The Patient's Experience with Motivational Interviewing (MI) during Medication Adherence Conversations by MI Trained Nurses

2.50
Hdl Handle:
http://hdl.handle.net/10755/308083
Category:
Abstract
Type:
Presentation
Title:
The Patient's Experience with Motivational Interviewing (MI) during Medication Adherence Conversations by MI Trained Nurses
Author(s):
Hyrkas, Kristiina
Lead Author STTI Affiliation:
Non-member
Author Details:
Kristiina Hyrkas, PhD, LicNSc, MNSc, RN, hyrkak@mmc.org
Abstract:

Session presented on: Monday, November 18, 2013

Aims:

(1) To compare the Kim Alliance Scale (KAS) with a new tool to measure the patient’s experience with Motivational Interviewing (MI).

(2) To examine a new tool, the Patient’s Experience Scale (PES) during medication adherence conversations by MI trained nurses.

Background: MI is a patient-centered, evidence-based method of communication. Therapeutic alliance conceptualizes patient-provider relationships focused on shared goal setting. Although therapeutic alliance captures one aspect of the MI relationship, a method for assessing the patient’s experience with MI was needed. 

Methods: The sample was a subset of 205 adult patients enrolled in a medication adherence study at a large north-eastern medical center. Twenty-two nurses received MI education. Prior to hospital discharge, 68 patients received medication education from MI trained nurses. Thirty-five percent (n=24) of the conversations were recorded and examined for MI proficiency. The 9-item PES was adapted from the Behavior Change Counseling Index. Patients completed the PES and the KAS during a phone call at 30 days. 

Results: The 30-item KAS had good reliability (Cronbach’s alpha .797) and showed adequate therapeutic alliance. However, the 16-item revised KAS-R had poor to adequate subscale reliability alphas for integration (.149), communication (.630), collaboration (.659), and empowerment (.555). Significant Spearman’s rho correlations between the PES and KAS were found, except for one PES item. Factor analysis of the PES resulted in three components: Support, Dialogue, and Acceptance. 

Conclusions: The KAS-R may not be adequate to measure therapeutic alliance in this setting. The PES item indicating that the nurse acknowledged that there may be challenges to taking medication was the only item without any significant association with therapeutic alliance. The PES showed promise to elicit the patient’s experience to medication adherence conversations by MI trained nurses. Further research comparing the KAS and the PES in acute care settings is warranted.

Keywords:
Instrument Testing; Motivational Interviewing; Therapeutic Alliance
Repository Posting Date:
19-Dec-2013
Date of Publication:
19-Dec-2013
Conference Date:
2013
Conference Name:
42nd Biennial Convention
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Indianapolis, Indiana, USA
Description:
42nd Biennial Convention 2013 Theme: Give Back to Move Forward. Held at the JW Marriott
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleThe Patient's Experience with Motivational Interviewing (MI) during Medication Adherence Conversations by MI Trained Nursesen_GB
dc.contributor.authorHyrkas, Kristiinaen_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsKristiina Hyrkas, PhD, LicNSc, MNSc, RN, hyrkak@mmc.orgen_GB
dc.identifier.urihttp://hdl.handle.net/10755/308083-
dc.description.abstract<p>Session presented on: Monday, November 18, 2013</p><b>Aims: </b><p>(1) To compare the Kim Alliance Scale (KAS) with a new tool to measure the patient’s experience with Motivational Interviewing (MI). <p>(2) To examine a new tool, the Patient’s Experience Scale (PES) during medication adherence conversations by MI trained nurses. <p><b>Background: </b>MI is a patient-centered, evidence-based method of communication. Therapeutic alliance conceptualizes patient-provider relationships focused on shared goal setting. Although therapeutic alliance captures one aspect of the MI relationship, a method for assessing the patient’s experience with MI was needed.<b> </b><p><b>Methods: </b>The sample was a subset of 205 adult patients enrolled in a medication adherence study at a large north-eastern medical center. Twenty-two nurses received MI education. Prior to hospital discharge, 68 patients received medication education from MI trained nurses. Thirty-five percent (n=24) of the conversations were recorded and examined for MI proficiency. The 9-item PES was adapted from the Behavior Change Counseling Index. Patients completed the PES and the KAS during a phone call at 30 days.<b> </b><p><b>Results: </b>The 30-item KAS had good reliability (Cronbach’s alpha .797) and showed adequate therapeutic alliance. However, the 16-item revised KAS-R had poor to adequate subscale reliability alphas for integration (.149), communication (.630), collaboration (.659), and empowerment (.555). Significant Spearman’s rho correlations between the PES and KAS were found, except for one PES item. Factor analysis of the PES resulted in three components: Support, Dialogue, and Acceptance.<b> </b><p><b>Conclusions: </b>The KAS-R may not be adequate to measure therapeutic alliance in this setting. The PES item indicating that the nurse acknowledged that there may be challenges to taking medication was the only item without any significant association with therapeutic alliance. The PES showed promise to elicit the patient’s experience to medication adherence conversations by MI trained nurses. Further research comparing the KAS and the PES in acute care settings is warranted.en_GB
dc.subjectInstrument Testingen_GB
dc.subjectMotivational Interviewingen_GB
dc.subjectTherapeutic Allianceen_GB
dc.date.available2013-12-19T17:26:40Z-
dc.date.issued2013-12-19-
dc.date.accessioned2013-12-19T17:26:40Z-
dc.conference.date2013en_GB
dc.conference.name42nd Biennial Conventionen_GB
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen_GB
dc.conference.locationIndianapolis, Indiana, USAen_GB
dc.description42nd Biennial Convention 2013 Theme: Give Back to Move Forward. Held at the JW Marriotten_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.en_GB
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