It is well known that in order to control the morbidity and mortality of cardiovascular disease patients, their lifestyle should be taken into account (American Heart Association, 2012; Klumbiene et al., 2002). Studies of various disease patients’ manners (Knight et al., 2006; Thompson et al., 2011) confirm that motivational interviewing (Miller & Rollnick, 2013) is an effective method for changing unhealthy behavior. Nevertheless, our practical experience of motivational interviewing based psychological counseling with rehabilitation hospitals’ cardiac patients’ (Sinkariova et al., 2015) revealed noteworthy observations about some participants lack of motivation to change unhealthy behavior. This observation encouraged us to start a study with the aim to find out if cardiac rehabilitation participants’ personality traits and emotional state are related to the effectiveness of motivational interviewing based psychological counseling. The study used a quasi-experiment where cardiac rehabilitation patients were assigned to control (regular rehabilitation, n=55) or experimental (rehabilitation plus motivational interviewing based psychological counseling intervention, n=64) groups. A total of 119 participants (male=83, female=36, M age=60.47, SD=8.762) attended a survey, which included NEO-FFI, HADs, and “Readiness to change questionnaire” at the beginning and end of cardiac rehabilitation. Nonparametric data analysis showed that patients’ personality traits are not related to the effectiveness of motivational interviewing based counseling, whereas depression is positively related to the effectiveness of intervention to change alcohol consumption. Conclusions/Implications: Depression as an expression of emotional state is an important feature for the effectiveness of motivational interviewing based counseling to change cardiac patients’ alcohol consumption. Further understanding of relationships between psychological characteristics and the effectiveness of intervention could help to improve cardiac diseases prevention, treatment, and rehabilitation.
SANTRAUKAReikšminiai žodžiai: motyvavimo pokalbis, sveikatai žalingas elgesys, saviveiksmingumas. Sveikatai palankaus elgesio rekomendacijų laikymasis palengvina sergančiųjų sąnarių ligomis sveikimą. Tačiau patys pacientai dažnai stokoja vidinės motyvacijos keisti įprastą elgesį. Sveikatai žalingas elgesys gali būti koreguojamas naudojant motyvavimo pokalbį, kuriuo siekiama sustiprinti asmens saviveiksmingumą ir vidinę motyvaciją keisti savo elgesį. Tyrimo tikslas. Įvertinti motyvavimo pokalbio konsultacijų efektyvumą keičiant sąnarių ligomis sergančiųjų su sveikata susijusį elgesį ir didinant jų saviveiksmingumą. Tyrimo medžiaga ir metodai. Tyrimo metodas -kvazieksperimentas. Tyrime dalyvavo 126 Abromiškių reabilitacijos ligoninės artrologijos-traumatologijos skyriaus pacientai (37 vyrai, 89 moterys), sergantys sąnarių ligomis. Iš jų 66 buvo priskirti poveikio grupei, o 60 -kontrolinei grupei. Tiriamųjų amžius svyravo nuo 21 iki 75 metų (vidurkis -57,69 ± 10,52 m.). Poveikio grupei per gydymosi laikotarpį buvo taikomos 1-4 motyvavimo pokalbio konsultacijos, jų elgesio ir saviveiksmingumo pokyčiai buvo lyginami su kontroline grupe. Su sveikata susi jusio elgesio (alkoholio vartojimo, rūkymo, fizinio aktyvumo, mitybos) pokyčiams išmatuoti naudotas pasirengimo pokyčiui klausimynas ("Readiness to Change Questionnaire", 1992), sudarytas pagal transteorinį pokyčių modelį ir atspindintis tris pokyčių stadijas: nesusimąstymo, mąstymo ir veiksmo. Saviveiksmingumui įvertinti naudotas sveikatos saviveiksmingumo klausimynas. Tiek poveikio, tiek kontrolinės grupės pacientai klausimynus pildė du kartus -gydymo pradžioje ir pabaigoje. Tyrimo rezultatai. Nustatyta, jog po motyvavimo pokalbio konsultacijų poveikio grupės tiriamieji pasistūmėjo aukštesnės pasirengimo keistis stadijos link vertinant fizinio aktyvumo ir rūkymo įpročius. Kontrolinės grupės tiriamieji taip pat perėjo į aukštesnę pasirengimo keisti fizinį aktyvumą stadiją reabilitacijos pabaigoje. Po motyvavimo pokalbio konsultacijų poveikio grupės tiriamųjų sveikatos saviveiksmingumo įverčiai padidėjo, palyginti su pirmąja apklausa. Kontrolinės grupės sveikatos saviveiksmingumas nesikeitė. Išvados. Motyvavimo pokalbio konsultacijos padeda sergantiesiems sąnarių ligomis reabilitacijos metu susimąstyti ir imtis veiksmų keičiant rūkymo ir fizinio aktyvumo įpročius bei didina jų sveikatos saviveiksmingumą. ABSTRACTKey words: motivational interviewing, health behavior, self-efficacy. Healthy lifestyle may improve the symptoms and recovering process for patients with musculoskeletal diseases. Despite this, patients are tend not to practice health promoting behavior. Previous studies show that using motivational interviewing might be effective in enhancing self-efficacy and promoting health behavior changes. The objective of the study is to evaluate the effcacy of motivational interviewing in promoting health behavior changes and enhancing self-efficacy among muskuloskeletal patients. Liuda Šinkariova Vytauto Didžiojo universiteto Teorinės psichologijos katedra Jonavos g. ...
Abstract. Background: It is well known that unhealthy lifestyle is one of the most important risk factors for morbidity and mortality due to cardiac diseases. People who suffered or are suffering from heart related problems usually undertake cardiac rehabilitation procedures which help them improve their health and make lifestyle changes. So it is important to have a valid, short, clear measure of readiness to change health behavior in the native (Lithuanian) language as change in lifestyle can be a problematic field in rehabilitation of cardiac patients in Lithuania. According to the results of national study, smoking, unhealthy diet, low physical activity, overweight and risky alcohol consumption persist as actual problem among Lithuanian adults nowadays. The aim of this analysis is to examine psychometric properties of the "Readiness to change questionnaire" (RCQ, Rollnick et al., 1992) among cardiac rehabilitation patients. Methods: The internal consistency, test-retest reliability, concurrent validity and factor structure of the RCQ was examined for 59 cardiac patients aged between 35 and 70 years (Mean = 55.68, SD = 8.62). The questionnaires for alcohol consumption, smoking, physical activity and diet were completed at the beginning and end of rehabilitation. Results: Cronbach's alpha coefficients of the RCQ showed poor to good internal consistency (0.51-0.87) and test-retest reliability Pearson's correlations ranged from 0.31 to 0.84. Concurrent validity is supported for the stages of alcohol consumption and diet. An exploratory factor analysis of the RCQ indicated the three-factor solution for readiness to change alcohol consumption and diet data best. Confirmatory factor analysis indicated that models demonstrate approximate data-model fit. Conclusions: The Lithuanian version of the RCQ is a reliable measure for group testing. Further investigations regarding validity and factor structure are required with a bigger sample size.
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