Create a script between health professional and patient that addresses the case, the purpose, principles, … expected outcomes of the interview (etc). You can add information that complements the case but you must not alter it. Example: Patient: I wish I didn’t eat so much fast food. Doctor: You eat fast food fairly often? Types of questions and interventions: open-ended questions Closed-ended questions offer affirmations Practice reflective listening Summarize the visit Empathy Support autonomy reflection 1. Introduction a. patient identification b. demographic data c. Reason for consultation d. Show empathy 2. Problem a. ?Beginning b. Description c. Current status d. Precipitating factors e. Triggering factors 3. Patient position a. Current problem b. Feelings c. Failed strategies d. Problem perception 4. Engaging a. Patient goals b. interview comfort c. interview safety d. Interview and professional health empathy e. Patient engagement evaluation 5. Discord a. Resistance to interpersonal factors b. Patient perspective and concerns c. Patient collaborative 6. Focusing a. Finding a clear direction and goal (Should be specific enough) b. Finding direction and patient goal (Should be specific enough) c. Particular goal for change (Should be specific enough) d. Evaluate patient mindfulness and focusing e. Patient aspirations f. Establish a common purpose (Professional and patient) g. Honing in on a target behavior h. exploring ambivalence i. Exploring barriers 7. Evoking a. Express how you can focus down and guide the client/offender towards a particular goal (identified in the focusing process) b. Evoke the patient’s internal motivations for change c. Express how to reinforce it to help build their motivation for change around the focused target behavior. d. Express how to guide to strategic and directional parts of MI e. Reinforce change talk f. Express the patient change
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5) Identify your answer with the numbers, according to the question. Start your answer on the same line, not the next
Example:
Q 1. Nursing is XXXXX
Q 2. Health is XXXX
Q3. Research is…………………………………………………. (a) The relationship between……… (b) EBI has to
6) You must name the files according to the part you are answering:
Example:
Part 1.doc
Part 2.doc
__________________________________________________________________________________
Motivational Interviewing
According to File Part 1
Patient position: She wants to change
*****The patient's responses must be complete lines.*****
Create a script between health professional and patient that addresses the case, the purpose, principles, … expected outcomes of the interview (etc). You can add information that complements the case but you must not alter it.
Example:
Patient: “I wish I didn't eat so much fast food.”
Doctor: “You eat fast food fairly often?”
Types of questions and interventions:
open-ended questions
Closed-ended questions
offer affirmations
Practice reflective listening
Summarize the visit
Empathy
Support autonomy
reflection
1. Introduction
a. patient identification
b. demographic data
c. Reason for consultation
d. Show empathy
2. Problem
a. Beginning
b. Description
c. Current status
d. Precipitating factors
e. Triggering factors
3. Patient position
a. Current problem
b. Feelings
c. Failed strategies
d. Problem perception
4. Engaging
a. Patient goals
b. interview comfort
c. interview safety
d. Interview and professional health empathy
e. Patient engagement evaluation
5. Discord
a. Resistance to interpersonal factors
b. Patient perspective and concerns
c. Patient collaborative
6. Focusing
a. Finding a clear direction and goal (Should be specific enough)
b. Finding direction and patient goal (Should be specific enough)
c. Particular goal for change (Should be specific enough)
d. Evaluate patient mindfulness and focusing
e. Patient aspirations
f. Establish a common purpose (Professional and patient)
g. Honing in on a target behavior
h. exploring ambivalence
i. Exploring barriers
7. Evoking
a. Express how you can focus down and guide the client/offender towards a particular goal (identified in the focusing process)
b. Evoke the patient's internal motivations for change
c. Express how to reinforce it to help build their motivation for change around the focused target behavior.
d. Express how to guide to strategic and directional parts of MI
e. Reinforce change talk
f. Express the patient change talk
g. Express the patient righting
8. Planning
a. Establish specific target behaviors
b. Helping the patient to build motivation towards these target behaviors
c. Establish specific patient skills and strategies
d. Establish goal-setting
e. Establish sorting options
f. Establish forming plans
g. building support
h. Time
9. Closing
to. Feedback (positive)
b. Summarize the case
c. Summarize the plan
d. Summarize goals
e. Establish the patient has clear all session
2
Motivational Interviewing
Motivational Interviewing (MI) focuses on patients redirecting their attention, behavior, feelings, and coping strategies. This type of interview prepares patients for the mobilization of their schemes and management of the disease to reinforce or promote change based on the affectation of the disease in their lives. Likewise, it allows patients to access the patient-centered counseling style from the humanistic and professional identification of the health professional. An important aspect is to facilitate in patients the self-disclosure of the problems, acceptance of them, and the approach to a favorable position focused on the resolution and adjustment.
Purposes
Motivate in patients the intention and need for change from self-discovery and disclosure of problems, needs, and resources to achieve change.
Motivate patients to identify the reasons for their problems, maintenance of problems, resistance to change, and intention to change.
Motivate patients to reduce resistance schemes and weaken the maintenance of problems.
Expected outcomes
Promote patient autonomy
Empower patients to make decisions
Reduce feelings of frustration, worry… etc
Increase patient confidence
Plan design with objectives and goals
Strengthen self-determination
Reduce or eliminate resistance
Case
A 23-year-old female patient attends a nutritional consultation. The patient has been diagnosed with bulimia for eight years. She attended the consultation because she has severe swelling in her throat and wear of her teeth, along with abdominal pain, irritability, and tiredness. She attended psychology therapy for the first three years, but after a love breakup, she stopped treatment and did not continue with the medical follow-up proposed by her doctor. She is currently a law student in final exams for university year promotion. The patient has a good weight for her height. However, she reported that the binge eating is so great that she does not have enough energy to vomit all her food. She describes feeling guilt, anxiety, and sadness when she plans to binge eat, but when she eats, she feels very calm, happy, and motivated to continue studying; finally, when she vomits, she feels tired, frustrated, and ashamed of her feeding habits. She tried to exercise and be more active, but her academic load prevented her from continuing, so she dedicated herself to studying. Her final exams cause her anxiety as she believes she does not have enough knowledge and skills to get good grades. However, her grades are above average, and she has a good reputation among her peers and teachers.
Motivational Interviewing
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