salford, UK
| | - Christopher EM Griffiths
- Dermatology Research Centre, University of Manchester, Manchester, UK
- Salford Royal NHS Foundation Trust, Salford, UK
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Kirschner V, Lamp N, Dinc Ü, Becker T, Kilian R, Mueller-Stierlin AS. The evaluation of a physical health promotion intervention for people with severe mental illness receiving community based accommodational support: a mixed-method pilot study. BMC Psychiatry 2022; 22:6. [PMID: 34983452 PMCID: PMC8728992 DOI: 10.1186/s12888-021-03640-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 12/03/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Unhealthy lifestyle constitutes a cause of increased morbidity and mortality in people with severe mental illness. The aim of this mixed-method pilot study was to investigate the feasibility and preliminary effectiveness of an intervention to promote a health-conscious lifestyle in comparison to care as usual among people with severe mental illness receiving accommodational support in community settings. METHODS This was a prospective, quasi-experimental, controlled study over four six-month assessment points (t0, + 6 months, + 12 months, + 18 months) with 70 persons with severe mental illness receiving community based accommodational support. Mental health staff members of the housing facilities were trained in Motivational Interviewing and conducted a six-week health course with the intervention group participants in addition to care as usual. Next to the primary outcome - self-rated physical well-being (FEW 16) - anthropometric parameters and unhealthy behaviours (diet, physical activity, alcohol and tobacco consumption, and oral hygiene) were examined. Effectiveness analysis was conducted using mixed-effects regression models with propensity score adjustment to control for selection bias. One year after the end of the intervention, semi-standardized expert interviews were conducted with 12 of these employees and evaluated by content analysis. RESULTS The qualitative interviews with mental health staff underline the intervention's feasibility in people with severe mental illness in sheltered housing, and the acceptability of and satisfaction with the intervention among mental health workers. But in this pilot study no superiority of the HELPS intervention compared to routine care could be demonstrated in terms of the investigated outcomes. CONCLUSIONS The findings of this pilot study underscore the feasibility and acceptability of health promotion programmes based on Motivational Interviewing and highlight the need to further develop multi-modal programs according to the needs of the target group. Long-term and sustainable support for healthy lifestyles of people with severe mental illness receiving community mental health care requires multi-modal concepts and organisational change. TRIAL REGISTRATION DRKS00011659 , date of registration was 2017/02/15; retrospectively registered as date of first enrolment was 2017/01/24.
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Affiliation(s)
- Viola Kirschner
- grid.6582.90000 0004 1936 9748Department of Psychiatry II, University of Ulm, Lindenallee 2, 89312 Günzburg, Germany
| | - Natalie Lamp
- grid.6582.90000 0004 1936 9748Department of Psychiatry II, University of Ulm, Lindenallee 2, 89312 Günzburg, Germany
| | - Ümmügülsüm Dinc
- grid.6582.90000 0004 1936 9748Department of Psychiatry II, University of Ulm, Lindenallee 2, 89312 Günzburg, Germany
| | - Thomas Becker
- grid.6582.90000 0004 1936 9748Department of Psychiatry II, University of Ulm, Lindenallee 2, 89312 Günzburg, Germany
| | - Reinhold Kilian
- grid.6582.90000 0004 1936 9748Department of Psychiatry II, University of Ulm, Lindenallee 2, 89312 Günzburg, Germany
| | - Annabel Sandra Mueller-Stierlin
- Department of Psychiatry II, University of Ulm, Lindenallee 2, 89312, Günzburg, Germany. .,Institute of Epidemiology and Medical Biometry, University of Ulm, Schwabstraße 13, 89075, Ulm, Germany.
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Bakhsh HR, Metikala S, Billy GG, Vairo GL. Association Between Self-Reported Kinesiophobia and Single-Leg Hop for Distance in Patients With ACL Reconstruction:A Systematic Review. Sports Health 2021; 14:674-680. [PMID: 34651507 DOI: 10.1177/19417381211049357] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
CONTEXT Psychological readiness is a significant factor in determining successful return to sport (RTS) and physical activities after anterior cruciate ligament (ACL) reconstruction. Knowing the influence of kinesiophobia on physical tests that are used to guide RTS, such as the single-leg hop for distance (SLHD), would contribute to advancing clinical practice. OBJECTIVE To investigate the association between kinesiophobia and SLHD performance in patients after ACL reconstruction. DATA SOURCES A comprehensive search strategy entailed surveying 6 databases for relevant articles published from January 2009 to March 2021. STUDY SELECTION Articles published in English that were a minimum of level 3 evidence describing kinesiophobia, as measured by the Tampa Scale for Kinesiophobia, and related to SLHD performance in patients after ACL reconstruction. STUDY DESIGN Systematic review. LEVEL OF EVIDENCE Level 3. DATA EXTRACTION Study characteristics, sample population demographics, instrument(s), or approach(s) used to assess kinesiophobia and SLHD performance, and corresponding results. RESULTS A total of 152 potential studies were identified, 106 studies underwent screening, 40 were reviewed in full, and 7 studies were included. Meta-analysis could not be performed because of differences in experimental design among studies and instances of missing outcome data. Currently, moderate evidence indicates patients with ACL reconstruction that exhibit less kinesiophobia perform better on the SLHD test. CONCLUSION The outcomes of this review propose that sports health practitioners consider the influence of kinesiophobia on SLHD performance as a criterion for RTS and physical activities in patients after ACL reconstruction. Higher quality studies are necessary to establish the extent of association between these variables.
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Affiliation(s)
- Hadeel R Bakhsh
- Department of Rehabilitation, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Sreenivasulu Metikala
- Department of Orthopaedic Surgery, Virginia Commonwealth University Medical Center, Richmond, Virginia
| | - Gregory G Billy
- Department of Orthopaedics & Rehabilitation, College of Medicine, Pennsylvania State University, University Park, Pennsylvania
| | - Giampietro L Vairo
- Department of Orthopaedics & Rehabilitation, College of Medicine, Pennsylvania State University, University Park, Pennsylvania.,Department of Kinesiology, College of Health and Human Development, Pennsylvania State University, University Park, Pennsylvania
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10
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Makin H, Chisholm A, Fallon V, Goodwin L. Use of motivational interviewing in behavioural interventions among adults with obesity: A systematic review and meta-analysis. Clin Obes 2021; 11:e12457. [PMID: 33955152 DOI: 10.1111/cob.12457] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 03/29/2021] [Accepted: 04/06/2021] [Indexed: 01/29/2023]
Abstract
This review aimed to identify whether motivational interviewing (MI) (a counselling approach for supporting behaviour change [BC]) helps to reduce bodyweight and BMI in an adult obesity context. This included evaluating effectiveness of MI interventions within this population and reporting the methodology used, including theoretical underpinnings and identification of BC and MI techniques. Eight databases were searched using controlled vocabulary. Eligible studies included adults with obesity (BMI ≥30 kg/m2 ), author-reported interventions using MI aiming to reduce body weight or BMI, and comparator groups not receiving an MI intervention. Data extraction and quality appraisal tools were used to identify study characteristics, intervention content was coded for techniques, and random-effects meta-analysis were conducted to investigate effects. Meta-analysis of 12 studies indicated no overall pooled effect on bodyweight and BMI outcomes between intervention and control groups (SMD = -0.01 [95%CI -0.13 to 0.12, P = .93]). Findings were limited by multiple sources accounting for risk of bias, and poor reporting of intervention fidelity and content. Intervention and control content descriptions indicated similar techniques, with social support, goal setting (behaviour) and self-monitoring of behaviour occurring most frequently across both. Findings do not contribute additional evidence for MI use in this context, however methodological limitations were identified which must be resolved to better identify the intervention effects on obesity-related outcomes.
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Affiliation(s)
- Harriet Makin
- Department of Psychology, Institute of Population Health, University of Liverpool, Merseyside, UK
| | - Anna Chisholm
- Department of Psychology, Institute of Population Health, University of Liverpool, Merseyside, UK
| | - Victoria Fallon
- Department of Psychology, Institute of Population Health, University of Liverpool, Merseyside, UK
| | - Laura Goodwin
- Department of Psychology, Institute of Population Health, University of Liverpool, Merseyside, UK
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11
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Motivational interviewing for caries prevention in adolescents: a randomized controlled trial. Clin Oral Investig 2021; 26:585-594. [PMID: 34254214 DOI: 10.1007/s00784-021-04037-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 06/14/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The objective of this study is to investigate the effectiveness of motivational interviewing (MI) in changing health behaviors (snack and toothbrushing) and preventing dental caries among adolescents. METHODS Five hundred and twelve adolescents with unfavorable caries-related behaviors ("snacking three times or more a day" and/or "toothbrushing less often than twice a day") were randomly assigned to three groups. Group I received prevailing health education (oral health talks and pamphlets). Participants in group II joined a one-on-one face-to-face MI session. In group III, a patient communication tool (Cariogram) was incorporated to facilitate the MI process. At baseline and 24 months post-intervention, a self-administered questionnaire gathered information of participants' sociodemographic characteristics and oral health self-efficacy and behaviors. Their oral hygiene and tooth status were assessed by a blinded examiner. RESULTS After 24 months, 460 (89.8%) participants were followed up. Compared with group I, (i) restriction of frequent snacking was more likely in group II [OR (95% CI): 3.91 (1.48-10.33)] and group III [OR (95% CI): 6.33 (2.46-16.27)], whereas group III tended to adopt the behavior of toothbrushing twice a day [OR (95% CI): 4.80 (1.79-12.85)]; (ii) no significant between-group difference in plaque score reduction was found (p > 0.05); and (iii) groups II and III developed fewer cavitated teeth (△DICDASII 3-6MFT) [β (95% CI): - 0.19 (- 0.37, - 0.01) and - 0.20 (- 0.38, - 0.02), respectively], whereas increment of total carious lesions (△DICDASII 1-6MFT) was lower in group III [β (95% CI): - 0.63 (- 1.24, - 0.02)]. CONCLUSION MI outperformed prevailing health education in improving oral health behaviors and preventing dental caries among adolescents. CLINICAL RELEVANCE Incorporating MI into dental care for caries-prone adolescents contributes to optimal health outcomes. TRIAL REGISTRATION HKUCTR-1852 ( http://www.hkuctr.com/ ) (Hong Kong, 2013).
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12
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Everett B, Salamonson Y, Koirala B, Zecchin R, Davidson PM. A randomized controlled trial of motivational interviewing as a tool to enhance secondary prevention strategies in cardiovascular disease (MICIS study). Contemp Nurse 2021; 57:80-98. [PMID: 34006176 DOI: 10.1080/10376178.2021.1927774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Physical activity/exercise has consistently been shown to improve objective measures of functional capacity, enhance quality of life, improve coronary risk profile, and reduce mortality for individuals with coronary heart disease. Despite the gains achieved by those who attend cardiac rehabilitation (CR) many individuals fail to maintain lifestyle changes. The aims of this study were to evaluate the effectiveness of motivational interviewing as a strategy for promoting maintenance of cardiac risk factor modification in patients who had participated in standard, 6-week outpatient CR programs. In a randomized controlled trail, participants in usual care and intervention group (Motivational interviewing supplemental to a standard 6-week CR program) were followed up at 6-weeks and 12-months. The primary outcome was distance walked on the six-minute walk test (6MWT), used as both an indicator of functional capacity and habitual physical activity. Secondary outcomes included modifiable coronary risk factors (smoking, self-reported physical activity, waist circumference, body mass index and medication adherence), psychological status (depression, anxiety, stress, perceived cardiac control, perceived social support, exercise self-efficacy) and quality of life. Total 110 patients, usual care (n = 58) and intervention (n = 52), consented to participate in the study. Overall, demographic and clinical characteristics did not differ between groups at baseline. Motivational interviewing was no more likely to promote maintenance of cardiac risk factor modification (both primary and secondary outcomes) than a standard CR program alone. Both intervention and control groups maintained the gains achieved during CR at the 12-month follow-up except for weight loss. Although both groups maintained the gains achieved during CR for physical activity, there was no effect of the intervention on maintenance of cardiac risk factor modification on both primary and secondary outcomes.
