동기강화상담 교육훈련 프로그램이 가정방문간호사의 의사소통능력과 직무효능감에 미치는 효과

BackgroundHIV counseling support staff (CSS) play a crucial role in HIV care outcomes, providing essential access to HIV test counseling, linkage-to-care support, adherence counseling, peer support, and navigation. Effective training in evidence-based interventions like motivational interviewing (MI) is imperative to maximize the impact of CSS in enhancing HIV care outcomes. MI is a collaborative, goal-oriented communication method aimed at bolstering an individual’s motivation and movement toward specific goals by eliciting and exploring personal arguments for change. MI has demonstrated efficacy across various medical and mental health outcomes, including its significant impact on the status-neutral HIV Care Continuum.ObjectiveThe objective of this study is to develop and pilot an interactive internet-based MI training program for HIV counseling support staff (iMI4HIV), aiming to enhance their communication skills in HIV care interactions.MethodsThe iMI4HIV Study will have 2 phases. In phase 1, Development, we will conduct formative focus groups (FGs) with CSS (n=16) to identify HIV care interactions for demonstration videos and to assess acceptability of gamification components; create MI demonstration videos depicting key interactions from status-neutral HIV Care Continuum; program iMI4HIV (including skills development tasks, gamification components, etc); and pilot a virtual MI (VMI) workshop followed by iMI4HIV (n=8). We will also conduct qualitative interviews with 8 leaders from HIV care agencies to explore their use of existing online MI training programs, acceptability of iMI4HIV, and possible facilitators and impediments to its adoption for training HIV CSS. In phase 2, pilot randomized controlled trial (RCT), we will randomize 30 CSS at a 2:1 ratio (VMI workshop + iMI4HIV vs VMI workshop + waitlist control) to assess the feasibility and acceptability of iMI4HIV and to pilot the RCT processes and assessments for a future efficacy trial. We will also explore the preliminary impact of iMI4HIV on MI skills acquisition.ResultsThe CSS focus groups began in August 2024, and programming of the training is near completion. We plan to conduct a pilot with 8 participants by the end of 2025, to obtain feedback and conclude phase 1 of the study. The phase 2 pilot RCT is expected to be launched in February 2026, with all data collection to be completed by October 2026.ConclusionsOur pilot study aims to demonstrate the feasibility and acceptability of an internet-based MI training program for HIV CSS. If successful, this training program has the potential to enhance the delivery of evidence-based interventions in HIV care settings, ultimately improving patient outcomes and adherence to treatment protocols. Further research and larger trials will be needed to confirm these findings and refine the training approach.International Registered Report Identifier (IRRID)DERR1-10.2196/82241

Purpose: The study’s aim was to describe the experience of motivational interviewing (MI) training for parents with adolescents. Methods: Focus group interviews were carried out with 12 mothers in 3 groups who participated in the MI training. The study had a qualitative descriptive design, and qualitative content analysis was used. Results: Data analysis was separated into 4 domains: acceptance, relational skills, self-reflection, and rebuilding relationships. Seven categories and 11 subcategories included (1) enhancing acceptance and empathy, (2) recognizing the importance of the MI spirit and applying core skills, (3) improving self-expression and self-control of negative emotions and behavior, (4) recognizing self-problems, and (5) true communication and recovery of trust. Conclusion: Through MI training, participants have experienced not only the enhancement of their communication skills but also personal modifications (in self-acceptance, self-reflection, and self-control) and positive interpersonal relationships (rebuilding relationships). In addition, participants have realized the importance of listening and reflection in such experiences. Reflection training has provided participants meaningful experiences. Our key insight from these findings is that skill is not most important in communication training. MI elements such as acceptance, collaboration, and a respectful attitude are more likely to be used than conventional communication skills.

Training in motivational interviewing for pediatricians was associated with a higher uptake of health behavior and lifestyle treatment: Results from the KP Wellness Coaching for Families and Kids (WC4K) Program.

