年度	2021
全部作者	翁嘉遜,Ehrlich-Jones, L, Kinnett-Hopkins, D., Wong, J., McKenzie, K.A., Engel, E., & Bombardier, C.H.
論文名稱	Use of motivational interviewing in physical/occupational therapy for inpatients with spinal cord injury.
會議名稱	Society of Behavioral Medicine's 2021 Annual Meeting & Scientific Sessions
地點	Virtual Conference
摘要	Background: The extent to which inpatients with spinal cord injury (SCI) actively participate in their rehabilitation significantly predicts important outcomes at discharge and one year. Participation in rehabilitation therapies may be influenced by therapist behaviors and the quality of the patient-therapist relationship. Motivational interviewing (MI) is an evidence-based behavior change counseling style used in healthcare settings. MI has been identified as a critical strategy to increase patients’ participation in rehabilitation and improve self-determination in their healthcare. Although not systematically taught, MI has been incorporated into many professional education programs in the rehabilitation field. However, no study investigated whether rehabilitative professionals integrate MI strategies into their daily practice. The aim of this project was to determine the extent to which physical and occupational therapists (PT, OT) utilize a MI counseling style in their treatment of inpatients with SCI. Methods: PTs and OTs working on the inpatient SCI units at a large Midwestern rehabilitation hospital were recruited to participate. They audio-recorded therapy sessions with SCI inpatients. For each therapist, two 20-minute audio segments were randomly selected for MI evaluation by trained raters. We used the Motivational Interviewing Treatment Integrity 4.2.1 protocol to code MI global relationship skills, MI technical skills and MI-consistent verbal behaviors. Results: Fourteen therapists (13 females) with average age of 28.6 years were recruited to participate. Thirteen were employed full time; 8 were OTs and 6 were PTs. Mean years of experience was 3 years (SD 2.1). Mean global scores (rated on a 1-5 scale where 3.5 or higher is fair to good) were 2.72 for partnership (expertise and wisdom about change resides within the client) and 2.03 for showing empathy (understanding of clients’ perspective and experience). Technical codes of eliciting change talk and softening sustain talk were virtually absent. Mean behavior counts of affirms (something positive about the client), seeks collaboration (acknowledges expertise of the client), and emphasizes autonomy (focus responsibility with client about decisions and actions) were 3.48, 2.48, and 0.41. Conclusions: Although many rehabilitative professional programs provide MI introduction in class, PTs and OTs without formal training in MI do not exhibit these evidence-based counseling skills in therapeutic sessions with SCI inpatients. We found they demonstrated low global MI relationship building skills, almost no MI technical skills and infrequent use of MI-consistent behaviors. Further research is needed regarding the potential benefits of training therapists in MI to help inpatients with SCI increase their participation in therapies.
語言	英文