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Affiliation(s)
- B Everett
- School of Nursing and Midwifery, Western Sydney Local Health District, Sydney, NSW, Australia
| | - Y Salamonson
- School of Nursing and Midwifery, Western Sydney Local Health District, Sydney, NSW, Australia
| | - B Koirala
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - R Zecchin
- NUM-Area Cardiac Rehabilitation, Western Sydney Local Health District, Australia
| | - P M Davidson
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA.,Faculty of Health, University of Technology Sydney, Australia
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13
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Rijpkema CJ, Verweij L, Jepma P, Latour CHM, Peters RJG, Scholte Op Reimer WJM, Buurman BM. The course of readmission in frail older cardiac patients. J Adv Nurs 2021; 77:2807-2818. [PMID: 33739473 PMCID: PMC8251632 DOI: 10.1111/jan.14828] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/02/2021] [Accepted: 02/28/2021] [Indexed: 12/14/2022]
Abstract
AIM The aim of this study is to explore patients' and (in)formal caregivers' perspectives on their role(s) and contributing factors in the course of unplanned hospital readmission of older cardiac patients in the Cardiac Care Bridge (CCB) program. DESIGN This study is a qualitative multiple case study alongside the CCB randomized trial, based on grounded theory principles. METHODS Five cases within the intervention group, with an unplanned hospital readmission within six months after randomization, were selected. In each case, semi-structured interviews were held with patients (n = 4), informal caregivers (n = 5), physical therapists (n = 4), and community nurses (n = 5) between April and June 2019. Patients' medical records were collected to reconstruct care processes before the readmission. Thematic analysis and the six-step analysis of Strauss & Corbin have been used. RESULTS Three main themes emerged. Patients experienced acute episodes of physical deterioration before unplanned hospital readmission. The involvement of (in)formal caregivers in adequate observation of patients' health status is vital to prevent rehospitalization (theme 1). Patients and (in)formal caregivers' perception of care needs did not always match, which resulted in hampering care support (theme 2). CCB caregivers experienced difficulties in providing care in some cases, resulting in limited care provision in addition to the existing care services (theme 3). CONCLUSION Early detection of deteriorating health status that leads to readmission was often lacking, due to the acuteness of the deterioration. Empowerment of patients and their informal caregivers in the recognition of early signs of deterioration and adequate collaboration between caregivers could support early detection. Patients' care needs and expectations should be prioritized to stimulate participation. IMPACT (In)formal caregivers may be able to prevent unplanned hospital readmission of older cardiac patients by ensuring: (1) early detection of health deterioration, (2) empowerment of patient and informal caregivers, and (3) clear understanding of patients' care needs and expectations.
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Affiliation(s)
- Corinne J. Rijpkema
- Department of Internal MedicineSection of Geriatric MedicineAmsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands
| | - Lotte Verweij
- Department of CardiologyAmsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands
- Center of Expertise Urban VitalityFaculty of HealthAmsterdam University of Applied ScienceAmsterdamThe Netherlands
| | - Patricia Jepma
- Department of CardiologyAmsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands
- Center of Expertise Urban VitalityFaculty of HealthAmsterdam University of Applied ScienceAmsterdamThe Netherlands
| | - Corine H. M. Latour
- Center of Expertise Urban VitalityFaculty of HealthAmsterdam University of Applied ScienceAmsterdamThe Netherlands
| | - Ron J. G. Peters
- Department of CardiologyAmsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands
| | - Wilma J. M. Scholte Op Reimer
- Department of CardiologyAmsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands
- Research Group Chronic DiseasesUniversity of Applied Sciences UtrechtUtrechtThe Netherlands
| | - Bianca M. Buurman
- Department of Internal MedicineSection of Geriatric MedicineAmsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands
- Center of Expertise Urban VitalityFaculty of HealthAmsterdam University of Applied ScienceAmsterdamThe Netherlands
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14
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Mace RA, Gates MV, Bullard B, Lester EG, Silverman IH, Quiroz YT, Vranceanu AM. Development of a Novel Mind-Body Activity and Pain Management Program for Older Adults With Cognitive Decline. THE GERONTOLOGIST 2021; 61:449-459. [PMID: 32601670 DOI: 10.1093/geront/gnaa084] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Chronic pain (CP) and cognitive decline (CD) often co-occur in older adults, which can reinforce a "disability spiral." Early interventions teaching pain coping skills and gradual increases in activity (walking) are needed to promote overall well-being and potentially delay further decline of cognition and daily functioning. The goal of this mixed-methods study was to guide the development of two mind-body activity programs for CP and CD which focus on increasing walking using time goals (Active Brains) or step count reinforced by a Fitbit (Active Brains-Fitbit). RESEARCH DESIGN AND METHODS Older adults with CP and CD (N = 23) participated in a one-time focus group (four total) and completed measures of physical, emotional, and cognitive functioning. Qualitative analyses identified population-specific needs, preferences, and perceptions of proposed program skills. Quantitative analysis compared clinical characteristics to population norms and explored intercorrelations among treatment targets. RESULTS Thematic analyses revealed six main themes: (1) challenges living with CP and (2) CD, (3) current walking, (4) technology (Fitbit) to increase walking, (5) perceptions of proposed program skills (e.g., mind-body, pain, and increased walking), and (6) program barriers and facilitators. Quantitative analyses showed that (a) participants had physical function below reference values and (b) higher self-efficacy correlated with higher cognitive, emotional, and physical functioning. DISCUSSION AND IMPLICATIONS Focus group participants were enthusiastic about the proposed program skills. Current work includes open pilot testing, qualitative interviews, and a small randomized controlled trial to optimize the programs and methodology in preparation for efficacy testing against an educational control.
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Affiliation(s)
- Ryan A Mace
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston.,Harvard Medical School, Boston, Massachusetts
| | - Melissa V Gates
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston
| | - Breanna Bullard
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston
| | - Ethan G Lester
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston.,Harvard Medical School, Boston, Massachusetts
| | - Ilyssa H Silverman
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston
| | - Yakeel T Quiroz
- Harvard Medical School, Boston, Massachusetts.,Department of Neurology, Massachusetts General Hospital, Boston
| | - Ana-Maria Vranceanu
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston.,Harvard Medical School, Boston, Massachusetts
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15
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Chima CC, Swanson B, Anikpezie N, Salemi JL. Alleviating diabetes distress and improving diabetes self-management through health coaching in a primary care setting. BMJ Case Rep 2021; 14:14/4/e241759. [PMID: 33879465 PMCID: PMC8061809 DOI: 10.1136/bcr-2021-241759] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Considering the rising global burden of diabetes and its complications, effective interventions for addressing barriers to diabetes self-management are needed. Diabetes distress, a psychological barrier to diabetes self-management, has become increasingly recognised in the literature, but effective and feasible ways of addressing it in routine primary care settings are not known. We present the case of a middle-aged non-Hispanic white American woman with poorly controlled diabetes (haemoglobin A1c (HbA1c): 13.9%) and elevated diabetes distress (baseline Diabetes Distress Scale Score: 2.53) who participated in a health coaching intervention. After the 5-month programme, which included eight 45 minute long sessions with a trained health coach, the patient achieved and sustained a 0.8-point reduction in diabetes distress, an improvement in insulin adherence and a 3.6-point reduction in HbA1c. This case demonstrates a novel approach to managing diabetes distress that entails providing patients a safe, nonjudgemental space to express their feelings and explore challenges with diabetes self-management.
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Affiliation(s)
- Charles C Chima
- Department of Population Health Science, The University of Mississippi Medical Center, Jackson, Mississippi, USA .,Family and Community Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Brenna Swanson
- Department of Nutrition and Dietetics, University of North Dakota, Grand Forks, North Dakota, USA
| | - Nnabuchi Anikpezie
- Department of Population Health Science, The University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Jason L Salemi
- Family and Community Medicine, Baylor College of Medicine, Houston, Texas, USA.,College of Public Health, University of South Florida, Tampa, Florida, USA
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16
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Kaczmarek T, Van Netten JJ, Lazzarini PA, Kavanagh D. Effects of training podiatrists to use imagery-based motivational interviewing when treating people with diabetes-related foot disease: a mixed-methods pilot study. J Foot Ankle Res 2021; 14:12. [PMID: 33568218 PMCID: PMC7877056 DOI: 10.1186/s13047-021-00451-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 01/26/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Self-care in diabetes related foot disease (DFD) is challenging and contributes to poor outcomes. Motivational Interviewing (MI) can engage people in self-care and modifying it by integrating imagery may further improve its outcomes. No previous studies have trained podiatrists in using MI to address DFD self-care. This was the first study on training podiatrists to conduct imagery-based motivational interviewing (MI) when treating people with DFD, and to examine impacts on MI related skills, job satisfaction and subjective experiences in a mixed-methods pilot study. METHODS Eleven recruited podiatrists (median age: 35 years, 9 female and 2 male) received two 4-h training sessions, and three received subsequent mentoring. MI and imagery skills were rated using validated tools during two clinical sessions per participant at baseline, and 2- and 12-weeks post-training. Job satisfaction was assessed at baseline and 12 weeks. Semi-structured interviews at 12 weeks were analysed using the framework approach. RESULTS Significant improvements over time (p = .006-.044) with substantial effect sizes (η2 = .50-.67) were found in three of four global MI related communication skills and two of four MI behaviours. However, effects on these indices were not sustained to 12 weeks, and imagery was rarely used. Job satisfaction was high at baseline and unchanged at follow-up (p = 0.34, η2 = .100). In qualitative interviews, MI training and skills were valued, but significant challenges in using MI when treating people with DFD were reported. CONCLUSION Training podiatrists in MI may have potential but more training, observation and mentoring appear needed to obtain sustained communication changes in practice.
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Affiliation(s)
- Tracey Kaczmarek
- School of Clinical Sciences, Queensland University of Technology, The Prince Charles Hospital Rhode Road, Brisbane, Queensland, 4032, Australia.
- Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
- Department of Podiatry, Metro North Hospital & Health Service, Queensland Health, Brisbane, QLD, Australia.
| | - Jaap J Van Netten
- School of Clinical Sciences, Queensland University of Technology, The Prince Charles Hospital Rhode Road, Brisbane, Queensland, 4032, Australia
- Amsterdam UMC, University of Amsterdam, Department of Rehabilitation, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, The Netherlands
| | - Peter A Lazzarini
- Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
- Department of Podiatry, Metro North Hospital & Health Service, Queensland Health, Brisbane, QLD, Australia
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
- Allied Health Research Collaborative, Metro North Hospital & Health Service, Queensland Health, Brisbane, Queensland, Australia
| | - David Kavanagh
- Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
- Centre for Child Health Research and School of Psychology & Counselling, Queensland University of Technology, Brisbane, QLD, Australia
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17
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Heng ML, Kwan YH, Ilya N, Ishak IA, Jin PH, Hogan D, Carmody D. A collaborative approach in patient education for diabetes foot and wound care: A pragmatic randomised controlled trial. Int Wound J 2020; 17:1678-1686. [PMID: 32729231 DOI: 10.1111/iwj.13450] [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: 05/18/2020] [Revised: 06/17/2020] [Accepted: 06/22/2020] [Indexed: 12/30/2022] Open
Abstract
Foot care education is an important strategy in reducing lower limb complications. There is evidence that contemporary communication approaches can improve patient education outcomes. To inform the potential of such methods in diabetic foot education, we trialled a collaborative approach in patient education counselling in a podiatry clinic. We conducted a single-blind pragmatic randomised controlled trial on 52 diabetes patients who had an active foot ulcer. Participants were randomised to either collaborative education or traditional didactic education. Outcomes on knowledge and self-care behaviours were collected via a pre and post study questionnaire (max score: 75). The study ended at 12 weeks or when the wound healed prior. 42 (80.7%) participants completed the study. The collaborative patient education group had a significant increase in score post-study (38.8 ± 8.5) compared to pre-study (32.8 ± 6.9; P < .001). The control group had no significant increase in score post study. The difference in scores between groups had a moderate effect size (d = 0.54). The use of a collaborative approach in patient education was able to produce significantly greater increase in knowledge retention and self-care behaviours, without the need for additional consultation time in a podiatry clinic.
