Motivational interviewing to improve the self-care behaviors for patients with chronic heart failure: A randomized controlled trial

Objectives:This study aimed to investigate the effect of motivational interviewing on the self-care behaviours in patients with chronic heart failure.Methods:Sixty-two hospitalized patients with chronic heart failure were recruited in this study from April 2014 to April 2015 from a hospital.Twenty-nine patients were in the intervention group,and 33 patients were in the control group.Patients in the intervention group received four sessions of motivational interviewing,whereas those in the control group received traditional health education.At 2,4,and 8 weeks post-discharge,the intervention group underwent telephone follow-up based on motivational interviewing,whereas the control group underwent routine telephone follow-up.Primary outcome was measured using the Self-care of Heart Failure Index at baseline and at 2 months postdischarge.Results:Before intervention,the self-care behaviours scores were 79.00±48.80 in the intervention group and 88.68±29.26in the control group.No statistically significant differences were found between two groups in scores for each subscale and total scale(P>0.05).After intervention,the scores of self-care behaviours in the two groups were both improved at 155.13±35.65 for the intervention group and 115.44±22.82 for the control group with statistically significance(P<0.01).The score of self-care behaviours increased by 76.13 point in the intervention group on average,whereas 26.76 point in the control group.There was significant difference between increases in scores of self-care behaviours in two groups(P<0.01).Conclusions:The self-care behaviours of patients with chronic heart failure could be improved effectively through motivational interviewing.

Impact of motivational interviewing on the quality of life and its related factors in type 2 diabetes mellitus patients with poor long-term glycemic control

Purpose:The aim of this study was to evaluate the impact of motivational interviewing(MI)on the quality of life and its related factors in type 2 diabetes mellitus(T2DM)patients with poor long-term glycemic control.Design and methods:One hundred tenT2DMpatientswithpoor long-termglycemic control that were hospitalized in our institution were enrolled in this study and randomly assigned to receive eitherMI or routine diabetes education intervention.Patients'body mass index values,Homeostatic Model Assessment-Insulin Resistance(HOMA-IR)scores,and levels of glycated hemoglobin(HbA1C),triglycerides,high-and low-density lipoproteincholesterols,Summary of Diabetes Self-management Activities and Diabetes Specific Quality of Life assessments were recorded before and six months after intervention.Results:Baseline scores for all measurements did not differ between patients in the control and MI groups.Although MI resulted in a significant reduction of HbA1c and serum lipid levels compared with the baseline,the effect was not significantly different from the control intervention.However,the improvement in HOMA-IR scores was significantly greater in the MI group compared with the control intervention(2.8±2.8 vs.5.7±4.7;p=0.000).Moreover,MI significantly elevated diabetes self-management activities ratings compared with the control intervention(13.2±3.4 vs.10.9±4.3;p=0.004).Conclusion:Compared to routine diabetes education,MI is a more effective approach for improving HOMA-IR and self-management of T2DM patients with poor long-term glycemic control.

Effect of motivational interviewing on selfmanagement in patients with type 2 diabetes mellitus: A meta-analysis

Objective:The objective of this meta-analysis was to evaluate the effect of motivational interviewing(MI)on self-management in patients with type 2 diabetes.Methods:Randomised controlled trials that assessed the effects of MI on self-management and HbA1c levels in patients with type 2 diabetes were systematically reviewed using multiple electronic databases.Weighted mean differences with 95%confidence intervals were calculated for continuous data.Results:Ten trials were included in this meta-analysis.The self-management ability of patients with type 2 diabetes who underwent MI was significantly better than that of patients in the control group(WMD,2.37;95%CI,1.77e2.98;p<0.00001).Subgroup analysis showed that short-term MI(
6 months)resulted in a significant decrease in the HbA1c level(p<0.05)but that this advantage was not present for relatively long-term MI(>6 months)(p>0.05).Conclusions:MI was associated with improved self-management abilities among patients with type 2 diabetes,and short-term MI(
6 months)effectively decreased the HbA1c level.The effect of long-term MI(>6 months)on the HbA1c level remains uncertain.Large-scale,higher-quality randomised controlled trials are needed to confirm the present findings.

Effect of motivational interviewing on postoperative weight control in patients with obstructive sleep apnea-hypopnea syndrome

