Background
Aims
Research questions
Methods
Design
Sample
Characteristics | |
---|---|
Age (years), range (mean) | 23-76 (51.5) |
Gender, n (%) | |
Female
| 21 (65.6) |
Male
| 11 (34.4) |
Area of residence, n (%) | |
Urban area
| 20 (62.5) |
Rural area
| 12 (37.5) |
Education, n (%) | |
Compulsory school
| 10 (31.3) |
High school degree
| 14 (43.8) |
University degree
| 8 (25.1) |
Occupation, n (%) | |
Employed
| 21 (65.6) |
Retired
| 9 (28.1) |
Studying
| 1 (3.1) |
Unemployed
| 1 (3.1) |
Data collection
Audio-record
Target behaviors | Numbera |
---|---|
Quit smoking. | 7 |
Make lifestyle changes to improve health. | 6 |
Gain control over blood sugar (with diet, exercise and medication). | 2 |
Lose weight. Improve diet and exercise habits. | 2 |
Maintain control over blood sugar (medication, complications, diet) | 1 |
Maintain lifestyle improvements to gain control over blood sugar/metabolic syndrome including ordination adherence. | 1 |
Quit smoking. Improve diet and exercise habits. | 1 |
Lower blood pressure through lifestyle changes. | 1 |
Improve diet and exercise habits. Explore origin of cough. | 1 |
Maintain lifestyle improvements. | 1 |
Join quit smoking group. | 1 |
Begin asthma treatment. | 1 |
Adherence to medication/treatment. Maintain non-smoking. | 1 |
Follow eczema treatment recommendations. | 1 |
Establish sleep routines and begin social training. | 1 |
Establish sleep routines. | 1 |
Actively contribute to language development and eat less sweets. | 1 |
Seek help for depression. | 1 |
Questionnaires
Procedure
Data analysis
Global score
Behavior counts
Summary score
MITI variables | ICC | (95 % Cl) |
---|---|---|
Empathy | 0.42 | (-0.12-0.77) |
Evocation | 0.14 | (-0.42-0.62) |
Collaboration | 0.49 | (0.00-0.80) |
Autonomy/Support | 0.34 | (-0.25-0.73) |
Direction | 0.55 | (0.08-0.82) |
Giving information | 0.88 | (0.66-0.96) |
MI adherent | 0.66 | (0.02-0.89) |
MI non-adherent | 0.72 | (0.33-0.90) |
Closed questions | 0.96 | (0.88-0.99) |
Open questions | 0.95 | (0.87-0.99) |
Simple reflections | 0.69 | (0.29-0.89) |
Complex reflections | 0.83 | (0.57-0.94) |
Ethical considerations
Results
Characteristics of the nurses’ training in and use of MI
Nurse | Years since MI training | Days of MI training | Supervision | Feedback | Who provided the feedbackc | How they received the feedbackd |
---|---|---|---|---|---|---|
1 | 8 | 10b | No | Yes | A | L, A, |
2 | 5 | 3 | Yes | Yes | B | V, P |
3 | 2 | 2b | Yes | Yes | B, E | A, V, G, P, W |
4 | 6 | 3 | No | No | - | - |
5 |
a
| 2b | No | No | - | - |
6 | 4 | 7b | Yes | Yes | B, C | L, O, V, G |
7 | 7 | 2 | No | No | - | - |
8 | 12 | 7b | Yes | Yes | B | L, A |
9 | 5 | 3 | Yes | Yes | C | O |
10 | 12 | 2.5 | Yes | Yes | D | V, P |
11 | 10 | 10 | No | No | - | - |
12 | 9 | 3 | No | No | - | - |
Scores on global dimensions of the MITI vs. self-ratings of MI performance