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Affiliation(s)
- Marabelle Liwen Heng
- Podiatry Department, Singapore General Hospital, Singapore.,School of Allied Health and Human Performance, University of South Australia, Adelaide, South Australia
| | - Yu Heng Kwan
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Nik Ilya
- Podiatry Department, Singapore General Hospital, Singapore.,School of Humanities and Behavioural Sciences, Singapore University of Social Sciences, Singapore
| | | | | | - Debbie Hogan
- Academy of Solutions Focused Training, Singapore
| | - David Carmody
- Department of Endocrinology, Singapore General Hospital, Singapore
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18
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Allin S, Shepherd J, Thorson T, Tomasone J, Munce S, Linassi G, McBride CB, Jiancaro T, Jaglal S. Web-Based Health Coaching for Spinal Cord Injury: Results From a Mixed Methods Feasibility Evaluation. JMIR Rehabil Assist Technol 2020; 7:e16351. [PMID: 32589148 PMCID: PMC7428932 DOI: 10.2196/16351] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 06/10/2020] [Accepted: 06/14/2020] [Indexed: 01/16/2023] Open
Abstract
Background Individuals with spinal cord injury (SCI) are at high risk of experiencing secondary conditions like pressure injuries. Self-management programs may reduce the risk of complications, but traditional programs have proven to be insufficiently tailored to the needs of people with SCI. To overcome barriers to self-management support, a web-based, self-management program was developed for Canadians with SCI called SCI & U. Objective This study aims to evaluate the feasibility and potential impact of the SCI & U program in the context of a mixed methods pilot study. Methods The study followed an explanatory, sequential mixed methods design. Participants (N=11) were Canadians with SCI who had been living in the community for more than 1 year. Each took part in a self-paced, six-session self-management program guided by a trained peer health coach. During sessions, participants could discuss a health topic with their coach from a predefined list (eg, skin or bowel management). Quantitative data were gathered before and after program participation to assess program feasibility and impact. Feasibility measures included attrition rates, frequency of topics selected, and recorded goals, whereas impact measures included measures of self-efficacy (University of Washington Self-Efficacy Scale [UW-SES]), mood (Personal Health Questionnaire Depression Scale [PHQ-8]), secondary conditions (Spinal Cord Injury Secondary Conditions Scale [SCI-SCS]), and resilience (Spinal Cord Injury Quality of Life Resilience Scale [SCI-QOL-R]). Qualitative measures were based on postintervention interviews; these were designed to confirm and expand on quantitative Results Of the 11 participants, 10 completed pre- and postassessments, and 6 coaching sessions. Sessions lasted between 31 and 81 min (average 55, SD 13), and the duration of the program ranged from 35 to 88 days (average 56, SD 23). Diet and exercise were selected as topics 40% (20/50 sessions with topics) of the time, whereas topics such as mental health, bladder management, pain, and bowel management were chosen less frequently. Results gathered before and after the pilot study demonstrated improvements with moderate effect sizes on the UW-SES and the electronic health literacy scale (ie, Hedges g>0.5). Effect sizes for measures of resilience (SCI-QOL-R), depression (PHQ-8), and secondary conditions (SCI-SCS) were small (ie, Hedges g>0.3). Qualitative results confirmed a common focus on diet and exercise, and defined coaches as sources of accountability, information, reassurance and affirmation, and emotional and technical support. Conclusions Results demonstrated that a web-based self-management program is feasible and acceptable by Canadians with SCI. Results also indicated a web-based, peer-led self-management program may impact resilience, self-efficacy, mood, and secondary complications. Finally, results illuminated the role of the coach in facilitating behavior change. Future work seeks to validate results in the context of a randomized controlled trial.
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Affiliation(s)
- Sonya Allin
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - John Shepherd
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | | | - Jennifer Tomasone
- School of Kinesiology and Health Studies, Queens University, Kingston, ON, Canada
| | - Sarah Munce
- Toronto Rehabilitation Institute, Toronto, ON, Canada
| | - Gary Linassi
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Tizneem Jiancaro
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Susan Jaglal
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
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19
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Bailey JE, Surbhi S, Gatwood J, Butterworth S, Coday M, Shuvo SA, Dashputre AA, Brooks IM, Binkley BL, Riordan CJ, Steinberg HO, Gutierrez ML, Haley LE, Leak CL, Tolley EA. The management of diabetes in everyday life study: Design and methods for a pragmatic randomized controlled trial comparing the effectiveness of text messaging versus health coaching. Contemp Clin Trials 2020; 96:106080. [PMID: 32653539 DOI: 10.1016/j.cct.2020.106080] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 06/15/2020] [Accepted: 07/06/2020] [Indexed: 01/13/2023]
Abstract
Background African American patients with uncontrolled diabetes living in medically underserved areas need effective clinic-based interventions to improve self-care behaviors. Text messaging (TM) and health coaching (HC) are among the most promising low-cost population-based approaches, but little is known about their comparative effectiveness in real-world clinical settings. Objective Use a pragmatic randomized controlled trial design to determine the comparative effectiveness of TM and HC with enhanced usual care (EC) in African American adults with uncontrolled diabetes and multiple chronic health conditions. Methods/design The Management of Diabetes in Everyday Life (MODEL) study is randomizing 646 patients (n = 581with anticipated 90% retention) to 3 intervention arms: TM, HC, and EC. Participants are African American adults living in medically underserved areas of the Mid-South, age ≥ 18, with uncontrolled diabetes (A1c ≥ 8), one or more additional chronic conditions, and who have a phone with texting and voicemail capability. Primary outcome measures: the general diet, exercise, and medication adherence subscales of the revised Summary of Diabetes Self-Care Activities questionnaire assessed at one year. Secondary outcomes: diabetes-specific quality of life, primary care engagement, and average blood sugar (A1c). The study will also assess heterogeneity of treatment effects by six key baseline participant characteristics. Conclusions We describe the design and methods of the MODEL study along with design revisions required during implementation in a pragmatic setting. This trial, upon its conclusion, will allow us to compare the effectiveness of two promising low-cost primary care-based strategies for supporting self-care behaviors among African Americans individuals with uncontrolled diabetes. ClinicalTrials.gov registration number: NCT02957513.
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Affiliation(s)
- James E Bailey
- Center for Health System Improvement, University of Tennessee Health Science Center, Memphis, TN, United States of America; Division of General Internal Medicine, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States of America; Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, United States of America.
| | - Satya Surbhi
- Center for Health System Improvement, University of Tennessee Health Science Center, Memphis, TN, United States of America; Division of General Internal Medicine, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States of America
| | - Justin Gatwood
- Center for Health System Improvement, University of Tennessee Health Science Center, Memphis, TN, United States of America; College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN, United States of America
| | - Susan Butterworth
- Center for Health System Improvement, University of Tennessee Health Science Center, Memphis, TN, United States of America; Q-consult, LLC, St. Petersburg, FL, United States of America
| | - Mace Coday
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, United States of America
| | - Sohul A Shuvo
- Center for Health System Improvement, University of Tennessee Health Science Center, Memphis, TN, United States of America; Institute for Health Outcomes and Policy, College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, TN, United States of America
| | - Ankur A Dashputre
- Center for Health System Improvement, University of Tennessee Health Science Center, Memphis, TN, United States of America; Institute for Health Outcomes and Policy, College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, TN, United States of America
| | - Ian M Brooks
- Center for Health System Improvement, University of Tennessee Health Science Center, Memphis, TN, United States of America; Department of Surgery, Anne Arundel Medical Center, Annapolis, MD, United States of America
| | - Bonnie L Binkley
- Center for Health System Improvement, University of Tennessee Health Science Center, Memphis, TN, United States of America
| | - Carrie Jo Riordan
- Center for Health System Improvement, University of Tennessee Health Science Center, Memphis, TN, United States of America
| | - Helmut O Steinberg
- Center for Health System Improvement, University of Tennessee Health Science Center, Memphis, TN, United States of America; Division of Endocrinology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States of America
| | - Mary Lou Gutierrez
- Center for Health System Improvement, University of Tennessee Health Science Center, Memphis, TN, United States of America
| | - Lauren E Haley
- Center for Health System Improvement, University of Tennessee Health Science Center, Memphis, TN, United States of America
| | - Cardella L Leak
- Center for Health System Improvement, University of Tennessee Health Science Center, Memphis, TN, United States of America
| | - Elizabeth A Tolley
- Center for Health System Improvement, University of Tennessee Health Science Center, Memphis, TN, United States of America; Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, United States of America
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Ede J, Jones P, Westgate V, Darbyshire J, Gustafson O, Subbe CP. Resilience and Motivation Following Intensive Care Unit Admission: Tools for Survivorship. Nurs Crit Care 2020; 24:253-255. [PMID: 31633279 DOI: 10.1111/nicc.12474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Wong MK, Cheng SYR, Chu TK, Lam FY, Lai SK, Wong KC, Liang J. Impact of Motivational Interviewing on Self-Management in Patients With Type 2 Diabetes: Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e15709. [PMID: 32229475 PMCID: PMC7157490 DOI: 10.2196/15709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/28/2019] [Accepted: 02/03/2020] [Indexed: 11/22/2022] Open
Abstract
Background The nonpharmacological approach to diabetic control in patients with diabetes focuses on a healthy diet, physical activity, and self-management. Therefore, to help patients change their habits, it is essential to identify the most effective approach. Many efforts have been devoted to explain changes in or adherence to specific health behaviors. Such efforts have resulted in the development of theories that have been applied in prevention campaigns and include brief advice and counseling services. Within this context, motivational interviewing (MI) has proven to be effective in changing health behaviors for specific cases. However, stronger evidence is needed on the effectiveness of MI in treating chronic pathologies such as diabetes. Objective This study will obtain preliminary data on the impact of a nurse-led MI intervention in improving glycemic control, as well as clinical, psychosocial, and self-care outcomes for individuals with type 2 diabetes mellitus when compared with usual care, with the aim of improving diabetic control in patients with diabetes. Methods An open, two-arm, parallel, randomized controlled, pilot exploratory trial will be performed. Two government outpatient clinics in the New Territories West Cluster in Hong Kong will be involved. In total, 20 to 25 participants will be invited in each arm. Intervention participants will receive face-to-face MI interventions in addition to their usual care from the clinic. Control participants will only receive usual care. Outcomes are assessed at baseline, 6 months, and 12 months. The primary outcome measure is glycated hemoglobin levels. Secondary outcomes include blood pressure, BMI, hip and waist circumference, fasting blood, and psychosocial and self-care measures. Results This study is currently underway with funding support from the Hong Kong College of Family Physician Research Seed Fund 2017. Conclusions MI skills constitute the main strategies primary care nurses use on their patients. Having economical, simple, effective, and applicable techniques is essential for primary care professionals to help their patients change their lifestyle and improve their health. This study will provide scientific evidence on the effectiveness of MI. It will be performed with strict control over the data collection, ensuring the maintenance of therapeutic integrity. Trial Registration Centre for Clinical Research and Biostatistics CUHK_CCRB00614; https://tinyurl.com/v9awzk6 International Registered Report Identifier (IRRID) DERR1-10.2196/15709
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Affiliation(s)
- Man Kin Wong
- Department of Family Medicine and Primary Health Care, Tuen Mun Hospital, New Territories West Cluster, New Territories, Hong Kong
| | - Sai Yip Ronald Cheng
- Department of Family Medicine and Primary Health Care, Tuen Mun Hospital, New Territories West Cluster, New Territories, Hong Kong
| | - Tsun Kit Chu
- Department of Family Medicine and Primary Health Care, Tuen Mun Hospital, New Territories West Cluster, New Territories, Hong Kong
| | - Fung Yee Lam
- Department of Family Medicine and Primary Health Care, Tuen Mun Hospital, New Territories West Cluster, New Territories, Hong Kong
| | - Shiu Kee Lai
- Department of Family Medicine and Primary Health Care, Tuen Mun Hospital, New Territories West Cluster, New Territories, Hong Kong
| | - Kai Chung Wong
- Department of Family Medicine and Primary Health Care, Tuen Mun Hospital, New Territories West Cluster, New Territories, Hong Kong
| | - Jun Liang
- Department of Family Medicine and Primary Health Care, Tuen Mun Hospital, New Territories West Cluster, New Territories, Hong Kong
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Zabolypour S, Alishapour M, Behnammoghadam M, Abbasi Larki R, Zoladl M. A Comparison of the Effects of Teach-Back and Motivational Interviewing on the Adherence to Medical Regimen in Patients with Hypertension. Patient Prefer Adherence 2020; 14:401-410. [PMID: 32161450 PMCID: PMC7049851 DOI: 10.2147/ppa.s231716] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 01/22/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Arterial hypertension is considered a chronic medical problem and also a challenging condition. The present study aimed to compare the effects of motivational interviewing and teach-back on people with hypertension. MATERIALS AND METHODS In this clinical trial conducted in Yasuj in 2018 a total of 81 patients with essential hypertension were selected in terms of the inclusion criteria. Then, they were randomly divided into three groups: teach-back (Group 1), motivational interviewing (Group 2), and control (Group 3). Three teach-back sessions were held for the teach-back group, five sessions of motivational interviewing for the motivational interviewing group, and the routine care was provided for the control group. In addition, data were collected by the demographic form and scale of Adherence to Systemic Hypertension Treatment, which were completed by participants of all three groups at baseline and also two months from the intervention. Data were analyzed using SPSS 21 by applying descriptive statistics, one-way ANOVA, chi-squared test, Fisher's exact test, and Bonferroni test. FINDINGS Two months from the interventions, in Group 1, the score of adherence to the hypertension treatment regimen significantly increased by 816.38 points compared to the control group, in Group 2 by 1228.9 points compared to the control group, and in Group 2 by 412.6 points compared to Group 1 (p >0.05). CONCLUSION Both teach-back and motivational interviewing increased the adherence to the hypertension treatment regimen; however, motivational interviewing was more effective compared to teach-back in boosting adherence to the hypertension treatment regimen.