Motivational interviewing (MI) is a patient-centered approach to behavior change counseling that is used among health professionals across multiple disciplines. However, MI training has yet to be broadly offered to health professional (HP) students. This study aimed to evaluate student interest in MI and the efficacy of an MI workshop to assess whether MI training should be incorporated into HP curricula. We conducted a needs assessment to evaluate HP student interest in learning MI. We then hosted a 6.5-hour MI workshop, followed by optional standardized patient encounters (SPEs). SPE performance was evaluated with a scored competency assessment. Needs assessment respondents (N=93) were predominantly medical students (53%), of which 49% were interested in primary care-related fields. Most (58%) reported receiving 0 to 2 hours of MI training in their required curricula, yet 87% intended to use MI and were interested in receiving training. Nineteen students attended the MI workshop. Postworkshop knowledge assessment (N=11) improved by an average of 34% (premean [±SD], 41% [±12]; postmean [±SD], 75% [±10]; P<.001). The SPE mean competency score (5.09) surpassed the threshold for competence of 5. HP students reported receiving minimal MI training in their curricula despite being highly interested in MI. Interested students responded to our interdisciplinary MI workshop and SPEs with high satisfaction, suggesting that HP schools may benefit from incorporating MI into their curricula. Nevertheless, response rates were low, and selection bias may have skewed responses toward more favorable perceptions of MI.

the authors propose that motivational interviewing (MI), a brief intervention designed to manage ambivalence regarding complex behavior change, is well suited for integration into psychiatric residency training programs. the authors provide a brief description of MI. In addition, based on a review of the literature the authors explore which core competencies the empirically validated, client-centered, and directive method of MI would address. the authors argue that psychiatric residency programs can effectively address several core competencies through the addition of MI training in their curricula, including Brief Psychotherapy, Patient Care, and Interpersonal and Communication Skills. the implementation of MI training offers psychiatric residency programs potential benefits in several key areas. However, the authors provide guidance for important research questions to more confidently ascertain whether MI training for psychiatric residents is worthwhile.

Training in motivational interviewing: A systematic review

ObjectiveThe aim of this study was to evaluate the attitudes and perceptions of health care professionals (HCPs) who have been trained in motivational interviewing (MI) to improve adherence. Another objective of this study was to compare groups of HCPs with different levels of training in adherence (trained vs untrained; previous training in adherence education [AdhE] vs specific training in MI).MethodsFor this study, a national questionnaire-based survey was conducted among HCPs treating asthma. A total of 360 HCPs were surveyed (allergists: n=110; pulmonologists: n=120; general practitioners: n=130). Of them, 180 physicians had received a training intervention (training in AdhE: n=90; training in MI to promote adherence: n=90).ResultsOf the total surveyed HCPs, 92.8% reported adherence is highly important in asthma control. More professionals trained in MI compared to those trained in AdhE considered that “simplifying treatment as far as possible” (85.6% vs 68.9%, P=0.0077), “involving the patient in treatment plans” (85.6% vs 71.1%, P=0.0187), “giving the patient self-care patterns” (52.2% vs 36.7%, P=0.0357) and “performing MI” (42.2% vs 15.6%, P<0.0001) were the most important interventions to promote adherence. “Empathy between doctor and patient” (93.3% vs 77.8%, P=0.0036) and “concordance of medical and patient treatment goals” (96.7% vs 72.2%, P<0.0001) were the factors perceived as having the greatest influence in improving adherence to asthma treatment by the physicians in the MI group as opposed to those in the AdhE group. The use of MI in asthma consultation was the most highly valued resource to promote adherence to treatment among all the professionals, particularly those who had received specific MI training compared to those who had received any kind of previous training in AdhE (96.7% vs 66.7%, P<0.0001).ConclusionMI is considered an important tool to promote adherence to asthma treatment among HCPs, especially among those specifically trained in that aspect. MI training interventions seem to influence HCPs’ approaches to improve self-care and to engage patients in treatment plans rather than approaches solely centered on AdhE.

