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Motivational Interviewing is an Effective Way to Connect with Patients

Posted Nov 03 2008 9:02pm

Because my job doesn’t involve direct patient contact, there are times when I come across what I believe to be a new bright idea for improving patient-nurse interaction that turns out to have been around awhile. Such is the case with a practice called Motivational Interviewing, a plan a nurse can use to forge a partnership with the patient who needs to make lifestyle changes in order to lessen risks to his health.

Using the Motivational Interviewing (MI) technique, the nurse takes on the non-confrontational roles of counselor, cheerleader and partner to, for and with the patient. Such strategies can encourage the patient to more closely follow guidelines that lead to optimum health. MI, which got its start in 1991 in the area of treating addiction, is significantly helpful in the self-management of chronic illness, when a longtime, perhaps even lifelong, commitment to change is required of the patient.

Simply knowing what we should do doesn’t always equate to our doing it. I know, because of my high cholesterol levels, that I should avoid animal fats in my diet. But, when Granny’s homemade yeast rolls are passed around the table, do I send the butter dish past without slicing off a pat? Not always. It takes an unusually dedicated person to always make the best and healthiest choice, and I suspect there are precious few of us who are that perfect. Those in the know point out that the ability to make changes is influenced more by motivation than by information, so that puts most of us in the position of needing something (i.e. quality of life) and/or someone (a motivational interviewer) to guide us along and encourage us.

The nurse in this situation must abandon a strictly instructional role and become a facilitator who can put frustration aside when the patient is lackadaisical about following the path to best health. The MI nurse’s role requires empathy when the patient is non-compliant, while continuing to promote healthy choices and to assist the patient in identifying not-always-obvious reasons for his resistance and devise solutions to break through the road blocks. It can seem like a never-ending task in some cases, I’m sure, but worthwhile for the patient and gratifying for the nurse when even small victories come about.

There is special training available for nurses who’re interested in this approach to patient education and health management. Information regarding the MI approach and training can be found at www.motivationalinterview.org/training/index.html.

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