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Affiliation(s)
- Soheila Zabolypour
- Medical Surgical Nursing Department, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Maryam Alishapour
- Student Research Committee, Yasuj University of Medical Sciences, Yasuj, Iran
| | | | - Rozina Abbasi Larki
- Urology Department, Medicine Faculty, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Mohammad Zoladl
- Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
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23
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Li Z, Chen Q, Yan J, Liang W, Wong WCW. Effectiveness of motivational interviewing on improving Care for Patients with type 2 diabetes in China: A randomized controlled trial. BMC Health Serv Res 2020; 20:57. [PMID: 31973759 PMCID: PMC6979352 DOI: 10.1186/s12913-019-4776-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 11/22/2019] [Indexed: 11/12/2022] Open
Abstract
Background To assess the effects of a motivational interviewing (MI)-based patient empowerment program (PEP) on type 2 diabetes mellitus (DM) patient self-management compared to traditional diabetes health education. Methods Two hundred and twenty-five patients, recruited from community health centers (CHCs) and the family medicine clinic in the University of Hong Kong-Shenzhen Hospital in Shenzhen, were randomly assigned to the intervention or control groups. Patients in the intervention group (n = 117) received a four-session PEP in small groups over 1 month by trained nurses and doctors. The control group (n = 108) received the traditional lecture-style health education on DM. All the patients were followed up for 3 months. Outcomes included problem areas in diabetes (PAID) that measures diabetes-related emotional distress, patient enablement index (PEI), mental health, patient satisfaction respectively as well as lifestyle behaviors were assessed at baseline, post-activity and 3 months. Results At post-intervention and the 3-month follow-up, the PAID score improved significantly in the intervention group (12.7 ± 13.6, 5.8 ± 7.6) compared to the control group (22.7 ± 22.8, 11.7 ± 14.6). No difference was found between groups for changes to exercise, diet, and medication adherence. The PEI score improved significantly at the 3-month follow-up in the MI group (7.27 ± 2.45 vs 5.81 ± 2.97). Conclusion The PEP has a significant effect on improving diabetes-related distress, but MI was not significantly different from the traditional health education programs when it comes to the readiness to change. Trial registration NCT04120844, ClinicalTrials.Gov. Date of registration: October 9th 2019 (Retrospectively registered).
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Affiliation(s)
- Zhe Li
- Family Medicine Department, The University of Hong Kong - Shenzhen Hospital, 1, Haiyuan 1st Road, Futian District, Shenzhen, China
| | - Qingqi Chen
- Family Medicine Department, The University of Hong Kong - Shenzhen Hospital, 1, Haiyuan 1st Road, Futian District, Shenzhen, China
| | - Jingya Yan
- WHO Health Promoting Hospital Office, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
| | - Wei Liang
- Endocrinology Department, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
| | - William C W Wong
- Family Medicine Department, The University of Hong Kong - Shenzhen Hospital, 1, Haiyuan 1st Road, Futian District, Shenzhen, China. .,Clinical Associate Professor, Department of Family Medicine and Primary Care, The University of Hong Kong, 1, Haiyuan 1st Road, Futian District, Shenzhen, China.
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24
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Hoekstra F, Hoekstra T, van der Schans CP, Hettinga FJ, van der Woude LHV, Dekker R. The implementation of a physical activity counseling program in rehabilitation care: findings from the ReSpAct study. Disabil Rehabil 2019; 43:1710-1721. [PMID: 31622120 DOI: 10.1080/09638288.2019.1675188] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE This study aimed to evaluate the implementation of a physical activity counseling program in rehabilitation and to study heterogeneity in received counseling and investigate its association with changes in patients' physical activity outcomes. METHODS This prospective cohort study was conducted in 18 rehabilitation institutions. Data were collected using surveys completed by professionals (n= ±70) and patients (n = 1719). Implementation was evaluated using different process outcomes: reach, dosage, satisfaction, maintenance. Patients' physical activity outcomes included changes in total minutes/week of physical activity. Latent class analyses were conducted to identify profiles of received counseling characteristics and multilevel models were used to investigate associations with physical activity outcomes. RESULTS 5873 Patients were provided with motivational interviewing-based counseling after rehabilitation. Professionals and patients were positive about the program. Sixteen institutions (89%) formally agreed to continue the program. The four identified profiles of counseling characteristics illustrate a large variation in received counseling among patients. No substantial differences in physical activity outcomes were found between profiles. CONCLUSION After a three-year program period, the physical activity counseling centers were sustainably implemented in Dutch rehabilitation care. This study illustrated an innovative approach to assess heterogeneity in implementation outcomes (e.g., counseling profiles) in relation to program outcomes (e.g., physical activity).Implications for rehabilitationPhysical activity counseling after rehabilitation is important to support people with disabilities in making the step from rehabilitation-based physical activities to community-based physical activities.Establishing "Physical Activity Counseling Centers" is a promising "disability-overarching" strategy to promote physical activity after rehabilitation.Although the actual received counseling (dosage) varied among patients, this did not coincide with large differences in physical activity outcomes.The training in Motivational Interviewing, the financial incentives, and the advisory support were considered as important or essential ingredients for a successful implementation of the counseling program in rehabilitation practice.
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Affiliation(s)
- Femke Hoekstra
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Center for Rehabilitation, Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Trynke Hoekstra
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Center for Rehabilitation, Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Cees P van der Schans
- Center for Rehabilitation, Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.,Dept Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Florentina J Hettinga
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, United Kingdom
| | - Lucas H V van der Woude
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Center for Rehabilitation, Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Rienk Dekker
- Center for Rehabilitation, Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Center for Sports Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Swanson V, Maltinsky W. Motivational and behaviour change approaches for improving diabetes management. PRACTICAL DIABETES 2019. [DOI: 10.1002/pdi.2229] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Vivien Swanson
- Centre for Health and Behaviour Change, Psychology DivisionUniversity of Stirling Stirling UK
| | - Wendy Maltinsky
- Centre for Health and Behaviour Change, Psychology DivisionUniversity of Stirling Stirling UK
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Oeffinger KC, Ford JS, Moskowitz CS, Chou JF, Henderson TO, Hudson MM, Diller L, McDonald A, Ford J, Mubdi NZ, Rinehart D, Vukadinovich C, Gibson TM, Anderson N, Elkin EB, Garrett K, Rebull M, Leisenring W, Robison LL, Armstrong GT. Promoting Breast Cancer Surveillance: The EMPOWER Study, a Randomized Clinical Trial in the Childhood Cancer Survivor Study. J Clin Oncol 2019; 37:2131-2140. [PMID: 31260642 PMCID: PMC6698920 DOI: 10.1200/jco.19.00547] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The aim of the current study was to increase the uptake of screening mammography among high-risk women who were treated for a childhood cancer with chest radiotherapy. PATIENTS AND METHODS Two hundred four female survivors in the Childhood Cancer Survivor Study who were treated with chest radiotherapy with 20 Gy or greater, age 25 to 50 years, and without breast imaging in the past 24 months were randomly assigned 2:1 to receive a mailed informational packet followed by a tailored telephone-delivered brief motivational interview (intervention) versus an attention control. Primary outcome was the difference in the proportion of participants who completed a screening mammogram by 12 months as evaluated in an intent-to-treat analysis. Stratum-adjusted relative risk (RR) and 95% CI were estimated using the Cochran-Mantel-Haenszel method. Secondary outcomes included the completion of screening breast magnetic resonance imaging (MRI) and barriers to screening and moderating factors. RESULTS Women in the intervention group were significantly more likely than those in the control group to report a mammogram (45 [33.1%] of 136 v 12 [17.6%] of 68; RR, 1.9; 95% CI, 1.1 to 3.3). The intervention was more successful among women age 25 to 39 years (RR, 2.2; 95% CI, 1.1 to 4.7) than among those age 40 to 50 years (RR, 1.4; 95% CI, 0.6 to 3.2). The proportion of women who reported a breast MRI at 12 months was similar between the two groups: 16.2% (intervention) compared with 13.2% (control; RR, 1.2; 95% CI, 0.6 to 2.5). Primary barriers to completing a screening mammogram and/or breast MRI included lack of physician recommendation, deferred action by survivor, cost, and absence of symptoms. CONCLUSION Use of mailed materials followed by telephone-delivered counseling increased mammography screening rates in survivors at high risk for breast cancer; however, this approach did not increase the rate of breast MRI. Cost of imaging and physician recommendation were important barriers that should be addressed in future studies.
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Affiliation(s)
| | - Jennifer S Ford
- 2Hunter College, City University of New York, New York, NY.,3The Graduate Center of the City University of New York, New York, NY
| | | | - Joanne F Chou
- 4Memorial Sloan Kettering Cancer Center, New York, NY
| | | | | | - Lisa Diller
- 7Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | | | - James Ford
- 6St Jude Children's Research Hospital, Memphis, TN
| | - Nidha Z Mubdi
- 4Memorial Sloan Kettering Cancer Center, New York, NY
| | | | | | | | | | - Elena B Elkin
- 4Memorial Sloan Kettering Cancer Center, New York, NY
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Arkkukangas M, Hultgren S. Implementation of motivational interviewing in a fall prevention exercise program: experiences from a randomized controlled trial. BMC Res Notes 2019; 12:270. [PMID: 31088557 PMCID: PMC6518683 DOI: 10.1186/s13104-019-4309-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 05/08/2019] [Indexed: 11/27/2022] Open
Abstract
Objective The elderly population over 65 is increasing globally, and interventions promoting health and preventive work, especially fall prevention, will constitute a large part of physiotherapists’ duties in the near future. To address the challenges of promoting effective and sustainable health behavior changes among older persons, physiotherapists need support when it comes to how to apply behavior change strategies, especially in fall prevention. Therefore, the aim of this study was to describe implementation of motivational interviewing in a fall prevention exercise program. This study is a side product of another project. Results Data from a recently performed three-armed randomized controlled trial were used to describe the implementation of motivational interviewing in the exercise group (n = 58). Level of motivation (priorities) and self-efficacy for both the physiotherapist and the participant in treatment, and to use a guide targeted towards the planned treatment are recommended actions. Regular meetings and follow ups as well as updates of motivational interviewing skills during a treatment period, should also be considered to achieve treatment fidelity. Trial registration NCT01778972, Retrospectively registered January 29, 2013
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Affiliation(s)
- Marina Arkkukangas
- Department of Neuroscience, Physiotherapy, Uppsala University, Box 593, 751 24, Uppsala, Sweden. .,Center for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden.
