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  • 751.
    Åsenlöf, Pernilla
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Denison, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Lindberg, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Idiographic outcome analyses of the clinical significance of two interventions for patients with musculoskeletal pain2006In: Behaviour Research and Therapy, ISSN 0005-7967, E-ISSN 1873-622X, Vol. 44, no 7, p. 947-965Article in journal (Refereed)
    Abstract [en]

    This study adopted a perspective of the individual to define domains of everyday life for the analysis of clinically meaningful change. The purpose was to compare the clinical significance of two interventions for patients with musculoskeletal pain, applying an idiographic outcome measure, The Patient Goal Priority Questionnaire, in combination with the Jacobson and Truax methodology [(1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 67 (3), 300–307] for determination of clinical significance. The concurrent validity of the outcome variables behavioral performance, satisfaction with behavioral performance, and fulfilled pre-treatment expectations was also studied. Eighty-two patients, randomized to either individually tailored behavioral medicine treatment (experimental group) or physical exercise therapy (control group) were evaluated at baseline and 3 months post-treatment regarding behavioral treatment goals. The experimental intervention had high impact on participants’ performance of their highest ranked everyday life activities, and resulted in larger proportions of clinically significant outcomes compared with controls. The concurrent validity of the outcomes was high for those reporting clinically significant changes, but more generally, there was a moderate agreement across outcome categories. The individual should be the unit for analyses of clinical significance to enhance the ecological validity of the construct. Further development of idiographic outcome measures is necessary, as is the inclusion in pain intervention research.

  • 752.
    Åsenlöf, Pernilla
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Denison, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Lindberg, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Individually tailored treatment targeting activity, motor behavior, and cognitions reduces pain-related disability: a randomized controlled trial in patients with musculoskeletal pain2005In: Pain forum, ISSN 1082-3174, The Journal of Pain, Vol. 6, no 9, p. 588-603Article in journal (Refereed)
    Abstract [en]

    This study compares the outcomes of an individually tailored behavioral medicine intervention (experimental) with physical exercise therapy (control). The experimental intervention was systematically individualized according to each participant’s behavioral treatment goals and functional behavioral analyses. One hundred twenty-two patients seeking care at 3 primary health care clinics because of musculoskeletal pain were randomized. Ninety-seven completed the trial. Data were collected at baseline, immediately after treatment, and at a 3-month follow-up. Analyses of data from completers, as well as intention-to-treat analyses, showed that the experimental group experienced lower levels of disability (P = .01), lower maximum pain intensity (P = .02), higher levels of pain control (P = .001), and lower fear of movement (P = .022) as a result of treatment condition. Self-efficacy (P = .0001) and physical performance (P = .0001) increased over time for both groups. Participants in the experimental group generally reported more positive effects after treatment. Treatment fidelity was maintained during the course of the study. Activity can be resumed and pain might be managed by the patients themselves if treatment incorporates the biopsychosocial explanatory model of pain and strategies are tailored according to individual’s priorities of everyday life activities and empirically derived determinants of pain-related disability.

  • 753.
    Åsenlöf, Pernilla
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Denison, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Lindberg, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Individually tailored treatment targeting motor behavior, cognitions, and disability: Two experimental single case studies of patients with recurrent and persistent pain in primary health care2005In: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 85, no 10, p. 1061-1077Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND PURPOSE:

    This article introduces an individually tailored intervention targeting motor behavior, cognition, and disability in patients managed by physical therapists in primary health care. Effects on self-rated disability, pain intensity, and pain control are described.

    SUBJECTS:

    Two women with recurrent or persistent disabling musculoskeletal pain were selected.

    METHODS:

    Two experimental single-subject A(1)-B-C-A(2) studies with multiple baselines across situations were used. Principal outcome data were collected daily with patient-specific continuous measures for 3 weeks before intervention, continuously during intervention, and for 2 weeks during each of the 1-, 4-, 6-, and 12-month follow-up examinations.