Motivational interviewing (MI) has proven a well-established psychotherapeutic intervention designed to enhance motivation for behavior change. While the benefits of MI have been established, little research has systematically evaluated dissemination of MI efforts to healthcare providers, especially among pediatric providers. The present pilot study evaluated whether healthcare providers gained valuable knowledge, confidence and desire to utilize MI, and skills in MI techniques and if these outcomes varied based on provider characteristics or duration and intensity of MI training. Twenty pediatric healthcare professionals in a large academic pediatric hospital completed an advanced 20-h MI training and 103 pediatric healthcare professionals completed a basic 4-h MI workshop. The study demonstrated no significant differences in post-workshop MI knowledge, confidence, or desire based on trainee demographics. We also found no significant change from post-basic workshop to post-advanced workshop for advanced MI trainees. However, the advanced training workshop participants evidenced significant growth in utilizing MI skills (via MITI coding) and self-reported confidence in using MI skills. We therefore conclude that while the basic workshop allows participants to gain valuable MI knowledge and confidence and desire to utilize MI, it is through the advanced training that providers have the opportunity to practice these skills, receive feedback, and ultimately gain the expertise necessary to be effective MI providers. Overall, results from this pilot study suggest MI training in pediatric hospitals represents an important area of opportunity for multidisciplinary training, dissemination, and practice.

Motivational interviewing (MI) is a counseling approach that allows a provider to engage in a dialog with patients to evoke motivation for health behavior change or decision-making. MI is a relatively recent addition to the curricula of genetic counseling programs, and recent research has demonstrated its utility in genetic counseling practice. However, the perspectives of genetic counselors trained in MI have yet to be studied with the intent of illuminating how it is applied in practice or what should be emphasized in training. This qualitative study interviewed fifteen genetic counselors from various practice areas who have had training in MI. The interviews focused on how MI is being used in practice, and the strengths and weaknesses of their MI training. Five themes were identified through inductive qualitative analysis: (a) utility of MI in genetic counseling practice, (b) value of MI in genetic counseling training, (c) barriers to implementing MI in genetic counseling practice, (d) barriers to training genetic counselors in MI, and (e) timing of MI training. The perspectives discovered from this study can help inform genetic counseling educators who wish to include MI in their curriculum. In addition for those programs that already include MI, these results serve as a guide for the development of training role-plays and/or standardized patient encounter scenarios.

Use of community health workers (CHWs) has increased in recent years, with many being tasked with providing motivational interviewing (MI). However, little research exists regarding ideal means of training CHWs in MI. Therefore, the objective of this study was to explore the feasibility and perceptions of a CHW-focused MI training. This feasibility study employed a single-arm pre-post design, with a convenience sample of n = 24 Oklahoma-based CHWs. For MI training, four online asynchronous modules and one in-person session were developed and delivered by a graduate student competent in MI in collaboration with a member of the Motivational Interviewing Network of Trainers and per corresponding recommendations. The following indicators of feasibility were assessed via both pre-post surveys and semi-structured interviews: acceptability, demand, implementation, limited efficacy, and Practicality. Among responding CHWs, both the training and delivery of MI by CHWs as a whole were deemed feasible, including acceptability (e.g., 93% of respondents reported as "Excellent" or "Very Good"), demand (e.g., increase in actual MI use), implementation (e.g., exceeded recruitment goal), limited efficacy (e.g., some increases in knowledge), and practicality (e.g., delivery of MI training in existing systems, yet consistent with existing literature). Primary challenges included completion of data collection procedures and perceptions of overwhelm. These data indicate training CHWs in MI is feasible and in high demand, but there are important considerations, including minimizing data collection burden, delivering training in smaller intervals over longer periods of time, providing more opportunities for practice, and evaluating context-specific opportunities for feedback and coaching to achieve proficiency.

Background: Through evaluations of training programs, systematic reviews, and meta-analyses, advances in identifying best practices for disseminating motivational interviewing (MI) have emerged. To advance this work further, inclusion of thorough descriptions of the following is needed in research publications: study (design, trainee characteristics, setting characteristics), training and coaching methods (if applicable), trainer qualifications, and evaluation of MI skills. Methods: The purpose of this study was to systematically evaluate the research on MI training of substance use treatment professionals for the inclusion of such descriptions. Twenty-five studies were reviewed using a scoring rubric developed by the authors. Results: Just over two thirds of the studies (68%) were randomized controlled trials of MI training. The majority of studies provided information about (a) trainee characteristics (professional background = 76%, education = 60%, experience = 56%); (b) setting characteristics (80%); (c) training methods (format = 96%, length = 92%); (d) coaching (76%); and (e) evaluation of MI skills (92%). Conclusion: Findings suggest advancements in MI training studies since previous reviews, especially in regards to the inclusion of feedback and coaching. However, this review also found that inconsistencies in methods and reporting of training characteristics, as well as limited follow-up assessment of trainees’ skill, continue to limit knowledge of effective training methods.

