Motivational interviewing in a nurse-led outpatient clinic to support lifestyle behaviour change after admission to a stroke unit: a randomized controlled trial
Abstract:Aims
Modification of health behaviour is an important part of stroke risk management. However, the majority of people with cardiovascular disease fail to sustain lifestyle modification in the long term. We aimed to evaluate the effectiveness of motivational interviewing to encourage lifestyle behaviour changes after transient ischaemic attack (TIA) or minor ischaemic stroke.
Methods and results
We performed a randomized cont… Show more
“…An increasing body of research has repeatedly indicated that physical activity interventions led by nurses may be effective for increasing physical activity in primary care settings (Olsen et al, 2018; Richards & Cai, 2016). Similarly, nurses have been shown to be valuable in hospital-based physical activity interventions and rehabilitation, including in patients undergoing hemodialysis (Perez-Dominguez et al, 2021) and those admitted to a stroke unit (Brouwer-Goossensen et al, 2021). More specifically, one of the most important roles that nurses can offer is physical activity counselling, specifically by providing support and motivation to clients (Richards & Cai, 2016).…”
Background Nurses may be well poised for providing physical activity guidance and support to patients. Purpose The purposes of this study were to examine the effectiveness of a concise, evidence based online learning modules strategy (OLMS) for improving nurses’ physical activity counselling. Methods 68 nurses were randomly assigned to either an OLMS group or control group. The OLMS group completed a series of six online learning modules aimed at improving physical activity counselling practice. Results The OLMS group, compared to the control group, showed a trend for improvement in Physical Activity Counselling Practice ( p = .063) after controlling for baseline values, and significant improvement in (a) Self-efficacy for Physical Activity Counselling ( p = .001), (b) Knowledge of Physical Activity Guidelines, ( p = .031), and (c) Perceived Benefits of Physical Activity Counselling ( p = .014) over the course of the intervention. No significant change was found for Barriers for Providing Physical Activity Counselling ( p > .05). Conclusions The OLMS tested may be an effective means for improving self-efficacy, knowledge, and perceived benefits of physical activity counselling, suggesting the utility of online learning strategies for improving nurses’ physical activity counselling practice. Given barriers to providing physical activity counselling were not affected by the intervention, future interventions and policy change could target these barriers specifically in order to give nurses more tools and time for reaching patients and addressing physical activity counselling in practice.
“…An increasing body of research has repeatedly indicated that physical activity interventions led by nurses may be effective for increasing physical activity in primary care settings (Olsen et al, 2018; Richards & Cai, 2016). Similarly, nurses have been shown to be valuable in hospital-based physical activity interventions and rehabilitation, including in patients undergoing hemodialysis (Perez-Dominguez et al, 2021) and those admitted to a stroke unit (Brouwer-Goossensen et al, 2021). More specifically, one of the most important roles that nurses can offer is physical activity counselling, specifically by providing support and motivation to clients (Richards & Cai, 2016).…”
Background Nurses may be well poised for providing physical activity guidance and support to patients. Purpose The purposes of this study were to examine the effectiveness of a concise, evidence based online learning modules strategy (OLMS) for improving nurses’ physical activity counselling. Methods 68 nurses were randomly assigned to either an OLMS group or control group. The OLMS group completed a series of six online learning modules aimed at improving physical activity counselling practice. Results The OLMS group, compared to the control group, showed a trend for improvement in Physical Activity Counselling Practice ( p = .063) after controlling for baseline values, and significant improvement in (a) Self-efficacy for Physical Activity Counselling ( p = .001), (b) Knowledge of Physical Activity Guidelines, ( p = .031), and (c) Perceived Benefits of Physical Activity Counselling ( p = .014) over the course of the intervention. No significant change was found for Barriers for Providing Physical Activity Counselling ( p > .05). Conclusions The OLMS tested may be an effective means for improving self-efficacy, knowledge, and perceived benefits of physical activity counselling, suggesting the utility of online learning strategies for improving nurses’ physical activity counselling practice. Given barriers to providing physical activity counselling were not affected by the intervention, future interventions and policy change could target these barriers specifically in order to give nurses more tools and time for reaching patients and addressing physical activity counselling in practice.