Global scorea and Self-ratingsb | ||||||
---|---|---|---|---|---|---|
Primary care nurses | Evocation | Collaboration | Autonomy/Support | Direction | Empathy | |
Session | I/II/III | I/II/III | I/II/III | I/II/III | I/II/III | |
Nurse 1 | Global score | 3/4/3 | 3/4/4 | 3/3/4 | 4/4/4 | 4/4/4 |
Self-ratings | 3/4/4 | 3/4/4 | 4/4/4 | 3/4/4 | 4/4/3 | |
Nurse 2 | Global score | 3/3/3 | 3/3/3 | 3/3/4 | 4/5/5 | 4/4/3 |
Self-ratings | 4/4/4 | 4/4/4 | 3/4/4 | 4/4/4 | 4/4/4 | |
Nurse 3 | Global score | 2/3/c | 2/3/c | 3/2/c | 5/5/c | 4/4/c |
Self-ratings | 3/d/c | 2/d/c | 3/d/c | 4/d/c | 3/d/c | |
Nurse 4 | Global score | 3/2/2 | 2/2/2 | 3/2/2 | 4/4/5 | 3/3/4 |
Self-ratings | 4/5/5 | 5/4/5 | 5/4/4 | 3/5/5 | 4/4/5 | |
Nurse 5 | Global score | 3/2/1 | 3/2/2 | 4/3/1 | 5/5/4 | 4/3/2 |
Self-ratings | 5/4/3 | 4/4/3 | 5/4/4 | 5/4/4 | 5/4/4 | |
Nurse 6 | Global score | 2/4/c | 2/4/c | 2/3/c | 5/5/c | 3/4/c |
Self-ratings | 4/4/c | 4/4/c | 4/3/c | 3/4/c | 4/4/c | |
Nurse 7 | Global score | e/2/1 | 2/2/2 | 2/2/2 | e/2/3 | 3/2/3 |
Self-ratings | 4/4/4 | 4/4/5 | 3/3/4 | 4/4/5 | 4/4/4 | |
Nurse 8 | Global score | 1/3/2 | 3/2/2 | 4/3/3 | 1/5/5 | 3/3/3 |
Self-ratings | d/4/c | d/3/c | d/4/4 | d/2/2 | d/2/4 | |
Nurse 9 | Global score | 2/3/2 | 3/4/1 | 3/3/2 | 2/3/3 | 3/3/2 |
Self-ratings | 3/4/4 | 5/4/4 | 5/3/4 | 3/3/4 | 3/4/5 | |
Nurse 10 | Global score | 1/1/2 | 1/1/2 | 1/2/2 | 5/5/3 | 2/2/3 |
Self-ratings | 4/3/3 | 4/4/5 | 4/3/4 | 4/3/4 | 4/4/4 | |
Nurse 11 | Global score | 1/2/c | 1/1/c | 1/1/c | 5/5/c | 1/2/c |
Self-ratings | 5/5/c | 5/5/c | 5/5/c | 5/5/c | 5/5/c | |
Nurse 12 | Global score | 1/1/c | 2/1/c | 3/2/c | 2/4/c | 2/2/c |
Self-ratings | 4/3/c | 4/4/c | 4/4/c | 3/3/c | 4/3/c | |
Summary of scores and self-ratings | Number of Sessions/Number of Nurses | |||||
Global scores |
High score (4-5)
| 2/2 | 4/3 | 4/4 | 23/10 | 10/6 |
Low score (1-2)
| 19/10 | 20/10 | 15/9 | 4/4 | 9/6 | |
Self-ratings |
High rate (4-5)
| 21/11 | 25/10 | 23/11 | 20/10 | 25/11 |
Low rate (1-2)
| 0 | 1/1 | 0 | 2/1 | 1/1 | |
Overestimatesf |
(+2 steps)
| 10/6 | 7/7 | 9/6 | 2/1 | 5/4 |
(+3-4 steps)
| 5/7 | 9/6 | 4/3 | 0 | 3/3 | |
Underestimatesf |
(-2-4 steps)
| 0 | 0 | 0 | 4/3 | 0 |
MITI counts of specific behaviors vs. self-ratings of performance
Behavior countsa | |||||||||
---|---|---|---|---|---|---|---|---|---|
Primary care nurses | Length of coded part of the sessionb (minutes) | Length of session (minutes) | Giving information | MI Adherent (MiA) | MI Non-adherent (MiNa) | Closed questions (cq) | Open questions (oq) | Simple reflections (sr) | Complex reflections (cr) |
Session | I/II/III | I/II/III | I/II/III | I/II/III | I/II/III | I/II/III | I/II/III | I/II/III | I/II/III |
Nurse 1 | 20/20/20 | 51/51/54 | 18/20/22 | 2d/0/5d | 0/0/1 | 24e/15/15 | 19/21/13 |
24/33/20
| 15/21/15 |
Nurse 2 | 20/20/20 | 54/50/48 | 15/18/14 | 5e/1/2d | 0/0/0 | 16e/20e/12e | 9/8/7 | 13e/6e/4 | 6/5/5 |