    RESULTS:

    Disability and pain intensity decreased, and pain control increased in both subjects. The results were maintained at the follow-up examinations.

    DISCUSSION AND CONCLUSION:

    Positive outcomes of the intervention were reported from 2 subjects with recurrent and persistent disabling pain. Procedures for systematic tailoring of treatment to behavioral goals and individual patient characteristics are available as a result of the successful application. The results need to be replicated in future clinical controlled group studies.

  • 754.
    Östlund, Ann-Sofi
    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, Högskolan i Gävle.
    Motivational Interviewing in Primary Care: Nurses´ experiences and actual use of the method2015Doctoral 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.

    List of papers
    1. District nurses' and registered nurses' training in and use of motivational interviewing in primary care settings
    Open this publication in new window or tab >>District nurses' and registered nurses' training in and use of motivational interviewing in primary care settings
    2014 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, no 15-16, p. 2284-2294Article 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.

    Keywords
    education, health promotion, motivational interviewing, nurses, primary health care, training
    National Category
    Nursing
    Research subject
    Caring Sciences
    Identifiers
    urn:nbn:se:uu:diva-211414 (URN)10.1111/jocn.12509 (DOI)000339431800022 ()24372665 (PubMedID)
    Available from: 2013-11-22 Created: 2013-11-22 Last updated: 2017-12-06Bibliographically approved
    2. Motivational Interviewing: Experiences Of Primary Care Nurses Trained In The Method
    Open this publication in new window or tab >>Motivational Interviewing: Experiences Of Primary Care Nurses Trained In The Method
    2015 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 15, no 2, p. 111-118Article in journal (Refereed) Published
    Abstract [en]

    Motivational interviewing is a person-centered counseling style used to promote behavioral change regarding a wide variety of lifestyle problems. Use of motivational interview is growing worldwide and among many different healthcare professions, including primary care nursing. The study aim was to describe motivational interview trained nurses' experiences of motivational interviewing in primary care settings. The study had a qualitative descriptive design. It was carried out in Swedish primary care settings in two county council districts, with 20 primary care nurses trained in motivational interviewing. Half of them used the method in their work, half did not. Qualitative semi-structured interviews were used. Data were analyzed using qualitative content analysis. The nurses experienced that openness to the approach and an encouraging working climate are required to overcome internal resistance and to increase use of motivational interviewing. They also experienced mutual benefit: motivational interviewing elicits and develops abilities in both nurses and patients. For the nurses using it, motivational interviewing is perceived to facilitate work with patients in need of lifestyle change. Lack of training/education, support, interest and appropriate work tasks/patients are reasons for not using motivational interviewing.

    Keywords
    experiences, motivational interviewing, nurses, primary care, qualitative study, training/education
    National Category
    Nursing
    Research subject
    Caring Sciences
    Identifiers
    urn:nbn:se:uu:diva-237735 (URN)10.1016/j.nepr.2014.11.005 (DOI)000352330500005 ()
    Available from: 2014-12-04 Created: 2014-12-04 Last updated: 2017-12-05Bibliographically approved
    3. Primary care nurses' performance in motivational interviewing: a quantitative descriptive study
    Open this publication in new window or tab >>Primary care nurses' performance in motivational interviewing: a quantitative descriptive study
    2015 (English)In: BMC Family Practice, ISSN 1471-2296, E-ISSN 1471-2296, Vol. 16, article id 89Article in journal (Refereed) Published
    Abstract [en]