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Lukaschek K, Schneider N, Schelle M, Kirk UB, Eriksson T, Kunnamo I, Rochfort A, Collins C, Gensichen J. Applicability of Motivational Interviewing for Chronic Disease Management in Primary Care Following a Web-Based E-Learning Course: Cross-Sectional Study. JMIR Ment Health 2019; 6:e12540. [PMID: 31033446 PMCID: PMC6658265 DOI: 10.2196/12540] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 01/30/2019] [Accepted: 02/18/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Motivational interviewing (MI) is an established communication method for enhancing intrinsic motivation for changing health behavior. E-learning can reduce the cost and time involved in providing continuing education and can be easily integrated into individual working arrangements and the daily routines of medical professionals. Thus, a Web-based course was devised to familiarize health professionals with different levels of education and expertise with MI techniques for patients with chronic conditions. OBJECTIVE The aim of this study was to report participants' opinion on the practicality of MI (as learned in the course) in daily practice, stratified by the level of education. METHODS Participants (N=607) of the MI Web-based training course evaluated the course over 18 months, using a self-administered questionnaire. The evaluation was analyzed descriptively and stratified for the level of education (medical students, physicians in specialist training [PSTs], and general practitioners [GPs]). RESULTS Participants rated the applicability of the skills and knowledge gained by the course as positive (medical students: 94% [79/84] good; PSTs: 88.6% [109/123] excellent; and GPs: 51.3% [182/355] excellent). When asked whether they envisage the use of MI in the future, 79% (67/84) of the students stated to a certain extent, 88.6% (109/123) of the PSTs stated to a great extent, and 38.6% (137/355) of GPs stated to a great extent. Participants acknowledged an improvement of communication skills such as inviting (medical students: 85% [72/84]; PSTs: 90.2% [111/123]; GPs: 37.2% [132/355]) and encouraging (medical students: 81% [68/84]; PSTs: 45.5% [56/123]; GPs: 36.3% [129/355]) patients to talk about behavior change and conveying respect for patient's choices (medical students: 72% [61/84]; PSTs: 50.0% [61/123]; GPs: 23.4% [83/355]). CONCLUSIONS Participants confirmed the practicality of MI. However, the extent to which the practicality of MI was acknowledged as well as its expected benefits depended on the individual's level of education/expertise.
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Affiliation(s)
- Karoline Lukaschek
- Institute of General Practice and Family Medicine, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Nico Schneider
- Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, University of Jena, Jena, Germany.,Institute of General Practice and Family Medicine, Jena University Hospital, University of Jena, Jena, Germany
| | - Mercedes Schelle
- Institute of General Practice and Family Medicine, Jena University Hospital, University of Jena, Jena, Germany
| | - Ulrik Bak Kirk
- European Society for Quality and Safety in Family Practice, København, Denmark
| | - Tina Eriksson
- European Society for Quality and Safety in Family Practice, København, Denmark
| | - Ilkka Kunnamo
- The Finnish Medical Society Duodecim, Helsinki, Finland
| | | | | | - Jochen Gensichen
- Institute of General Practice and Family Medicine, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany.,Institute of General Practice and Family Medicine, Jena University Hospital, University of Jena, Jena, Germany
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Chima CC, Salemi JL, Sidani MA, Zoorob RJ. Coaching and Education for Diabetes Distress (CEDD): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e12166. [PMID: 30938687 PMCID: PMC6465980 DOI: 10.2196/12166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 01/26/2019] [Accepted: 02/10/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Diabetes distress (DD), a type of psychological distress specific to people with diabetes, is strongly associated with difficulties in performing self-care and inability to meet glycemic targets. Despite increased recognition of the need to manage DD, interventions that are both feasible and effective for reducing DD in routine care settings are not yet known. A pilot study showed that health coaching (HC) has some efficacy in addressing DD, but no adequately powered study has implemented a pragmatic research design capable of assessing the real-world effectiveness of HC in reducing DD. OBJECTIVE The aim of this study is to describe the rationale and design of an ongoing clinical trial, Coaching and Education for Diabetes Distress trial, that seeks to assess whether HC effectively reduces DD among primary care patients with diabetes and whether HC is more effective than an educational program targeting DD. METHODS The 2-arm randomized controlled trial is taking place at an academic family medicine practice in Houston, Texas. Both arms will receive usual care, which includes education about DD. In addition, the intervention arm will receive 8 HC sessions over a 5-month period. The primary outcome measure is reduction in DD over a 6-month period. Additional outcome measures include changes in hemoglobin A1c and self-care practices (medication-taking, dietary, and physical activity behaviors). RESULTS As of March 2019, screening and recruitment are ongoing, and the results are expected by July 2020. CONCLUSIONS HC is feasible in primary care and has been successfully applied to improving chronic disease self-management and outcomes. This study will provide evidence as to whether it has significant value in addressing important unmet psychological and behavioral needs of patients with diabetes. TRIAL REGISTRATION ClinicalTrials.gov NCT03617146; https://clinicaltrials.gov/ct2/show/NCT03617146 (Archived by WebCite at http://www.webcitation.org/76Va37dbO). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/12166.
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Affiliation(s)
- Charles C Chima
- Department of Population Health Science, John D Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, United States.,Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Jason L Salemi
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Mohamad A Sidani
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Roger J Zoorob
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, United States
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30
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Hoekstra T, Alingh RA, de Vries HS, Bes R, Hoekstra F, van der Schans CP, Dekker R, Hettinga FJ, van der Woude LHV. A questionnaire to assess rehabilitation patients’ experiences with motivational interviewing consultation in the context of physical activity stimulation. Disabil Rehabil 2019; 42:2198-2203. [DOI: 10.1080/09638288.2018.1545055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Trynke Hoekstra
- Center for Human Movement Sciences, University Medical Center Groningen, Groningen, The Netherlands
- Department of Rehabilitation Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - Rolinde A. Alingh
- Center for Human Movement Sciences, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Rik Bes
- Centre for Motivation and Change, Hilversum, The Netherlands
| | - Femke Hoekstra
- Center for Human Movement Sciences, University Medical Center Groningen, Groningen, The Netherlands
| | - Cees P. van der Schans
- Research and Innovation Group in Health Care and Nursing, Hanze University Groningen, Groningen, The Netherlands
| | - Rienk Dekker
- Center for Human Movement Sciences, University Medical Center Groningen, Groningen, The Netherlands
- Center for Sports Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - Florentina J. Hettinga
- School of Biological Sciences, Centre of Sport and Exercise Science, University of Essex, Colchester, UK
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Binning J, Woodburn J, Bus SA, Barn R. Motivational interviewing to improve adherence behaviours for the prevention of diabetic foot ulceration. Diabetes Metab Res Rev 2019; 35:e3105. [PMID: 30513132 DOI: 10.1002/dmrr.3105] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 11/01/2018] [Accepted: 11/18/2018] [Indexed: 11/06/2022]
Abstract
Diabetic foot ulceration is a major complication associated with high morbidity. Little evidence exists on which interventions are effective at preventing ulceration. Participants who are adherent to self-care behaviours have significantly better outcomes. Motivational interviewing is an intervention that has been used successfully for conditions where adherence is important, such as reduction of obesity and HbA1c levels. A systematic review was conducted to determine whether motivational interviewing is effective at improving adherence for the prevention of Diabetic Foot Ulceration. Electronic searches were run without date or language restrictions in MEDLINE (viaEBSCOhost), CINAHL (viaEBSCOhost), ProQuest (Health and Medical Collection, Nursing and Allied Health Database, PsycINFO, Psychology, PsychArticles), AMED, EMBASE, Cochrane Central Register of Controlled Trials, ScienceDirect, and Web of Science Core Collections. Papers were included if participants had or were at risk of diabetic foot ulceration. Studies required motivational interviewing or a motivational approach as the sole intervention or as a component. Randomised controlled trials and quasi-experimental studies were included if ulceration and/or at least one behavioural outcome was measured before and after the intervention. Five studies met the inclusion criteria. Heterogeneity prevented the pooling of data. One study used motivational interviewing as the sole intervention. This study found a short-term positive effect on footwear adherence. The remaining four studies had a motivational component within their interventions. Two of these studies showed the intervention to be effective but both were at a high risk of bias. This review demonstrates an evidence gap. More research is needed.
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Affiliation(s)
- Jodi Binning
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Jim Woodburn
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Sicco A Bus
- Department of Rehabilitation, Academic Medical Center, Amsterdam Movement Sciences, University of Amsterdam, The Netherlands
| | - Ruth Barn
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
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Mehralian G, Sheikhi S, Peiravian F. Diabetic Patients’ Views on Services Provided by Community Pharmacies. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2018. [DOI: 10.1111/jphs.12229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Gholamhossein Mehralian
- Department of Pharmacoeconomics and Pharma Management; School of Pharmacy; Shahid Beheshti University of Medical Sciences; Tehran Iran
| | - Shiva Sheikhi
- Department of Pharmacoeconomics and Pharma Management; School of Pharmacy; Shahid Beheshti University of Medical Sciences; Tehran Iran
| | - Farzad Peiravian
- Department of Pharmacoeconomics and Pharma Management; School of Pharmacy; Shahid Beheshti University of Medical Sciences; Tehran Iran
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Frost H, Campbell P, Maxwell M, O’Carroll RE, Dombrowski SU, Williams B, Cheyne H, Coles E, Pollock A. Effectiveness of Motivational Interviewing on adult behaviour change in health and social care settings: A systematic review of reviews. PLoS One 2018; 13:e0204890. [PMID: 30335780 PMCID: PMC6193639 DOI: 10.1371/journal.pone.0204890] [Citation(s) in RCA: 154] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 09/17/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The challenge of addressing unhealthy lifestyle choice is of global concern. Motivational Interviewing has been widely implemented to help people change their behaviour, but it is unclear for whom it is most beneficial. This overview aims to appraise and synthesise the review evidence for the effectiveness of Motivational Interviewing on health behaviour of adults in health and social care settings. METHODS A systematic review of reviews. Methods were pre-specified and documented in a protocol (PROSPERO-CRD42016049278). We systematically searched 7 electronic databases: CDSR; DARE; PROSPERO; MEDLINE; CINAHL; AMED and PsycINFO from 2000 to May 2018. Two reviewers applied pre-defined selection criteria, extracted data using TIDIER guidelines and assessed methodological quality using the ROBIS tool. We used GRADE criteria to rate the strength of the evidence for reviews including meta-analyses. FINDINGS Searches identified 5222 records. One hundred and four reviews, including 39 meta-analyses met the inclusion criteria. Most meta-analysis evidence was graded as low or very low (128/155). Moderate quality evidence for mainly short term (<6 months) statistically significant small beneficial effects of Motivational Interviewing were found in 11 of 155 (7%) of meta-analysis comparisons. These outcomes include reducing binge drinking, frequency and quantity of alcohol consumption, substance abuse in people with dependency or addiction, and increasing physical activity participation. CONCLUSIONS We have created a comprehensive map of reviews relating to Motivational Interviewing to signpost stakeholders to the best available evidence. More high quality research is needed to be confident about the effectiveness of Motivational Interviewing. We identified a large volume of low quality evidence and many areas of overlapping research. To avoid research waste, it is vital for researchers to be aware of existing research, and the implications arising from that research. In the case of Motivational Interviewing issues relating to monitoring and reporting fidelity of interventions need to be addressed.
