This paper describes how difficult it can be to discuss the experience of breathlessness with patients, as identified by respiratory trainees in a psychology-led workshop. The value of preparing a patient to actively engage with their breathlessness management is highlighted.
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ABSTRACT This paper describes how difficult it can be to discuss the experience of breathlessness with patients, as identified by respiratory trainees in a psychology-led workshop. This Article doi: Classifications Opinion. Services Email this article to a colleague Alert me when this article is cited Alert me if a correction is posted Similar articles in this journal Similar articles in Web of Science Download to citation manager. The score assigned to each item was the number of suggestions 0 to 3 that adhered to principles of motivation, as judged by 3 experienced counselors who were blinded to whether responses appeared in pretests or posttests.
Disparate ratings were resolved by consensus. For the pretest, the specified timeframe was since the beginning of the year; for the posttest, since the TIBS workshop.
Means and standard deviations were calculated for each item of the evaluation questionnaire. Effect sizes were computed as the absolute value of the difference between the posttest and pretest scores divided by the mean of the standard deviations for each. Analysis was performed with standard statistical software. One hundred and three For items 17 and 18, responses to case scenarios improved after TIBS.
Four students reported having used motivational interviewing techniques before TIBS. Most students found the educational content important and appropriate for their level of training.
Several effect sizes were near, at, or higher than a medium strength of 0. Role modeling by primary care faculty may have helped, too.
Request Username Can't sign in? Strengths and Limitations. MI is a nonjudgmental approach, based on compas- sion, respect, and empathy. This guide will not only teach you the concepts and skills of MI, but it will empower you, as a physician trainee, to find the most effective ways of integrating MI into your trainingand eventually into your medical practice. Individuals may present with specific questions about how to continue to make or maintain the changes they have already determined they want to make. Amid a seemingly endless number of tasks, responsibilities, and challenges that face medical trainees, MI can seem like yet another unwelcome distraction that delays the completion of each days duties. Many people have supported me, in one way or another, in the writing of the book, and I owe special thanks, particularly to Cindy Hurney and Kimberly Smith.
Students demonstrated improvement in perceived and actual knowledge and in perceived skills to promote behavior change. This initial study of the TIBS curriculum had some important limitations. Historical effects cannot be excluded, because there was no control group. However, any such effects were probably small, because most students reported that their GPP preceptors were not familiar with motivational interviewing, and other coursework was unrelated.
Subsequently, Papadakis et al. The current study echoes their findings. The current study is unique, however, in its employment of tobacco intervention training as an initial experience for training medical students in promoting a variety of changes in health risk behaviors, and in its findings that students can be prompted to apply new tobacco intervention skills in practice and extend the model to other behaviors.
A study comparing individuals trained under different curricula could provide a definitive answer. Until then, theory would predict yes. Expectancy value theory suggests that trainees would be more disposed to promote behavior change after exposure to greater numbers of positive experiences and respected individuals who supported such behaviors. Many colleagues assisted with this project. Marijka Hambrecht created web pages.
Jane Banning, MS, trained the standardized patients. Marlon Mundt, MA, assisted with statistical analysis. Health Resources and Services Administration.
Volume 19 , Issue 5p2. The full text of this article hosted at iucr. If you do not receive an email within 10 minutes, your email address may not be registered, and you may need to create a new Wiley Online Library account.
If the address matches an existing account you will receive an email with instructions to retrieve your username. Free Access. Richard L. Search for more papers by this author. Judie M. Pfeifer MEd Search for more papers by this author. Craig L. Gjerde PhD Search for more papers by this author. Christine S. Seibert MD Search for more papers by this author.
Cynthia L. Haq MD Search for more papers by this author. Tools Request permission Export citation Add to favorites Track citation. Share Give access Share full text access. Share full text access. Please review our Terms and Conditions of Use and check box below to share full-text version of article. Behavior Change Model We selected motivational interviewing 16 , 17 as a framework for promoting behavior change.
Curriculum Development Several principles guided curriculum development. Learning Activities Key Components 1. Other results are reported as means and standard deviations of ratings from 1 to 7, with 1 being the highest. Part of a physician's duty is to help patients change their unhealthy and risky behaviors. Physicians can help many patients change their unhealthy and risky behaviors. Physicians should expect their patients to have relapses after changing their behaviors.
I feel knowledgeable about Prochaska and DiClemente's stages of readiness for change. I feel that I am able to conduct an interview to assess a patient's readiness to change unhealthy or risky behavior, using the Prochaska and DiClemente model. I feel I know which motivational interviewing techniques should be applied at particular stages of readiness to change.