    Background: Motivational interviewing is a collaborative conversational style intended to strengthen motivation to change. It has been shown to be effective in addressing many different lifestyle problems as well as in chronic disease management, and many disease prevention guidelines promote use of motivational interviewing. The aim of the present study was twofold: to assess to what extent the primary care nurses in the study perform motivational interviewing according to the Motivational Interviewing Treatment Integrity Code and to investigate how the participating primary care nurses rated their own performance in motivational interviewing. Method: The study was based on twelve primary care nurses' audio-recorded motivational interviewing sessions with patients (total 32 sessions). After each session, the nurses completed a questionnaire regarding their experience of their own performance in motivational interviewing. The audio-recorded sessions were analyzed using Motivational Interviewing Integrity Code 3.1.1. Results: None of the nurses achieved beginning proficiency in all parts of any motivational interviewing sessions and two nurses did not achieve beginning proficiency in any parts or sessions. Making more complex than simple reflections was the specific verbal behavior/summary score that most nurses achieved. Beginning proficiency/competency in "percent open questions" was the summary score that fewest achieved. Conclusion: Primary care nurses did not achieve beginning proficiency/competency in all aspects of motivational interviewing in their recorded sessions with patients, where lifestyle change was discussed. This indicates a need for improvement and thus additional training, feedback and supervision in clinical practice with motivational interviewing.

    Keywords
    Self-ratings, Motivational interviewing, Motivational interviewing treatment integrity code, Nurse, Performance, Primary care, Proficiency/competency
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology
    Identifiers
    urn:nbn:se:uu:diva-260618 (URN)10.1186/s12875-015-0304-z (DOI)000358355600001 ()26205692 (PubMedID)
    Funder
    Swedish Heart Lung Foundation
    Note

    Funding: University of Gavle in Sweden, STROKE-Riksforbundet (The Swedish Stroke Association) in Sweden, Erik, Karin och Gosta Selanders Foundation in Sweden 

    Available from: 2015-08-24 Created: 2015-08-21 Last updated: 2017-12-04Bibliographically approved
    4. Primary care nurses´ communication and its influence on patient talk during motivational interviewing
    Open this publication in new window or tab >>Primary care nurses´ communication and its influence on patient talk during motivational interviewing
    Show others...
    2016 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, no 11, p. 2844-2856Article in journal (Refereed) Published
    Abstract [en]

    Aim. The aim of this study was to describe what verbal behaviours/kinds of talk occur during recorded motivational interviewing sessions between nurses in primary care and their patients. The aim was also to examine what kinds of nurse talk predict patient change talk, neutral talk and/or sustain talk. Background. Motivational interviewing is a collaborative conversational style. It has been shown to be effective, in addressing health behaviours such as diet, exercise, weight loss and chronic disease management. In Sweden, it is one of the approaches to disease prevention conversations with patients recommended in the National Guidelines for Disease Prevention. Research on the mechanisms underlying motivational interviewing is growing, but research on motivational interviewing and disease prevention has also been called for. Design. A descriptive and predictive design was used. Methods. Data were collected during 2011-2014. Fifty audio-recorded motivational interviewing sessions between 23 primary care nurses and 50 patients were analysed using Motivational Interviewing Sequential Code for Observing Process Exchanges. The frequency of specific kinds of talk and sequential analysis (to predict patient talk from nurse talk) were computed using the software Generalized Sequential Querier 5. Findings. The primary care nurses and patients used neutral talk most frequently. Open and negative questions, complex and positive reflections were significantly more likely to be followed by change talk and motivational interviewing-inconsistent talk, positive questions and negative reflections by sustain talk. Conclusions. To increase patients' change talk, primary care nurses need to use more open questions, complex reflections and questions and reflections directed towards change.

    Keywords
    behaviour; communication; in-session; motivational interviewing; nurse; primary care; sequential analysis; talk
    National Category
    Nursing
    Research subject
    Caring Sciences
    Identifiers
    urn:nbn:se:uu:diva-264258 (URN)10.1111/jan.13052 (DOI)000386079500025 ()27345818 (PubMedID)
    Funder
    Swedish Heart Lung Foundation
    Note

    Funding: University of Gävle, STROKE-Riksförbundet (The Swedish Stroke Association), The Swedish Heart and Lung Association and the Erik, Karin and Gösta Selander Foundation, all located in Sweden.