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Affiliation(s)
- Helen Frost
- School of Health and Social Care, Edinburgh Napier University, Sighthill Court, Scotland, United Kingdom
| | - Pauline Campbell
- Nursing, Midwifery, Allied Health Professional Research Unit (NMAHP-RU), Glasgow Caledonian University, Glasgow, United Kingdom
| | - Margaret Maxwell
- Nursing, Midwifery, Allied Health Professional Research Unit (NMAHP-RU), School of Health Sciences, University of Stirling, Stirling, Scotland, United Kingdom
| | - Ronan E. O’Carroll
- School of Health Sciences, Division of Psychology, University of Stirling, Stirling, Scotland, United Kingdom
| | - Stephan U. Dombrowski
- School of Health Sciences, Division of Psychology, University of Stirling, Stirling, Scotland, United Kingdom
| | - Brian Williams
- School of Health and Social Care, Edinburgh Napier University, Sighthill Court, Scotland, United Kingdom
| | - Helen Cheyne
- Nursing, Midwifery, Allied Health Professional Research Unit (NMAHP-RU), School of Health Sciences, University of Stirling, Stirling, Scotland, United Kingdom
| | - Emma Coles
- Nursing, Midwifery, Allied Health Professional Research Unit (NMAHP-RU), School of Health Sciences, University of Stirling, Stirling, Scotland, United Kingdom
| | - Alex Pollock
- Nursing, Midwifery, Allied Health Professional Research Unit (NMAHP-RU), Glasgow Caledonian University, Glasgow, United Kingdom
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Ringen PA, Falk RS, Antonsen B, Faerden A, Mamen A, Rognli EB, Solberg DK, Martinsen EW, Andreassen OA. Using motivational techniques to reduce cardiometabolic risk factors in long term psychiatric inpatients: a naturalistic interventional study. BMC Psychiatry 2018; 18:255. [PMID: 30111298 PMCID: PMC6094458 DOI: 10.1186/s12888-018-1832-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 07/30/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND People with severe mental illness have markedly reduced life expectancy; cardiometabolic disease is a major cause. Psychiatric hospital inpatients have elevated levels of cardiometabolic risk factors and are to a high degree dependent of the routines and facilities of the institutions. Studies of lifestyle interventions to reduce cardiometabolic risk in psychiatric inpatients are few. The current study aimed at assessing the feasibility and effects of a lifestyle intervention including Motivational Interviewing (MI) on physical activity levels, cardiometabolic risk status and mental health status in psychotic disorder inpatients. METHODS Prospective naturalistic intervention study of 83 patients at long term inpatient psychosis treatment wards in South-Eastern Norway. Patients were assessed 3-6 months prior to, at start and 6 months after a life-style intervention program including training of staff in MI, simple changes in routines and improvements of facilities for physical exercise. Assessments were done by clinical staff and included level of physical activity, motivation, life satisfaction, symptom levels (MADRS, AES-C, PANSS, and GAF) as well as anthropometric and biochemical markers of cardiometabolic risk. A mixed model was applied to analyze change over time. RESULTS A total of 88% of patients received MI interventions, with a mean of 2.5 MI interventions per week per patient. The physical activity level was not increased, but activity level was positively associated with motivation and negatively associated with positive symptoms. Triglyceride levels and number of smokers were significantly reduced and a significant decrease in symptom levels was observed. CONCLUSIONS The current results suggest that a simple, low cost life-style intervention program focusing on motivational change is feasible and may reduce symptoms and improve lifestyle habits in psychosis patients in long term treatment facilities. Similar programs may easily be implemented in other psychiatric hospitals. TRIAL REGISTRATION ClinicalTrials.gov . NCT03528278 , date of registration: 05/16/2018 (retrospectively registered).
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Affiliation(s)
- Petter Andreas Ringen
- Division of Mental Health and Addiction, Oslo University Hospital and NORMENT, KG Jebsen Centre, University of Oslo, Ullevål Hospital, P.O.Box 4956, 0424, Nydalen, Oslo, Norway.
| | - Ragnhild S. Falk
- 0000 0004 0389 8485grid.55325.34Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, P.O.Box 4950, 0424 Nydalen, Oslo Norway
| | - Bjørnar Antonsen
- 0000 0004 0627 3157grid.416137.6Department of Psychiatry, Lovisenberg Diaconal Hospital, P.O.Box 4970, 0440 Nydalen, Oslo Norway
| | - Ann Faerden
- Division of Mental Health and Addiction, Oslo University Hospital and NORMENT, KG Jebsen Centre, University of Oslo, Ullevål Hospital, P.O.Box 4956, 0424 Nydalen, Oslo Norway
| | - Asgeir Mamen
- grid.488488.0Kristiania University College, P.O.Box 1190, 0107 Sentrum, Oslo Norway
| | - Eline B. Rognli
- 0000 0004 0389 8485grid.55325.34Division of Mental Health and Addiction, Oslo University Hospital, Ullevål Hospital, P.O.Box 4956, 0424 Nydalen, Oslo Norway
| | - Dag K. Solberg
- 0000 0004 0512 8628grid.413684.cSkjelfoss Psychiatric Center, Lukas Foundation and Center for Psychopharmacology Diakonhjemmet Hospital, Postboks 23, 0319 Vinderen, Oslo Norway
| | - Egil W. Martinsen
- 0000 0004 0389 8485grid.55325.34Division of Mental Health and Addiction, Oslo University Hospital and University of Oslo, Ullevål Hospital, P.O.Box 4956, 0424 Nydalen, Oslo Norway
| | - Ole A. Andreassen
- NORMENT, KG Jebsen Centre, Oslo University Hospital, and University of Oslo, Ullevål Hospital, Building 49, P.O. Box 4956, 0424 Nydalen, Oslo Norway
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Paranjothy S, Copeland L, Merrett L, Grant A, Phillips R, Gobat N, Sanders J, Fitzsimmons D, Hunter B, Regan S, Playle R, Brown A, Tedstone S, Trickey H, Robling M. A novel peer-support intervention using motivational interviewing for breastfeeding maintenance: a UK feasibility study. Health Technol Assess 2018; 21:1-138. [PMID: 29265999 DOI: 10.3310/hta21770] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND In total, 81% of women in the UK start breastfeeding, but fewer than half continue beyond 6 weeks. Peer support in the early postnatal period may encourage women to breastfeed for longer. OBJECTIVE To develop a breastfeeding peer-support intervention based on motivational interviewing (MI) for breastfeeding maintenance and to test the feasibility of delivering it to mothers in areas with high levels of social deprivation. DESIGN Intervention development and a non-randomised multisite feasibility study. SETTING Community maternity services in three areas with high levels of social deprivation and low breastfeeding initiation rates in England and Wales. PARTICIPANTS Pregnant women considering breastfeeding. Women who did not plan to breastfeed, who had a clinical reason that precluded breastfeeding continuation or who were unable to consent were excluded. INTERVENTION The intervention Mam-Kind was informed by a survey of infant feeding co-ordinators, rapid literature review, focus groups with service users and peer supporters and interviews with health-care professionals and a Stakeholder Advisory Group. It consisted of face-to-face contact at 48 hours after birth and proactive one-to-one peer support from the Mam-Kind buddy for 2 weeks, followed by mother-led contact for a further 2-6 weeks. MAIN OUTCOME MEASURES Recruitment and retention of Mam-Kind buddies, uptake of Mam-Kind by participants, feasibility of delivering Mam-Kind as specified and of data collection methods, and acceptability of Mam-Kind to mothers, buddies and health-care professionals. RESULTS Nine buddies were recruited to deliver Mam-Kind to 70 participants (61% of eligible women who expressed an interest in taking part in the study). Participants were aged between 19 and 41 years and 94% of participants were white. Intervention uptake was 75% and did not vary according to age or parity. Most contacts (79%) were initiated by the buddy, demonstrating the intended proactive nature of the intervention and 73% (n = 51) of participants received a contact within 48 hours. Follow-up data were available for 78% of participants at 10 days and 64% at 8 weeks. Data collection methods were judged feasible and acceptable. Data completeness was > 80% for almost all variables. Interviews with participants, buddies and health service professionals showed that the intervention was acceptable. Buddies delivered the intervention content with fidelity (93% of intervention objectives were met), and, in some cases, developed certain MI skills to a competency level. However, they reported difficulties in changing from an information-giving role to a collaborative approach. These findings were used to refine the training and intervention specification to emphasise the focus of the intervention on providing mother-centric support. Health-care professionals were satisfied that the intervention could be integrated with existing services. CONCLUSIONS The Mam-Kind intervention was acceptable and feasible to deliver within NHS maternity services and should be tested for effectiveness in a multicentre randomised controlled trial. The feasibility study highlighted the need to strengthen strategies for birth notification and retention of participants, and provided some insights on how this could be achieved in a full trial. LIMITATIONS The response rate to the survey of infant feeding co-ordinators was low (19.5%). In addition, the women who were recruited may not be representative of the study sites. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
| | - Lauren Copeland
- Division of Population Medicine, Cardiff University, Cardiff, UK
| | - Laura Merrett
- Division of Population Medicine, Cardiff University, Cardiff, UK
| | - Aimee Grant
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | | | - Nina Gobat
- Division of Population Medicine, Cardiff University, Cardiff, UK
| | - Julia Sanders
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | | | - Billie Hunter
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | | | - Rebecca Playle
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Amy Brown
- Public Health, Policy and Social Sciences, Swansea University, Swansea, UK
| | - Sally Tedstone
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - Heather Trickey
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement, Cardiff University, Cardiff, UK
| | - Mike Robling
- Centre for Trials Research, Cardiff University, Cardiff, UK
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Raj V, Opie M, Arnold AC. Cognitive and psychological issues in postural tachycardia syndrome. Auton Neurosci 2018; 215:46-55. [PMID: 29628432 DOI: 10.1016/j.autneu.2018.03.004] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 03/23/2018] [Accepted: 03/23/2018] [Indexed: 11/18/2022]
Abstract
Postural tachycardia syndrome (POTS) is one of the most common forms of chronic orthostatic intolerance. In addition to orthostatic symptoms, many POTS patients report incapacitating cognitive dysfunction or "brain fog" even while lying down or seated. Consistent with these subjective reports, there is accruing objective evidence of specific cognitive difficulties in POTS, with studies showing mild to moderate cognitive impairment using standardized neuropsychological assessment batteries. The precise profile of cognitive dysfunction in POTS patients has been shown to vary among these studies potentially due to the neuropsychological tests used, postural position, comorbidities and length of illness, inclusion of adolescent versus adult patients, and sites of recruitment. The extent of the impact that this cognitive challenge has in patients justifies ongoing investigation and research into lifestyle and pharmacological treatments. Psychologically, patients face challenges congruent with many chronic illnesses, perhaps especially early in adjusting to the condition. POTS patients often exhibit mild to moderate depression symptoms as well as symptoms of anxiety disorders. Since even low levels of anxiety can exacerbate symptoms, and a high number of patients experience sub-clinical low mood and sleep disturbances, there is a likely role for psychotherapy in helping control adjustment-related issues, and possibly aberrant physiology, in POTS.
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Affiliation(s)
- Vidya Raj
- Department of Psychiatry, Cardiac Sciences, and Family Medicine, University of Calgary, 1213 4th Street SW, Calgary, Alberta T2R 0X7, Canada
| | - Morwenna Opie
- Department of Psychological Medicine, King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, United Kingdom
| | - Amy C Arnold
- Department of Neural and Behavioral Sciences, Penn State College of Medicine, 500 University Drive, Mail Code H109, Hershey, PA, USA.
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Jafar TH, Tan NC, Allen JC, Finkelstein EA, Goh P, Moey P, Quah JHM, Hwang SW, Bahadin J, Thiagarajah AG, Chan J, Kang G, Koong A. Management of hypertension and multiple risk factors to enhance cardiovascular health in Singapore: The SingHypertension cluster randomized trial. Trials 2018. [PMID: 29540213 PMCID: PMC5852962 DOI: 10.1186/s13063-018-2559-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background Hypertension is a serious public health problem in Singapore and is associated with significant morbidity and mortality from cardiovascular disease (CVD) with considerable implications for health-care resources. The goal of the trial is to compare a multicomponent intervention (MCI) to usual care to evaluate the effectiveness and cost-effectiveness of the MCI for lowering blood pressure (BP) among adults with uncontrolled hypertension in Singapore primary-care clinics. Methods/design The study is a cluster randomized trial in eight polyclinics in Singapore: four deliver a structured MCI and four deliver usual care. The components of the MCI are: (1) an algorithm-driven antihypertensive treatment for all hypertensive individuals using single-pill combination (SPC) and lipid-lowering medication for high-risk hypertensive individuals, (2) a motivational conversation for high-risk hypertensive individuals, (3) telephone-based follow-ups of all hypertensive individuals by polyclinic nurses, and (4) discounts on SPC antihypertensive medications. The trial will be conducted with 1000 individuals aged ≥ 40 years with uncontrolled hypertension (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg, based on the mean of the last two of three measurements) in eight polyclinics in Singapore. The primary outcome is change in systolic BP from baseline to follow-up at 24 months post-randomization. The incremental cost of MCI per CVD disability adjusted life years (DALY) averted and quality adjusted life years (QALY) saved will be computed. Discussion The demonstration of an effective and cost-effective hypertension control program that is implementable in busy polyclinics would provide compelling evidence for upscaling the program across all primary-care centers in Singapore, and possibly other regional countries with a similar health-care structure. Trial registration Clinicaltrials.gov, NCT02972619. Registered on 23 November 2016. Electronic supplementary material The online version of this article (10.1186/s13063-018-2559-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tazeen H Jafar
- Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore. .,Department of Renal Medicine, Singapore General Hospital, Singapore, Singapore. .,Duke Global Health Institute, Duke University, Durham, North Carolina, USA.
