动机面谈在脑卒中二级预防中的作用—提高药物依从性.pptxVIP

文献学习 2015年11月 Background and Purpose Recurrent Stroke have not declined over past 3 decades. Motivational Interviewing (MI) MI is structured, patient-focused and more cost-effective than many other behavior change methods Purpose This study tested effectiveness of motivational interviewing (MI) for reducing stroke recurrence, measured by improving adherence to recommended medication and lifestyle changes compared with usual care. What is 动机性访谈 是由MILLER和ROLLNICK在上世纪90年代初根据治疗酒精依赖患者的经验建立起来的一种以咨客为中心的访谈技术。由于咨询过程中咨询者主要通过挖掘和妥善处理咨客行为改变过程中的矛盾情感，进而达到增强咨客行为改变的内在动机，故被称为动机性访谈。 与传统的行为改变干预技术相比，MI将当代不少行为改变的研究理论应用整合在实践中。MI整个访谈过程大致被分为两个阶段，第一阶段主要是帮助咨客增强行为改变的内在动机，第二阶段重点在于巩固咨客对行为改变的承诺以及制订并履行行为改变计划。 Motivational Interviewing Methods 排除标准(1) they had impairment precluding participation (eg, aphasia, psychiatric conditions, cognitive impairment); (2) they were unable to converse in English; (3) they were unable to give informed consent; (4) they had another condition likely to affect participation (eg, significant aphasia); (5) they were receiving psychiatric / psychological treatment that could contaminate the findings; (6) they were discharged to hospital / nursing home setting where medications are given by staff; (7) participation was likely to overburden the individual. Intervention The MI group received 4 MI sessions at 28 days, 3, 6, and 9 months post stroke. The initial interview was conducted face-to-face. ( 60 to 90 minutes ). Subsequent interviews were conducted by telephone. Initial interviews took( ≈30 minutes). Measures Assessments were conducted 28 days, 3, 6, 9, and 12 months post stroke over the telephone Medication adherence Analyses Results 1.Demographics and Primary Outcomes at Baseline： Randomization achieved good balance Results Results Discussion Discussion further research △the 12-month follow-up period may have been too short △ the timing and intensity of the intervention △ Whether this intervention is cos