    Available from: 2015-10-07 Created: 2015-10-07 Last updated: 2017-12-01Bibliographically approved
  • 755.
    Östlund, Ann-Sofi
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Kristofferzon, Marja-Leena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Häggström, Elisabeth
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Wadensten, Barbro
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Primary care nurses' performance in motivational interviewing: a quantitative descriptive study2015In: BMC Family Practice, ISSN 1471-2296, E-ISSN 1471-2296, Vol. 16, article id 89Article in journal (Refereed)
    Abstract [en]

    Background: Motivational interviewing is a collaborative conversational style intended to strengthen motivation to change. It has been shown to be effective in addressing many different lifestyle problems as well as in chronic disease management, and many disease prevention guidelines promote use of motivational interviewing. The aim of the present study was twofold: to assess to what extent the primary care nurses in the study perform motivational interviewing according to the Motivational Interviewing Treatment Integrity Code and to investigate how the participating primary care nurses rated their own performance in motivational interviewing. Method: The study was based on twelve primary care nurses' audio-recorded motivational interviewing sessions with patients (total 32 sessions). After each session, the nurses completed a questionnaire regarding their experience of their own performance in motivational interviewing. The audio-recorded sessions were analyzed using Motivational Interviewing Integrity Code 3.1.1. Results: None of the nurses achieved beginning proficiency in all parts of any motivational interviewing sessions and two nurses did not achieve beginning proficiency in any parts or sessions. Making more complex than simple reflections was the specific verbal behavior/summary score that most nurses achieved. Beginning proficiency/competency in "percent open questions" was the summary score that fewest achieved. Conclusion: Primary care nurses did not achieve beginning proficiency/competency in all aspects of motivational interviewing in their recorded sessions with patients, where lifestyle change was discussed. This indicates a need for improvement and thus additional training, feedback and supervision in clinical practice with motivational interviewing.

  • 756.
    Östlund, Ann-Sofi
    et al.
    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.
    Wadensten, Barbro
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Häggström, Elisabeth
    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.
    Kristofferzon, Marja-Leena
    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.
    District nurses' and registered nurses' training in and use of motivational interviewing in primary care settings2014In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, no 15-16, p. 2284-2294Article in journal (Refereed)
    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.

  • 757.
    Östlund, Ann-Sofi
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gavle, Fac Hlth & Occupat Studies, Gavle, Sweden.
    Wadensten, Barbro
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Häggström, Elisabeth
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gavle, Fac Hlth & Occupat Studies, Gavle, Sweden.
    Lindqvist, Helena
    Karolinska Inst, Dept Clin Neurosci, MIC Lab, Stockholm, Sweden.
    Kristofferzon, Marja-Leena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gavle, Fac Hlth & Occupat Studies, Gavle, Sweden.
    Primary care nurses´ communication and its influence on patient talk during motivational interviewing2016In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, no 11, p. 2844-2856Article in journal (Refereed)
    Abstract [en]

    Aim. The aim of this study was to describe what verbal behaviours/kinds of talk occur during recorded motivational interviewing sessions between nurses in primary care and their patients. The aim was also to examine what kinds of nurse talk predict patient change talk, neutral talk and/or sustain talk. Background. Motivational interviewing is a collaborative conversational style. It has been shown to be effective, in addressing health behaviours such as diet, exercise, weight loss and chronic disease management. In Sweden, it is one of the approaches to disease prevention conversations with patients recommended in the National Guidelines for Disease Prevention. Research on the mechanisms underlying motivational interviewing is growing, but research on motivational interviewing and disease prevention has also been called for. Design. A descriptive and predictive design was used. Methods. Data were collected during 2011-2014. Fifty audio-recorded motivational interviewing sessions between 23 primary care nurses and 50 patients were analysed using Motivational Interviewing Sequential Code for Observing Process Exchanges. The frequency of specific kinds of talk and sequential analysis (to predict patient talk from nurse talk) were computed using the software Generalized Sequential Querier 5. Findings. The primary care nurses and patients used neutral talk most frequently. Open and negative questions, complex and positive reflections were significantly more likely to be followed by change talk and motivational interviewing-inconsistent talk, positive questions and negative reflections by sustain talk. Conclusions. To increase patients' change talk, primary care nurses need to use more open questions, complex reflections and questions and reflections directed towards change.