| | - Ngiap Chuan Tan
- SingHealth Polyclinics, Singapore, Singapore.,Health Services Research Centre, SingHealth, Singapore, Singapore
| | - John C Allen
- Centre for Quantitative Medicine, Office of Clinical Sciences, Duke-NUS Medical School, Singapore, Singapore
| | - Eric A Finkelstein
- Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Paul Goh
- SingHealth Polyclinics, Singapore, Singapore
| | - Peter Moey
- SingHealth Polyclinics, Singapore, Singapore
| | | | | | | | | | - Jason Chan
- SingHealth Polyclinics, Singapore, Singapore
| | - Gary Kang
- SingHealth Polyclinics, Singapore, Singapore
| | - Agnes Koong
- SingHealth Polyclinics, Singapore, Singapore
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Keukenkamp R, Merkx MJ, Busch-Westbroek TE, Bus SA. An Explorative Study on the Efficacy and Feasibility of the Use of Motivational Interviewing to Improve Footwear Adherence in Persons with Diabetes at High Risk for Foot Ulceration. J Am Podiatr Med Assoc 2018; 108:90-99. [PMID: 29111785 DOI: 10.7547/16-171] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND In this explorative study, we assessed the effect and feasibility of using motivational interviewing to improve footwear adherence in persons with diabetes who are at high risk for foot ulceration and show low adherence to wearing prescribed custom-made footwear. METHODS Thirteen individuals with diabetes, ulcer history, and low footwear adherence (ie, <80% of steps taken in prescription footwear) were randomly assigned to standard education (ie, verbal and written instructions) or to standard education plus two 45-min sessions of motivational interviewing. Adherence was objectively measured over 7 days using ankle- and shoe-worn sensors and was calculated as the percentage of total steps that prescribed footwear was worn. Adherence was assessed at home and away from home at baseline and 1 week and 3 months after the intervention. Feasibility was assessed for interviewer proficiency to apply motivational interviewing and for protocol executability. RESULTS Median (range) baseline, 1-week, and 3-month adherence at home was 49% (6%-63%), 84% (5%-98%), and 40% (4%-80%), respectively, in the motivational interviewing group and 35% (13%-64%), 33% (15%-55%), and 31% (3%-66%), respectively, in the standard education group. Baseline, 1-week, and 3-month adherence away from home was 91% (79%-100%), 97% (62%-99%) and 92% (86%-98%), respectively, in the motivational interviewing group and 78% (32%-97%), 91% (28%-98%), and 93% (57%-100%), respectively, in the standard education group. None of the differences were statistically significant. Interviewer proficiency was good, and the protocol could be successfully executed in the given time frame. CONCLUSIONS Footwear adherence at home increases 1 week after motivational interviewing to clinically relevant but not statistically significant levels (ie, 80%) but then returns over time to baseline levels. Away from home, adherence is already sufficient at baseline and remains so over time. The use of motivational interviewing seems feasible for the given purpose and patient group. These findings provide input to larger trials and provisionally suggest that additional or adjunctive therapy may be needed to better preserve adherence.
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Affiliation(s)
- Renske Keukenkamp
- Department of Rehabilitation, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Maarten J. Merkx
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; HSK Group B.V., Arnhem, The Netherlands
| | - Tessa E. Busch-Westbroek
- Department of Rehabilitation, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Sicco A. Bus
- Department of Rehabilitation, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
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Zandwijk P, van Koppen B, van Mameren H, Winkens B, de Bie R. Physical activity preferences of patients experiencing non-specific low back pain. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2017. [DOI: 10.1080/21679169.2017.1357753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Pim Zandwijk
- Centre for Physical Therapy, Papendrecht, The Netherlands
| | | | - Henk van Mameren
- Department of Epidemiology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Bjorn Winkens
- Department of Methodology and Statistics, Maastricht University/CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands
| | - Rob de Bie
- Department of Epidemiology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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40
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Eisenberg MH, Lipsky LM, Gee B, Liu A, Nansel TR. Parent healthful eating attitudes and motivation are prospectively associated with dietary quality among youth with type 1 diabetes. VULNERABLE CHILDREN AND YOUTH STUDIES 2017; 12:226-240. [PMID: 29861779 PMCID: PMC5978430 DOI: 10.1080/17450128.2017.1308045] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A family-based behavioral nutrition intervention grounded in Social Cognitive and Self-Determination Theories showed an increased intake of whole plant foods. This study examined 1) whether the intervention changed parent diet-related attitudes/beliefs, 2) whether these attitudes/beliefs were associated with youth diet quality, and 3) the moderating roles of youth age and parent nutritional knowledge. Youth with type 1 diabetes and their parents (n = 136, mean ± SD youth age = 12.6 ± 2.8 years) participated in an 18-month trial targeting intake of whole plant foods. Parents reported attitudes/beliefs (self-efficacy, outcome expectations, perceived barriers, autonomous and controlled motivation) for providing healthy food to their families, and type 1 diabetes-specific nutrition knowledge at 6, 12, and 18 months. Whole Plant Food Density (WPFD; cup or ounce equivalents per 1000 kcal of whole grains, fruit, vegetables, legumes, nuts and seeds) was calculated from 3-day youth food records. Linear mixed models estimated the intervention effect on parent attitudes/beliefs, associations of parent attitudes/beliefs with youth WPFD and the moderating roles of parent nutrition knowledge and youth age. There was no effect of the intervention on parent attitudes/beliefs. Across groups, higher parent self-efficacy and autonomous motivation were positively associated with youth WPF. Parent perceived barriers and negative outcome expectations were inversely associated with youth WPFD, especially when parents had higher nutrition knowledge. Youth age did not modify any associations. Parent diet-related attitudes/beliefs were associated with youth diet quality, highlighting the importance of parent psychosocial factors across this age range. Despite a positive effect on youth diet, the intervention did not affect parent attitudes/beliefs, suggesting it worked through a different mechanism.
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Affiliation(s)
- Miriam H. Eisenberg
- Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, M.D
| | - Leah M. Lipsky
- Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, M.D
| | - Benjamin Gee
- Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, M.D
| | - Aiyi Liu
- Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of child Health and Human Development, Bethesda, M.D
| | - Tonja R. Nansel
- Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, M.D
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Chisholm A, Nelson P, Pearce C, Littlewood A, Kane K, Henry A, Thorneloe R, Hamilton M, Lavallee J, Lunt M, Griffiths C, Cordingley L, Bundy C. Motivational interviewing-based training enhances clinicians’ skills and knowledge in psoriasis: findings from the Pso Well®
study. Br J Dermatol 2017; 176:677-686. [DOI: 10.1111/bjd.14837] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2016] [Indexed: 01/14/2023]
Affiliation(s)
- A. Chisholm
- Manchester Centre for Dermatology Research; University of Manchester; Manchester U.K
- Manchester Academic Health Science Centre; University of Manchester; Manchester U.K
- Manchester Centre for Health Psychology; University of Manchester; Manchester U.K
| | - P.A. Nelson
- Manchester Centre for Dermatology Research; University of Manchester; Manchester U.K
- Manchester Academic Health Science Centre; University of Manchester; Manchester U.K
| | - C.J. Pearce
- Manchester Centre for Dermatology Research; University of Manchester; Manchester U.K
- Manchester Academic Health Science Centre; University of Manchester; Manchester U.K
- Manchester Centre for Health Psychology; University of Manchester; Manchester U.K
| | - A.J. Littlewood
- Manchester Centre for Dermatology Research; University of Manchester; Manchester U.K
- Manchester Academic Health Science Centre; University of Manchester; Manchester U.K
| | - K. Kane
- Manchester Centre for Dermatology Research; University of Manchester; Manchester U.K
- Manchester Academic Health Science Centre; University of Manchester; Manchester U.K
| | - A.L. Henry
- Manchester Centre for Dermatology Research; University of Manchester; Manchester U.K
- Manchester Academic Health Science Centre; University of Manchester; Manchester U.K
- Manchester Centre for Health Psychology; University of Manchester; Manchester U.K
| | - R. Thorneloe
- Manchester Centre for Dermatology Research; University of Manchester; Manchester U.K
- Manchester Academic Health Science Centre; University of Manchester; Manchester U.K
- Manchester Centre for Health Psychology; University of Manchester; Manchester U.K
| | - M.P. Hamilton
- Manchester Academic Health Science Centre; University of Manchester; Manchester U.K
- Manchester Centre for Health Economics; University of Manchester; Manchester U.K
| | - J. Lavallee
- School of Nursing, Midwifery and Social Work; University of Manchester; Manchester U.K
| | - M. Lunt
- Manchester Academic Health Science Centre; University of Manchester; Manchester U.K
- Centre for Musculoskeletal Research; University of Manchester; Manchester U.K
| | - C.E.M. Griffiths
- Manchester Centre for Dermatology Research; University of Manchester; Manchester U.K
- Manchester Academic Health Science Centre; University of Manchester; Manchester U.K
- Salford Royal NHS Foundation Trust; Manchester U.K
| | - L. Cordingley
- Manchester Centre for Dermatology Research; University of Manchester; Manchester U.K
- Manchester Academic Health Science Centre; University of Manchester; Manchester U.K
- Manchester Centre for Health Psychology; University of Manchester; Manchester U.K
| | - C. Bundy
- Manchester Centre for Dermatology Research; University of Manchester; Manchester U.K
- Manchester Academic Health Science Centre; University of Manchester; Manchester U.K
- Manchester Centre for Health Psychology; University of Manchester; Manchester U.K
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Motivational Interviewing in the Reciprocal Engagement Model of Genetic Counseling: a Method Overview and Case Illustration. J Genet Couns 2016; 26:300-311. [DOI: 10.1007/s10897-016-0053-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 12/01/2016] [Indexed: 10/20/2022]
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Solvang PK, Fougner M. Professional roles in physiotherapy practice: Educating for self-management, relational matching, and coaching for everyday life. Physiother Theory Pract 2016; 32:591-602. [DOI: 10.1080/09593985.2016.1228018] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Per Koren Solvang
- Department of Physiotherapy, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Marit Fougner
- Department of Physiotherapy, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
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Lomba L, Kroll T, Apóstolo J, Gameiro M, Apóstolo J. The use of motivational interviews by nurses to promote health behaviors in adolescents: a scoping review protocol. ACTA ACUST UNITED AC 2016; 14:27-37. [PMID: 27532460 DOI: 10.11124/jbisrir-2016-002564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
REVIEW QUESTION/OBJECTIVE The objective of this scoping review is to examine and map the use of motivational interviews (MI) by nurses in their clinical practice with adolescents to promote health behaviors.More specifically, the review will focus on the following questions:What is the current nature and extent of use of nurse-led MI in the promotion of health behaviors in adolescents?Which adolescent populations (in terms of health status and adoption or not of health risk behaviors have been included in nurse-led MI with the aim of promoting health behaviors?What are the contexts in which nurses have used MI to promote health behaviors in adolescents?Which specific MI techniques and/or strategies have been used by nurses to promote health behaviors in adolescents?What outcomes on the promotion of health behaviors have been reported from nurse-led MI with adolescents? CENTER CONDUCTING THE REVIEW The Portugal Centre for Evidence-based Practice: a Collaborating Centre of the Joanna Briggs Institute.