Nurse 3 | 20/20/c | 24/42/c | 15/15/c | 7d/1/c | 6/2/c | 12/14/c | 3/3/c | 6d/10/c | 13/15/c |
Nurse 4 | 14/20/20 | 21/41/84 | 10/17/15 | 1/3e/1e | 1/7/6 | 14e/15e/9 | 8/7/10 | 8d/10d/3d | 12/12/8 |
Nurse 5 | 18/20/20 | 30/44/40 | 21/22/21 | 4/5d/1e | 2/4/6 | 15e/21e/15 | 8/17/12 | 10d/7/8e |
15/6/5
|
Nurse 6 | 17/20/c | 20/26/c |
4/28/
c
| 1e/2/c | 3/0/c |
17
e
/7
e
/
c
| 5/8/c | 10/9/c | 3/2/c |
Nurse 7 | 11/11/19 | 13/17/30 |
14/10/30
| 2e/1e/0 | 4/8/7 | 20/14e/11 | 8/8/2 | 2d/2d/2 | 11/4/7 |
Nurse 8 | 14/20/20 | 21/22/21 |
22/35/46
| 3/5d/2e | 3/4/5 |
14/49/33
e
| 3/6/5 | 7/13/7d |
5/12/17
|
Nurse 9 | 18/16/18 | 24/22/23 |
17/23/34
| 8/10d/5 | 3/2/7 |
12
e
/22
e
/21
e
|
9/15/3
| 4d/3/8 | 8/3/1 |
Nurse 10 | 20/20/20 | 36/23/23 |
0/18/15
| 1e/2e/1e | 9/6/5 |
8/30
e
/20
e
| 7/5/6 |
8
d
/18/7
| 5/7/8 |
Nurse 11 | 20/20/c | 30/31/c | 21/14/c | 0e/2e/c |
17/5/
c
|
20
e
/38
e
/
c
| 7/5/c | 7/12/c | 2/2/c |
Nurse 12 | 20/20/c | 37/29/c |
3/48/
c
| 3/5e/c | 2/9/c |
16
e
/26
e
/
c
| 8/5/c | 3e/3e/c | 0/0/c |
Summary of self-ratings of performance | Number of Sessions/Number of Nurses | ||||||||
Self-ratings |
More MiA/oq/cr
than MiNa/cq/sr
| 9/6 | 11/7 | 2/2 | |||||
As many
MiA/oq/cr as MiNa/cq/sr
| 13/9 | 13/9 | 11/6 | ||||||
More MiNa/cq/sr
than MiA/oq/cr
| 6/5 | 5/5 | 16/10 | ||||||
Self-ratings compared with counts |
Overestimates
| 14/9 | 21/11 | 5/3 | |||||
Underestimates
| 7/6 | 0 | 10/7 |
Proficiency/competency in MI as stipulated by MITI thresholds
Summary scoresa | |||||||
---|---|---|---|---|---|---|---|
Primary care nurses | Reflections-to-questions ratio | Percent open questions | Percent complex reflections | Percent MI adherent | Empathy | MI spirit ratingb | |
Thresholds:
|
Beginning proficiency
| ≥1 | ≥ 50 % | ≥ 40 %, | ≥ 90 % | ≥ 3.5 | ≥ 3.5 |
Competency
| ≥ 2 | ≥ 70 % | ≥ 50 % | ≥ 100 % | ≥ 4 | ≥ 4 | |
Session | I/II/III | I/II/III | I/II/III | I/II/III | I/II/III | I/II/III | |
Nurse 1 | 0.9/1.5/1.3 | 44/58/46 | 38/39/43 | 100/0/83 | 4/4/4 | 3/3.7/3.7 | |
Nurse 2 | 0.8/0.4/0.5 | 36/29/37 | 32/45/56 | 100/100/100 | 4/4/3 | 3/3/3.3 | |
Nurse 3 | 1.3/1.5/c | 20/18/c | 68/60/c | 54/33/c | 4/4/c | 2.3/2.7/c | |
Nurse 4 | 0.9/1.0/0.6 | 36/32/53 | 60/55/73 | 50/30/14 | 3/3/4 | 2.7/2/2 | |
Nurse 5 | 1.1/0.3/0.5 | 35/45/44 | 60/46/38 | 67/56/14 | 4/3/2 | 3.3/2.3/1.3 | |
Nurse 6 | 0.6/0.7/c | 2/53/c | 23/18/c | 25/100/c | 3/4/c | 2/3.7/c | |
Nurse 7 | 0.5/0.3/0.7 | 29/36/15 | 85/67/78 | 33/11/0 | 3/2/3 | 1.3/2/1.7 | |
Nurse 8 | 0.7/0.4/0.6 | 18/11/13 | 42/48/71 | 50/56/29 | 3/3/3 | 2.7/2.7/2.3 | |
Nurse 9 | 0.6/0.2/0.4 | 43/41/13 | 67/50/11 | 73/83/42 | 3/3/2 | 2.7/3.3/1.7 | |
Nurse 10 | 0.9/0.7/0.6 | 47/14/23 | 38/28/53 | 10/25/17 | 2/2/3 | 1/1.3/2 | |
Nurse 11 | 0.3/0.3/c | 26/12/c | 22/14/c | 0/29/c | 1/2/c | 1/1.3/c | |
Nurse 12 | 0.1/0.1/c | 33/16/c | 0/0/c | 60/36/c | 2/2/c | 2/1.3/c |