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District nurses' and registered nurses' training in and use of motivational interviewing in primary care settings
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Akademin för hälsa och arbetsliv, Avd. för hälso- och vårdvetenskap, Högskolan i Gävle. (Vårdvetenskap)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. (Vårdvetenskap)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Akademin för hälsa och arbetsliv, Avd. för hälso- och vårdvetenskap, Högskolan i Gävle. (Vårdvetenskap)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Akademin för hälsa och arbetsliv, Avd. för hälso- och vårdvetenskap, Högskolan i Gävle. (Vårdvetenskap)
2014 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, no 15-16, 2284-2294 p.Article in journal (Refereed) Published
Abstract [en]

Aims and objectives

To examine to what extent district nurses and registered nurses have training in motivational interviewing, to what extent they use it and what prerequisites they have for using it; to compare district nurses and registered nurses, as well as to compare users and nonusers of motivational interviewing; and to examine possible relationships between use of motivational interviewing and the variables training, supervision and feedback in motivational interviewing and prerequisites for use.

Background

Motivational interviewing is an effective method for motivating patients to change their lifestyle, used increasingly in primary care. 

Design

A cross-sectional survey study. 

Methods

A study-specific questionnaire was sent to all district nurses and registered nurses (n = 980) in primary care in three counties in Sweden, from September 2011-January 2012; 673 (69%) responded. Differences between groups as well as relationships between study variables were tested. 

Results

According to self-reports, 59% of the respondents had training in motivational interviewing and 57% used it. Approximately 15% of those who reported using it had no specific training in the method. More district nurses than registered nurses had training in motivational interviewing and used it. The following factors were independently associated with the use of motivational interviewing: training in and knowledge of motivational interviewing, conditions for using it, time and absence of 'other' obstacles. 

Conclusions

Having knowledge in motivational interviewing and personal as well as workplace prerequisites for using it may promote increased use of motivational interviewing.

 Relevance to clinical practice

Having the prerequisites for using motivational interviewing at the workplace is of significance to the use of motivational interviewing. In the context of primary care, district nurses seem to have better prerequisites than registered nurses for using motivational interviewing.

Place, publisher, year, edition, pages
2014. Vol. 23, no 15-16, 2284-2294 p.
Keyword [en]
education, health promotion, motivational interviewing, nurses, primary health care, training
National Category
Nursing
Research subject
Caring Sciences
Identifiers
URN: urn:nbn:se:uu:diva-211414DOI: 10.1111/jocn.12509ISI: 000339431800022PubMedID: 24372665OAI: oai:DiVA.org:uu-211414DiVA: diva2:666602
Available from: 2013-11-22 Created: 2013-11-22 Last updated: 2017-12-06Bibliographically approved
In thesis
1. Motivational Interviewing in Primary Care: Nurses´ experiences and actual use of the method
Open this publication in new window or tab >>Motivational Interviewing in Primary Care: Nurses´ experiences and actual use of the method
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The overall aim of the present thesis was to describe and examine primary care nurses´ self-reports on training, use and performance as well as experiences and actual performance of MI.

Method: One qualitative and three quantitative studies were conducted among primary care nurses. A study-specific questionnaire was sent to 980 primary care nurses and 673 (69%) responded (Study I). Semi-structured interviews were conducted with 20 MI trained primary care nurses (Study II). MI sessions between 12 (Study III) respective 23 (Study IV) primary care nurses and patients (total 32 respective 50 sessions) were audio-recorded. Data were analyzed using qualitative content analysis, Motivational Interviewing Integrity Code, Motivational Interviewing Sequential Code for Observing Process Exchanges and statistical analysis.

Results: The findings showed that primary care nurses reported and experienced lack of training in MI and lack of prerequisites for using MI (Study I-II), while training, knowledge, prerequisites and time were associated with use of MI. They also reported and experienced that MI facilitated their work with patients (Study I-II) as well as elicited their own ability to motivate and be empathetic (Study II). About half of the primary care nurses reported that they used MI (Study I), and none of the nurses (Study III) achieved the approved skill levels in MI in their recorded sessions. They overestimated their performance on six of eight aspects of MI (Study III). The most frequently used nurse talk in the recorded sessions was neutral, which is not consistent with MI. Questions and reflections directed toward change were most likely to be followed by change talk among patients (Study IV).

Conclusions: Self-reported knowledge about MI and personal as well as workplace prerequisites for using it were associated with self-reported use of MI. Participating nurses´ experienced that MI requires openness, practice, support, feedback and willingness. The participating primary care nurses did not achieve approved levels of MI skills in their recorded MI sessions. Patients´ change talk is more likely to occur after open questions, complex reflections as well as after questions and reflections directed toward change.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2015. 82 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1142
Keyword
communication, experiences, health promotion, motivational interviewing, nurses, performance, primary care, talk, training, use
National Category
Nursing
Research subject
Caring Sciences
Identifiers
urn:nbn:se:uu:diva-264259 (URN)978-91-554-9365-3 (ISBN)
Public defence
2015-11-25, Sal IX, Universitetshuset, Biskopsgatan 3, Uppsala, 13:00 (Swedish)
Opponent
Supervisors
Note

Finansisärer: Högskolan i Gävle, STROKE-Riksförbundet, Hjärt-lung fonden och Erik, Karin and Gösta Selander Stiftelse

Available from: 2015-11-04 Created: 2015-10-08 Last updated: 2015-11-10

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Östlund, Ann-SofiWadensten, BarbroHäggström, ElisabethKristofferzon, Marja-Leena

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