  • 758.
    Östlund, Ann-Sofi
    et al.
    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, Högskolan i Gävle.
    Wadensten, Barbro
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Kristofferzon, Marja-Leena
    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, Högskolan i Gävle.
    Häggström, Elisabeth
    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, Högskolan i Gävle.
    Motivational Interviewing: Experiences Of Primary Care Nurses Trained In The Method2015In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 15, no 2, p. 111-118Article in journal (Refereed)
    Abstract [en]

    Motivational interviewing is a person-centered counseling style used to promote behavioral change regarding a wide variety of lifestyle problems. Use of motivational interview is growing worldwide and among many different healthcare professions, including primary care nursing. The study aim was to describe motivational interview trained nurses' experiences of motivational interviewing in primary care settings. The study had a qualitative descriptive design. It was carried out in Swedish primary care settings in two county council districts, with 20 primary care nurses trained in motivational interviewing. Half of them used the method in their work, half did not. Qualitative semi-structured interviews were used. Data were analyzed using qualitative content analysis. The nurses experienced that openness to the approach and an encouraging working climate are required to overcome internal resistance and to increase use of motivational interviewing. They also experienced mutual benefit: motivational interviewing elicits and develops abilities in both nurses and patients. For the nurses using it, motivational interviewing is perceived to facilitate work with patients in need of lifestyle change. Lack of training/education, support, interest and appropriate work tasks/patients are reasons for not using motivational interviewing.

  • 759.
    Östlund, Ulrika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Blomberg, Karin
    Örebro Univ, Sch Hlth Sci, Fac Med & Hlth, Örebro, Sweden.
    Söderman, Annika
    Örebro Univ, Sch Hlth Sci, Fac Med & Hlth, Örebro, Sweden.
    Harstäde, Carina Werkander
    Linnaeus Univ, Dept Hlth & Caring Sci, Ctr Collaborat Palliat Care, Kalmar Vaxjö, Sweden.
    How to conserve dignity in palliative care: suggestions from older patients, significant others, and healthcare professionals in Swedish municipal care2019In: BMC Palliative Care, ISSN 1472-684X, E-ISSN 1472-684X, Vol. 18, article id 10Article in journal (Refereed)
    Abstract [en]

    Background: An essential aspect of palliative care nursing is to conserve the dignity of the patient. A Dignity Care Intervention (DCI) has been developed in Scotland to facilitate this role for nurses. The DCI is now being adapted to a Swedish context (DCI-SWE) and a central step is to identify culturally relevant, dignity-conserving care actions. These care actions will be incorporated into the DCI-SWE. Therefore, the aim of this study was to suggest care actions for conserving dignity in palliative care from the perspectives of the patients, significant others (SOs), and health care professionals (HPs) in municipality care in Sweden.

    Methods: This study used a descriptive design with a qualitative approach. Data from 20 participants were collected through semi-structured individual interviews with patients (n = 3), SOs (n = 4), two focus groups with nurses (n = 9) and one focus group with physicians (n = 4) in two Swedish municipalities. These data were deductively analysed using qualitative content analysis with the Chochinov model of dignity as framework.

    Results: With the Chochinov model of dignity as a framework, care actions based on suggestions from the participants were identified and presented under three themes: Illness related concerns, Dignity conserving repertoire, and Social dignity inventory. The study found both specific concrete care actions and more general approaches. Such general approaches were found to be relevant for several dignity related issues as all-embracing attitudes and behaviours. However, these general approaches could also be relevant as specific care actions to conserve dignity in relation to certain issues. Care actions were also found to be linked to each other, showing the importance of a holistic perspective in conserving dignity.

    Conclusions: As part of the adaption of the DCI from a Scottish to a Swedish context, this study added relevant care actions for collaborative planning of individualised care in mutual dialogues between nurses and those they care for. The adapted intervention, DCI-SWE, has the potential to help the nurses in providing palliative care of evidence-based quality.

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