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Affiliation(s)
- Lurdes Lomba
- 1Health Sciences Research Unit: Nursing, Nursing School of Coimbra; The Portugal Centre for Evidence-Based Practice: a Collaborating Centre of the Joanna Briggs Institute, Coimbra, Portugal 2Disability and Public Health Research, Social Dimensions of Health Institute (SDHI) of the Universities of Dundee and St Andrews, St Andrews, Scotland 3Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal
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Fontaine G, Cossette S, Heppell S, Boyer L, Mailhot T, Simard MJ, Tanguay JF. Evaluation of a Web-Based E-Learning Platform for Brief Motivational Interviewing by Nurses in Cardiovascular Care: A Pilot Study. J Med Internet Res 2016; 18:e224. [PMID: 27539960 PMCID: PMC5010651 DOI: 10.2196/jmir.6298] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 08/03/2016] [Accepted: 08/08/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Brief motivational interviewing (MI) can contribute to reductions in morbidity and mortality related to coronary artery disease, through health behavior change. Brief MI, unlike more intensive interventions, was proposed to meet the needs of clinicians with little spare time. While the provision of face-to-face brief MI training on a large scale is complicated, Web-based e-learning is promising because of the flexibility it offers. OBJECTIVE The primary objective of this pilot study was to examine the feasibility and acceptability of a Web-based e-learning platform for brief MI (MOTIV@CŒUR), which was evaluated by nurses in cardiovascular care. The secondary objective was to assess the preliminary effect of the training on nurses' perceived brief MI skills and self-reported clinical use of brief MI. METHODS We conducted a single-group, pre-post pilot study involving nurses working in a coronary care unit to evaluate MOTIV@CŒUR, which is a Web-based e-learning platform for brief MI, consisting of two sessions lasting 30 and 20 minutes. MOTIV@CŒUR covers 4 real-life clinical situations through role-modeling videos showing nurse-client interactions. A brief introduction to MI is followed by role playing, during which a nurse practitioner evaluates clients' motivation to change and intervenes according to the principles of brief MI. The clinical situations target smoking, medication adherence, physical activity, and diet. Nurses were asked to complete both Web-based training sessions asynchronously within 20 days, which allowed assessment of the feasibility of the intervention. Data regarding acceptability and preliminary effects (perceived skills in brief MI, and self-reported clinical use of conviction and confidence interventions) were self-assessed through Web-based questionnaires 30 days (±5 days) after the first session. RESULTS We enrolled 27 women and 4 men (mean age 37, SD 9 years) in March 2016. Of the 31 participants, 24 (77%, 95% CI 63%-91%) completed both sessions in ≤20 days. At 30 days, 28 of the 31 participants (90%) had completed at least one session. The training was rated as highly acceptable, with the highest scores observed for information quality (mean 6.26, SD 0.60; scale 0-7), perceived ease of use (mean 6.16, SD 0.78; scale 0-7), and system quality (mean 6.15, SD 0.58; scale 0-7). Posttraining scores for self-reported clinical use of confidence interventions were higher than pretraining scores (mean 34.72, SD 6.29 vs mean 31.48, SD 6.75, respectively; P=.03; scale 10-50). Other results were nonsignificant. CONCLUSIONS Brief MI training using a Web-based e-learning platform including role-modeling videos is both feasible and acceptable according to cardiovascular care nurses. Further research is required to evaluate the e-learning platform in a randomized controlled trial. TRIAL REGISTRATION International Standard Randomized Controlled Trial Number (ISRCTN): 16510888; http://www.isrctn.com/ISRCTN16510888 (Archived by WebCite at http://www.webcitation.org/6jf7dr7bx).
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Rash JA, Lavoie KL, Sigal RJ, Campbell DJT, Manns BJ, Tonelli M, Campbell TS. The OPTIMIZE trial: Rationale and design of a randomized controlled trial of motivational enhancement therapy to improve adherence to statin medication. Contemp Clin Trials 2016; 49:47-56. [PMID: 27282119 DOI: 10.1016/j.cct.2016.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 05/30/2016] [Accepted: 06/04/2016] [Indexed: 12/23/2022]
Abstract
BACKGROUND Statins are a class of medications that are particularly effective for lowering cholesterol and reducing cardiovascular morbidity and mortality. Despite a range of benefits, non-adherence to statin medication is prevalent with 50% to 75% of patients failing to adhere to treatment within the first 2-years. A previous review on interventions to improve adherence to cholesterol lowering medication concluded that rigorous trials were needed with emphasis on the patient's perspective and shared decision making. Motivational interviewing (MInt) is a promising patient-centered approach for improving adherence in patients with chronic diseases. This manuscript describes the rational and design of a randomized controlled trial (RCT) testing the efficacy of MInt in improving adherence to statin medication. METHODS Patients filling their first statin prescription will be recruited to complete a 6-month observation run-in period (phase-1) after which medication possession ratio (MPR) will be assessed. Patients meeting criteria for non-adherence (MPR≤60%) will be invited to participate in the trial. 336 non-adherent new statin users will undergo a fasting lipid panel, complete baseline questionnaires, and be randomly allocated to receive four sessions of adherence education delivered using MInt (EdMInt) or to an education control (EC) delivered at 3-month intervals. Final assessments will occur 12-months after the first EdMInt or EC session. The primary outcome is change in MPR adherence to statin medication from baseline to 12-months. Secondary outcomes include within-patient change in self-reported medication adherence, stage of change and self-efficacy for medication adherence, motivation to adhere to statin medication, and lipid profile.
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Affiliation(s)
- Joshua A Rash
- Department of Psychology, University of Calgary, 2500 University Drive N.W., Calgary, AB, Canada
| | - Kim L Lavoie
- Department of Psychology, University of Quebec at Montreal (UQAM), CP 8888, Succursale Centre-Ville, Montreal, QC, H3C 3P8, Canada; Montreal Behavioral Medicine Centre (MBMC), Research Centre, Hopital du Sacre-Coeur de Montreal, 5400 Gouin Blvd West, J-3145, Montreal, QC, H2J 1C5, Canada
| | - Ronald J Sigal
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - David J T Campbell
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Braden J Manns
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Marcello Tonelli
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Tavis S Campbell
- Department of Psychology, University of Calgary, 2500 University Drive N.W., Calgary, AB, Canada.
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Hardcastle SJ, Fortier M, Blake N, Hagger MS. Identifying content-based and relational techniques to change behaviour in motivational interviewing. Health Psychol Rev 2016; 11:1-16. [DOI: 10.1080/17437199.2016.1190659] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Sarah J. Hardcastle
- Health Psychology and Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Curtin University, Perth, Australia
| | | | - Nicola Blake
- Health Improvement, Public Health, East Sussex County Council, Lewes, East Sussex, UK
| | - Martin S. Hagger
- Health Psychology and Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Curtin University, Perth, Australia
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Schwartz J, Evers AWM, Bundy C, Kimball AB. Getting under the Skin: Report from the International Psoriasis Council Workshop on the Role of Stress in Psoriasis. Front Psychol 2016; 7:87. [PMID: 26869982 PMCID: PMC4735345 DOI: 10.3389/fpsyg.2016.00087] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 01/15/2016] [Indexed: 01/10/2023] Open
Abstract
Psoriasis is a chronic inflammatory skin condition with significant physical and psychosocial comorbidity. A workshop of leading experts in dermatology and psychology with the purpose of better understanding the current role of psychological comorbidities in psoriasis was held by the International Psoriasis Council in November 2013. The role of stress reactivity with a focus on the hypothalamic-pituitary-adrenal axis was emphasized. While cognitive behavioral therapy remains the most extensively studied and successful treatment strategy in patients with psoriasis and various psychological comorbidities, new and innovative interventions such as online-based therapies have recently emerged. Strategies and recommendations toward approaching psychological comorbidities are discussed.
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Affiliation(s)
- Julia Schwartz
- Department of Dermatology, George Washington University Washington, DC, USA
| | - Andrea W M Evers
- Department of Health, Medical, and Neuropsychology, Leiden UniversityLeiden, Netherlands; Department of Medical Psychology, Radboud University Medical CenterNijmegen, Netherlands
| | - Christine Bundy
- Centre for Dermatology Research, University of Manchester and Manchester Academic Health Sciences Centre Manchester, UK
| | - Alexandra B Kimball
- Department of Dermatology, George Washington UniversityWashington, DC, USA; Harvard Medical SchoolBoston, MA, USA
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Christie D, Thompson R, Sawtell M, Allen E, Cairns J, Smith F, Jamieson E, Hargreaves K, Ingold A, Brooks L, Wiggins M, Oliver S, Jones R, Elbourne D, Santos A, Wong ICK, O'Neil S, Strange V, Hindmarsh P, Annan F, Viner RM. Effectiveness of a structured educational intervention using psychological delivery methods in children and adolescents with poorly controlled type 1 diabetes: a cluster-randomized controlled trial of the CASCADE intervention. BMJ Open Diabetes Res Care 2016; 4:e000165. [PMID: 27284455 PMCID: PMC4893872 DOI: 10.1136/bmjdrc-2015-000165] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 01/04/2016] [Accepted: 01/13/2016] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Type 1 diabetes (T1D) in children and adolescents is increasing worldwide with a particular increase in children <5 years. Fewer than 1 in 6 children and adolescents achieve recommended glycated hemoglobin (HbA1c) values. METHODS A pragmatic, cluster-randomized controlled trial assessed the efficacy of a clinic-based structured educational group incorporating psychological approaches to improve long-term glycemic control, quality of life and psychosocial functioning in children and adolescents with T1D. 28 pediatric diabetes services were randomized to deliver the intervention or standard care. 362 children (8-16 years) with HbA1c≥8.5% were recruited. Outcomes were HbA1c at 12 and 24 months, hypoglycemia, admissions, self-management skills, intervention compliance, emotional and behavioral adjustment, and quality of life. A process evaluation collected data from key stakeholder groups in order to evaluate the feasibility of delivering the intervention. RESULTS 298/362 patients (82.3%) provided HbA1c at 12 months and 284/362 (78.5%) at 24 months. The intervention did not improve HbA1c at 12 months (intervention effect 0.11, 95% CI -0.28 to 0.50, p=0.584), or 24 months (intervention effect 0.03, 95% CI -0.36 to 0.41, p=0.891). There were no significant changes in remaining outcomes. 96/180 (53%) families in the intervention arm attended at least 1 module. The number of modules attended did not affect outcome. Reasons for low uptake included difficulties organizing groups and work and school commitments. Those with highest HbA1cs were less likely to attend. Mean cost of the intervention was £683 per child. CONCLUSIONS Significant challenges in the delivery of a structured education intervention using psychological techniques to enhance engagement and behavior change delivered by diabetes nurses and dietitians in routine clinical practice were found. The intervention did not improve HbA1c in children and adolescents with poor control. TRIAL REGISTRATION NUMBER ISRCTN52537669, results.
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Affiliation(s)
- Deborah Christie
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Rebecca Thompson
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Mary Sawtell
- Social Sciences Research Unit, Institute of Education, London, UK
| | | | - John Cairns
- London School of Hygiene and Tropical Medicine, London, UK
| | | | | | | | - Anne Ingold
- Social Sciences Research Unit, Institute of Education, London, UK
| | - Lucy Brooks
- London School of Hygiene and Tropical Medicine, London, UK
| | - Meg Wiggins
- Social Sciences Research Unit, Institute of Education, London, UK
| | - Sandy Oliver
- Social Sciences Research Unit, Institute of Education, London, UK
| | - Rebecca Jones
- London School of Hygiene and Tropical Medicine, London, UK
| | - Diana Elbourne
- London School of Hygiene and Tropical Medicine, London, UK
| | - Andreia Santos
- London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Vicki Strange
- Social Sciences Research Unit, Institute of Education, London, UK
| | - Peter Hindmarsh
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Francesca Annan
- Royal Liverpool Children's Hospital NHS Trust, Liverpool, UK
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McKenzie KJ, Pierce D, Gunn JM. A systematic review of motivational interviewing in healthcare: the potential of motivational interviewing to address the lifestyle factors relevant to multimorbidity. JOURNAL OF COMORBIDITY 2015; 5:162-174. [PMID: 29090164 PMCID: PMC5636036 DOI: 10.15256/joc.2015.5.55] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 12/08/2015] [Indexed: 01/08/2023]
Abstract
Internationally, health systems face an increasing demand for services from people living with multimorbidity. Multimorbidity is often associated with high levels of treatment burden. Targeting lifestyle factors that impact across multiple conditions may promote quality of life and better health outcomes for people with multimorbidity. Motivational interviewing (MI) has been studied as one approach to supporting lifestyle behaviour change. A systematic review was conducted to assess the effectiveness of MI in healthcare settings and to consider its relevance for multimorbidity. Twelve meta-analyses pertinent to multimorbidity lifestyle factors were identified. As an intervention, MI has been found to have a small-to-medium statistically significant effect across a wide variety of single diseases and for a range of behavioural outcomes. This review highlights the need for specific research into the application of MI to determine if the benefits of MI seen with single diseases are also present in the context of multimorbidity.
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Affiliation(s)
- Kylie J. McKenzie
- Psychology Department, Ballarat Health Services and Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
| | - David Pierce
- Rural Health Academic Centre, University of Melbourne, Ballarat, Victoria, Australia
| | - Jane M. Gunn
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
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