BACKGROUND Obesity is an important factor to cause the obstructive sleep apnea-hypopnea syndrome(OSAHS).Higher body mass index(BMI)often results in more severe OSAHS.Currently,the common measures for controlling the weight mainly include diet control,increase exercise and so on.Motivational interviewing(MI)could explore the patient’s internal state and make the patient realize his/her ambivalence,resulting in the change in his/her behavior.This process emphasizes respecting the patient’s autonomy.AIM To evaluate the effect of MI on the weight control of patients with OSAHS.METHODS A randomized controlled study was conducted in 100 obese OSAHS patients undergoing surgical treatment at Shengjing Hospital of China Medical University.The patients were divided into an intervention group and a control group,with 50 cases each.The control group was given routine health education after the operation;in addition to the regular health education,the intervention group was given MI according to a predetermined plan.Obesity-related indicators,postoperative complications,and the sleep status of both groups were evaluated before and 6 mo after the intervention.RESULTS Patients in the intervention group had significantly improved body weight,BMI,and waist and neck circumferences compared with patients in the control group(P<0.05).Regarding complications at 6 mo after operation,the incidence of cough and reflux in patients in the intervention group was significantly lower than that in the control group(P<0.05).In addition,the Epworth Sleepiness Scale and Self-Rating Scale of Sleep scores of patients in the intervention group were significantly lower than those in the control group,and the sleep status of patients in the intervention group was improved(P<0.05).CONCLUSION MI intervention has a significant advantage over postoperative routine health education.It can greatly change the lifestyle,further control the postoperative weight,reduce the occurrence of complications,improve the quality of sleep,and improve long-term postoperative efficacy in OSAHS patients.

Motivational interviewing and its application in the management of coronary heart disease

Objective:This review paper explores the concept,spirit,principles,and core skills of moti-vational interviewing(MI)as a psychological approach applied to CHD patients.Methods:Literature reviews based on English and Chinese articles.Results:The English and Chinese literature provided strong evidence for the effectiveness of MI in terms of behavior changes,blood pressure control,hyperglycemia and hyperlipidemia control,compliance improvement,and improving quality of life amongst chronic heart failure patients.The Happy Life Club(HLC)is the only randomized controlled trial(RCT)that examined the effects of MI on behavior changes and self-management improvements in Chinese patients with type 2 diabetes mellitus.The HLC pilot revealed positive outcomes,and RCTs will provide further evidence.Conclusion:MI has been expanded in its application to a wider range of lifestyle-related chronic diseases,including CHD.At the time of this review,MI represents a new concept and ap-proach in China for improving physical and mental health(body and mind)in patients with CHD.In order to integrate MI into medical practice,the authors suggest improving the medical education curriculum and strengthening vocational training,while conducting further research initiatives to assess the innovation and inform practice management.

Medical consultation in ulcerative colitis:Key elements for improvement

Ulcerative colitis(UC)is a chronic inflammatory disease with a high impact.In order to improve patient outcomes,the clinician-patient relationship in daily practice is critical.Clinical guidelines provide a framework for UC diagnosis and treatment.However,standard procedures and the medical content focused upon medical consultations in UC patients has not yet been defined.Moreover,UC is a complex disease,given that patient characteristics and patient needs have been proven to vary during clinical consultation since establishing the diagnosis and upon the course of the disease.In this article,we have discussed the key elements and specific objectives to consider in medical consultation,such as diagnosis,first visits,follow-up visits,active disease patients,patients on topical therapies,new treatment initiation,refractory patients,extra-intestinal manifestations,as well as challenging situations.The key elements have been mentioned to comprise effective communication techniques,motivational interviewing(MI),as well as information and educational aspects,or organizational issues.The key elements to be implemented in daily practice were reported to comprise several general principles like duly prepared consultations,in addition to honesty and empathy with patients,as well as effective communication techniques,MI,information and educational points,or organizational issues.The role of other healthcare professionals such as specialized nurses,psychologists,or the use of checklists was also discussed and commented on.

<i>Partenariat Santé</i>: Results of a Community Program to Improve the Cardiovascular Health among Adult Population

Partenariat Santé (PS) launched in Québec in 2016, is inspired from the Cardiovascular Health Awareness Program (CHAP) and consists of a free session held in the community by students coming from different health sciences programs. The program’s mission is to make available early detection of modifiable CVD risk factors, raise awareness of participants about their impact on CVDs, and promote healthy life changes. In order to gather information to optimize the implementation of this program and eventually to enlarge its implementation to other sites, the first objective of this study was to explore the characteristics of the adult population participating in the PS program and to identify the risk factors they want to modify. The second objective was to evaluate one month later the effective implementation of the action plan elaborated during the motivational interview. The third objective was to evaluate the satisfaction of the participants with the PS program. One hundred ten subjects who attended PS sessions during this period were enrolled in the study. About 30% of participants have blood pressure values ≥ 140/90 mmHg and 40% present a waist circumference associated with higher risk profile. The behaviors to be changed mostly targeted by the participants were physical inactivity and nutrition. A motivational interview was conducted with the elaboration of an action plan to support the behavioral/outcomes changes. Sixty participants (54.5%) completed the questionnaire in the one-month follow-up. Forty-one (68.3%) participants revealed that they had put their action plans into practice, while 63.3% claimed that they mostly reached their objectives. Motivation remains high after one month for participants who put their action plans in place (7.8 ± 1.9 versus 7.4 ± 1.6;p = 0.214), whereas it decreased significantly for those who did not (6.8 ± 2.1 versus 5.8 ± 2.0;p = 0.029). The majority of them agreed that PS program was useful (75%) and led them to change their lifestyle related to cardiovascular health (62%). In conclusion, our results suggest that the PS program can produce benefits on the promotion of cardiovascular health in the community adult population, being evaluated as useful to change the lifestyle related to CVD risk.