“… 68 The longest total intervention duration was a multicomponent support programme incorporating motivational interviewing, this involved eight face-to-face appointments and continued up to 24 months poststroke. 55 Brief interventions included 15 min motivational interviewing sessions by an experienced nurse practitioner at 4, 8 and 12 weeks 41 and daily mobile phone messages for 3 months. 42 The e-health intervention provided constant monitoring for 14 days.…”
Section: Resultsmentioning
confidence: 99%
“…Eleven of the studies mentioned supporting self-management. 41 47 53 55 56 58–60 62 66 70 One study included carers in its outcome measures 66 and no fidelity testing was described. All intervention components are presented in online supplemental file 3 .…”
ObjectiveTo identify the breadth and range of follow-up interventions currently provided to people after minor stroke with a focus on the definitions used for minor stroke, intervention components, intervention theory and outcomes used. These findings will inform the development and feasibility testing of a pathway of care.DesignScoping review.Search strategyThe final search was run in January 2022. Five databases were searched—EMBASE, MEDLINE, CINAHL, British Nursing Index and PsycINFO. Grey literature was also searched. Title and abstract screening and full-text reviews were conducted by two researchers and a third was involved when differences of opinion existed. A bespoke data extraction template was created, refined and then completed. The Template for Intervention Description and Replication (TIDieR) checklist was used to describe interventions.ResultsTwenty-five studies, using a range of research methodologies were included in the review. A range of definitions were used for minor stroke. Interventions focused largely on secondary prevention and management of increased risk of further stroke. Fewer focused on the management of hidden impairments experienced after minor stroke. Limited family involvement was reported and collaboration between secondary and primary care was seldom described. The intervention components, content, duration and delivery were varied as were the outcome measures used.ConclusionThere is an increasing volume of research exploring how best to provide follow-up care to people after minor stroke. Personalised, holistic and theory-informed interdisciplinary follow-up is needed that balances education and support needs with adjustment to life after stroke.
“…This resulted in 14 citations that met criteria for inclusion in this scoping review. [23][24][25][26][27][28][29][30][31][32][33][34][35][36] The flow of citations through identification to final article selection is illustrated in Figure 1 Age, sex, and race. The average age of participants across studies was 64 (range: 50-71) years; the average age of participants was 50-59 years in 3 studies, 60-69 years in ten studies, and 70-71 years in 1 study.…”
Section: Resultsmentioning
confidence: 99%
“…This resulted in 14 citations that met criteria for inclusion in this scoping review. 23-36 The flow of citations through identification to final article selection is illustrated in Figure 1. The 14 included articles and abstracted study characteristics, intervention characteristics, dietary measures, and dietary outcomes are presented in Table 1 and summarized below.Figure 1.PRISMA flow diagram.…”
Objective: To identify and summarize studies that have implemented dietary behavior interventions and reported dietary outcomes in community-dwelling adult stroke survivors. Design: Scoping Review; Setting: Not applicable. Participants: Studies eligible for review included peer-reviewed studies describing both a dietary intervention and a dietary outcome among community-dwelling stroke survivors published between January 2000 and June 2022. Results: We identified 14 articles that included both a dietary behavior intervention and a dietary outcome. All studies (5 pilot randomized controlled trials (RCTs), 6 non-pilot RCTs, 3 cohort studies) delivered multimodal health behavior interventions that included a dietary component. Interventions were delivered weekly to every other month and lasted for 1–24 months. Most studies did not use standardized assessments to assess dietary outcomes; however, 8 studies reported improvement in dietary outcomes. Conclusions: This review provides support for the efficacy of dietary behavior interventions in stroke survivors. Variability in intervention format and assessment measures across studies impedes the ability to conduct meta-analyses of outcomes to inform research knowledge and clinical practice. Additional research is needed to determine mechanisms-of-action for dietary behavior change in stroke survivors.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