Introduction There is limited research addressing the experiences of patients in inpatient rehabilitation (rehabilitation), who often spend long periods in hospital, and the nursing approaches utilized. Aim Based on evidence that motivational interviewing (MI) may improve nursing practice, this was a pilot study evaluating the feasibility of training rehabilitation nurses in MI and measuring patient experience. Method Nurses underwent training and supervision focusing on MI spirit. Quantitative and qualitative measures were taken pretraining, 2months post-training and 8months post-training. Expert-by-experience research assistants facilitated patients' participation in the study. Results This study showed that training rehabilitation nurses in MI was feasible and relevant to their work. Patients participated in interviews and focus groups with support and potential improvements that require further empirical investigation in patient experience were found following the MI training. Discussion This pilot study establishes the feasibility of a larger study addressing efficacy. Tentative qualitative findings question whether interactions between nurses and patients are valued in rehabilitation and support MI as a promising skill set for rehabilitation nurses. Implications for practice Bringing MI into inpatient rehabilitation provoked reflection on nursing practice. Dilemmas for nurses about balancing safety with promoting autonomy and communicating constructively with patients emerged as important.

Motivational interviewing (MI) is the most successfully disseminated evidence-based practice in the substance use disorder (SUD) treatment field. This systematic review considers two questions relevant to policymakers and service providers: (1) does training in MI achieve sustained practice change in clinicians delivering SUD treatment; and (2) do clinicians achieve a level of competence after training in MI that impacts upon client outcomes? A systematic review was conducted and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, examining training outcomes for MI in the SUD treatment sector, and for clinicians working in a SUD treatment role. We determined a training method to have resulted in sustained practice change when over 75% of participants met beginning proficiency in MI spirit at a follow-up time-point. Of the 20 studies identified, 15 measured training at a follow-up time-point using standard fidelity measures. The proportion of clinicians who reached beginning proficiency was either reported or calculated for 11 of these studies. Only two studies met our criterion of 75% of clinicians achieving beginning proficiency in MI spirit after training. Of the 20 studies identified, two measured client substance use outcomes with mixed results. A broad range of training studies failed to achieve sustained practice change in MI according to our criteria. It is unlikely that 75% of clinicians can achieve beginning proficiency in MI spirit after training unless competency is benchmarked and monitored and training is ongoing. The impact of training on client outcomes requires future examination.

Strengthening Motivational Interviewing skills following initial training: A randomised trial of workplace-based reflective practice

BACKGROUNDMotivational interviewing (MI) aligns with the scope of practice and competency standards for Registered Dietitian Nutritionists; however, few dietitians receive adequate training. Furthermore, little is known about MI training within dietetics curricula.OBJECTIVEThe objective of this study was to determine differences in undergraduate and graduate-level dietetics students’ confidence and perceived competence before/after taking a MI course.METHODSA 38-item pre–postsurvey was completed by students enrolled in a Basic and Advanced MI course at Utah State University. The survey included demographic questions and questions related to confidence and perceived competence using MI techniques. Paired t-tests were used to compare pre/post results and analysis of variance was used to compare groups.RESULTSIncreased confidence and perceived competence were observed for Basic MI students (n = 72) (P < .0001) and Advanced MI students (n = 32) (P < .0001) after course completion. In the presurvey, Advanced MI students had higher confidence in 5 of 14 MI skills, higher competence in 2 of 11 MI skills, and higher overall MI competence scores (P = .008) than Basic MI students. Following completion of the course, Advanced MI students had higher overall MI confidence scores (P = .03).CONCLUSIONSStudents’ confidence and perceived competence with using MI increased after taking a college-level MI course. Incorporating MI courses into dietetics curricula may be an effective way to increase confidence and perceived competence of using MI techniques and therefore improving communication between dietitians and patients.