初级卫生保健专业人员实施动机谈话干预的过程分析--快乐生活俱乐部^TM项目成果报告

Process Analysis of Motivational Interviewing Intervention by Primary Health Care Setting Staffs in China——The Happy Life Club^(TM)

背景动机谈话(MI)是一种国际上广泛应用的心理学技术,它能够有效地帮助人们做出行为改变。该技术在国内的研究刚刚起步,尚缺乏对其在中国应用的实用性及效果分析。目的本研究旨在对中国初级卫生保健专业人员应用动机谈话实施干预的过程进行探讨,从而帮助研究者和社区健康工作者更好地理解动机谈话的干预过程。方法研究样本取自快乐生活俱乐部TM研究项目中健康教练提供的动机谈话录音资料,利用动机谈话序贯编码手册(MI-SCOPE)对51段健康教练的动机谈话干预录音进行编码,采用GSEQ 5.1软件对录音编码进行分析,包括对其频率、转移概率进行描述以及序贯分析。结果健康教练忠实于动机谈话精神的话语、简单反应、复杂反应,对患者行为改变的语言有促进作用;而不忠实于动机谈话精神的话语、封闭式提问、复杂反应,会使患者表达出更多维持现有行为的话语,可能不利于其发生行为改变。结论虽然健康教练在接受短期培训后并未完全掌握动机谈话技术,但忠实于动机谈话精神的话语仍可能易于促使患者发生行为改变。

Background Motivational interviewing（ MI） is an effective psychological strategy for behavior change while research in this field has just being highlighted in China. And there is still lack of practicability and effect analysis of its application at present. Objective This study was designed to explore and analyze the process of implementation of MI in primary health care setting in China, which can help future researcher and primary health care setting staffs to better understand of MI. Methods The audio sample are tape- recorded of health coaches＇ intervention process from Happy Life Club research project. MI- SCOPE is used to code the 51 audio samples This study will use GSEQ 5. 1 software to do the sequential analyses for the coded transcripts,as well as to describe the frequency of its transition probabilities. Results MICO,SR,CR can promote the change talk of patients,and the counter change talk are more likely following the MIIN,CQ and CR. Conclusion In this study,the health coaches did not fully master MI skills,but the MICO might lead to behaviour change.