地域および公衆衛生看護学ジャーナル

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Nurse Practitioner Confidence and Attitudes towards Brief Motivational Interventions to Improve Compliance with Health and Wellness Recommendations

Barbara M Brathwaite, Marie Ann Marino and Patricia Bruckenthal

Background: Health behavior risks prevail in older patients and can include unhealthy diet and nutrition, sedentary lifestyle and physical inactivity, alcohol use and abuse and poor oral hygiene. According to the Centers for Disease Control (CDC), most of the sickness, dependency, disability, use of resources, institutionalization and premature morbidity and mortality associated with chronic disease can be avoided through preventive measures and risk reduction. Preventive care is more effective in improving health than routine health care, yet research indicates that many patients do not seem to receive preventive strategies due to provider barriers. Evidence supports that training and education significantly improve practitioner knowledge, their decision to use strategies for behavior change and increases confidence.
The emerging body of evidence supports brief motivational interventions as effective strategies that can help patients change health behaviors and affect outcomes. The purpose of this study was to assess nurse practitioner student confidence and attitudes in using a brief motivational intervention. A secondary aim was to assess the degree of completion of each patient’s selected behavioral plan.

Methods: This investigator-initiated pilot study examined relationships among 15 nurse practitioner student confidence and attitudes toward delivery and implementation of a Brief Action Planning (BAP) intervention to 104 older adults. Nurse practitioner students received a BAP educational program and delivered BAP to older adults in an inter-professional collaborative practice that addresses the oral health, health promotion, clinical prevention and social services needs of community-dwelling older adults.
Results: Findings showed a significant change (p<0.05) in NP effectiveness, confidence, belief in and the ease of learning and incorporating BAP and the value of adding BAP to care. Forty two percent of patients fully completed, 35% partially completed and 23% did not complete their selected plan to change a health behavior.
Conclusion: An educational program increased NP confidence, effectiveness and belief in value and use of a brief motivational technique to change a health behavior. Provider training helps decrease barriers to implementing motivational techniques and prevention strategies. BAP shifts thinking about how to help motivate patients toward change, is easy to learn and feasible.