Barbara Riegel1, Victoria Vaughan Dickson2, Lydia Elena Garcia3, Ruth Masterson Creber4, Megan Streur5. 1. Edith Clemmer Steinbright Professor of Gerontology School of Nursing, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: briegel@nursing.upenn.edu. 2. Associate Professor, Rory Meyers College of Nursing, New York University, New York, NY, USA. 3. YMCA of Greater New York City, New York, NY, USA. 4. School of Nursing, Columbia University, New York, NY, USA. 5. Post-doctoral Fellow School of Nursing, University of Washington Seattle, WA, USA.
Abstract
Self-care is challenging but we previously demonstrated that motivational interviewing (MI) was effective in improving heart failure (HF) self-care. OBJECTIVE: To identify the mechanisms of intervention effectiveness by elucidating the MI techniques used and the relationship between the techniques and changes in self-care. METHODS: Audiotaped sessions (first and subsequent sessions) from 8 participants were transcribed verbatim and coded to evaluate changes in self-care. Using a sequential mixed method design, quantitative and qualitative self-care data were triangulated; congruence was 97%. The MI techniques used and mechanisms of intervention effectiveness were identified from the qualitative data. RESULTS: Three MI techniques used were related to improved self-care: 1) reflection and reframing, 2) genuine empathy, affirmation, and humor, and 2) individualized problem solving. These techniques stimulated openness to goal setting, positive self-talk, perceived ability to overcome barriers, and change talk. The mechanisms by which the techniques achieved the desired outcomes were the development of discrepancy and self-efficacy, which are consistent with the principles of MI. CONCLUSION: This study contributes to clarifying the mechanism by which MI facilitates behavioral change. PRACTICE IMPLICATIONS: Using MI to discuss self-care can help to overcome barriers and engage HF patients in goal setting for behavior change.
RCT Entities:
Self-care is challenging but we previously demonstrated that motivational interviewing (MI) was effective in improving heart failure (HF) self-care. OBJECTIVE: To identify the mechanisms of intervention effectiveness by elucidating the MI techniques used and the relationship between the techniques and changes in self-care. METHODS: Audiotaped sessions (first and subsequent sessions) from 8 participants were transcribed verbatim and coded to evaluate changes in self-care. Using a sequential mixed method design, quantitative and qualitative self-care data were triangulated; congruence was 97%. The MI techniques used and mechanisms of intervention effectiveness were identified from the qualitative data. RESULTS: Three MI techniques used were related to improved self-care: 1) reflection and reframing, 2) genuine empathy, affirmation, and humor, and 2) individualized problem solving. These techniques stimulated openness to goal setting, positive self-talk, perceived ability to overcome barriers, and change talk. The mechanisms by which the techniques achieved the desired outcomes were the development of discrepancy and self-efficacy, which are consistent with the principles of MI. CONCLUSION: This study contributes to clarifying the mechanism by which MI facilitates behavioral change. PRACTICE IMPLICATIONS: Using MI to discuss self-care can help to overcome barriers and engage HF patients in goal setting for behavior change.
Authors: Barbara Riegel; Victoria V Dickson; Linda Hoke; Janet P McMahon; Brendali F Reis; Steven Sayers Journal: J Cardiovasc Nurs Date: 2006 May-Jun Impact factor: 2.083
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Authors: Barbara Riegel; Alexandra L Hanlon; Norma B Coe; Karen B Hirschman; Gladys Thomas; Michael Stawnychy; Joyce W Wald; Kathryn H Bowles Journal: Contemp Clin Trials Date: 2019-09-06 Impact factor: 2.226
Authors: Amber E Johnson; Shuvodra Routh; Christy N Taylor; Meagan Leopold; Kathryn Beatty; Dennis M McNamara; Esa M Davis Journal: JMIR Cardio Date: 2022-03-21
Authors: Barbara Riegel; Debra K Moser; Harleah G Buck; Victoria Vaughan Dickson; Sandra B Dunbar; Christopher S Lee; Terry A Lennie; JoAnn Lindenfeld; Judith E Mitchell; Diane J Treat-Jacobson; David E Webber Journal: J Am Heart Assoc Date: 2017-08-31 Impact factor: 5.501