Application of motivational interviewing in the disease management in patients with chronic heart failure_West China Medical Journal

Authors：

ZHANG Wenmei ¹ ,  LENG Liang ¹ , ZHANG Qiufang ²

1. Department of Cardiovascular Medicine, Dongfeng Hospital Affiliated to Hubei University of Medicine, Shiyan, Hubei 442008, P. R. China;
2. Teaching and Research Section of Pharmacology, Hubei University of Medicine, Shiyan, Hubei 442008, P. R. China;

Corresponding author：

LENG Liang, Email: lengliang556@163.com

Keywords：

Motivational interviewing; Chronic heart failure; Disease management

DOI：

10.7507/1002-0179.201603006

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Objective To explore the effect of motivational interviewing (MI) on medication compliance and self-management behaviors of patients with chronic heart failure (CHF). Methods Between April 2013 and May 2015, 200 cases of CHF were randomly divided into control group (n=98) and MI group (n=102). Patients in the control group received routine nursing measures only. On the basis of routine nursing measures, patients in the MI group received MI program throughout the whole process inside and outside the hospital. The main contents of MI were medication compliance and self-management, to find the existing problems in patients’ daily living and make solutions with the patients. At the time of admission and 6 months after discharge, the Compliance Scale for Drug Treatment of Hypertension and the Self-management Scale for Patients with Heart Failure were conducted to asses the medication compliance and self-management behaviors of the two groups. Results Six months after discharge, the compliance level in the MI group was improved than that on admission with a significant difference (P<0.05), while the medication compliance in the control group was not improved significantly compared with that on admission (P>0.05). In the aspect of self-management, there was no significant difference in the control group between 6 months after discharge and on admission time (P>0.05); while the scores of diet management, drug management, symptom management, and psychological and social adjustment in the MI group (12.9±2.5, 16.1±2.8, 17.3±3.1, 17.0±2.4, respectively) were higer than those on admission (9.9±1.9, 13.3±2.7, 13.7±2.6, 12.8±2.2, respectively), with statistically significant differences (P<0.05). Conclusion MI can prompt CHF patients to improve medication compliance and the ability of self-management, and adopt a more healthy lifestyle.

Citation： ZHANG Wenmei, LENG Liang, ZHANG Qiufang. Application of motivational interviewing in the disease management in patients with chronic heart failure. West China Medical Journal, 2017, 32(8): 1258-1261. doi: 10.7507/1002-0179.201603006 Copy

1.	中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 中国心力衰竭诊断和治疗指南2014. 中华心血管病杂志, 2014, 42(2): 98-122.
2.	Creber RM, Patey M, Lee CS. Motivational interviewing to improve self-care for patients with chronic heart failure: MITI-HF randomized controlled trial. J Card Fail, 2015, 21(8, S): S78.
3.	Yancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol, 2013, 62(16):e147-e239.
4.	Creber RM. Baseline sample for motivational interviewing tailored intervention to promote heart failure self-care (MITI-HF). Nurs Res, 2014, 63(2): E30.
5.	McCarthy MM, Dickson VV, Katz SD, et al. Process evaluation of an exercise counseling intervention using motivational interviewing. Appl Nurs Res, 2015, 28(2): 156-162.
6.	张萍, 郑丽维. 高血压药物治疗依从性测量的研究进展.中华现代护理杂志,2012,18(28):3459-3461.
7.	施小青, 曹伟新, 吴蓓雯, 等. 心力衰竭病人自我管理量表的初步构建.护理研究,2012,26(35):3347-3350.
8.	Otsu H, Moriyama M. 36-month follow-up study of post-intervention chronic heart failure patients. Health, 2014, 6(7): 559-575.
9.	Toback M, Clark N. Strategies to improve self-management in heart failure patients. Contemp Nurse, 2017, 53(1):105-120.
10.	李利娜, 裴大军, 李梅, 等. 动机性访谈对慢性心力衰竭患者疾病管理的影响. 中华现代护理杂志, 2015, 21(2): 179-181.
11.	Vaillant-Roussel H, Laporte C, Pereira B, et al. Patient education in chronic heart failure in primary care (ETIC) and its impact on patient quality of life: design of a cluster randomised trial. BMC Fam Pract, 2014, 15(1): 5.
12.	Stawnychy M, Masterson CR, Riegel B. Using brief motivational interviewing to address the complex needs of a challenging patient with heart failure. J Cardiovasc Nurs, 2014, 29(5): E1-E6.

1. 中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 中国心力衰竭诊断和治疗指南2014. 中华心血管病杂志, 2014, 42(2): 98-122.
2. Creber RM, Patey M, Lee CS. Motivational interviewing to improve self-care for patients with chronic heart failure: MITI-HF randomized controlled trial. J Card Fail, 2015, 21(8, S): S78.
3. Yancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol, 2013, 62(16):e147-e239.
4. Creber RM. Baseline sample for motivational interviewing tailored intervention to promote heart failure self-care (MITI-HF). Nurs Res, 2014, 63(2): E30.
5. McCarthy MM, Dickson VV, Katz SD, et al. Process evaluation of an exercise counseling intervention using motivational interviewing. Appl Nurs Res, 2015, 28(2): 156-162.
6. 张萍, 郑丽维. 高血压药物治疗依从性测量的研究进展.中华现代护理杂志,2012,18(28):3459-3461.
7. 施小青, 曹伟新, 吴蓓雯, 等. 心力衰竭病人自我管理量表的初步构建.护理研究,2012,26(35):3347-3350.
8. Otsu H, Moriyama M. 36-month follow-up study of post-intervention chronic heart failure patients. Health, 2014, 6(7): 559-575.
9. Toback M, Clark N. Strategies to improve self-management in heart failure patients. Contemp Nurse, 2017, 53(1):105-120.
10. 李利娜, 裴大军, 李梅, 等. 动机性访谈对慢性心力衰竭患者疾病管理的影响. 中华现代护理杂志, 2015, 21(2): 179-181.
11. Vaillant-Roussel H, Laporte C, Pereira B, et al. Patient education in chronic heart failure in primary care (ETIC) and its impact on patient quality of life: design of a cluster randomised trial. BMC Fam Pract, 2014, 15(1): 5.
12. Stawnychy M, Masterson CR, Riegel B. Using brief motivational interviewing to address the complex needs of a challenging patient with heart failure. J Cardiovasc Nurs, 2014, 29(5): E1-E6.

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