The Effect of Motivational Interviewing on Fatigue in Patients with Multiple Sclerosis

Abstract

Background:Fatigue is taken into account as one of the most important factors affecting quality of life in patients with multiple sclerosis. Such patients can certainly control levels of fatigue, increase their abilities to perform daily activities, and show adaptive behaviors if they are aware of non -pharmacological approaches to reduce fatigue. Thus, the purpose of the present study was to determine the effect of motivational interviewing on fatigue among patients affected by multiple sclerosis in the city of Ilam, Iran. Methods: In the present quasi -experimental study, a total number of 60 patients with multiple sclerosis referring to Shahid Mostafa Khomeini Teaching Hospital in the city of Ilam were randomly allocated to two experimental (intervention) (32 patients) and control (28 patients) groups. To collect the data, the fatigue impact scale (FIS) was used. The experimental (intervention) group also received motivational interviewing based on Miller and Rollnick's Model. To this end, the given patients were divided to seven groups of five individuals and the motivational interviews were conducted lasting between 45 to 60 minutes during five sessions and on a weekly basis for each group. The questionnaires were also completed prior to the intervention and four weeks after the final training session by patients in the experimental (intervention) and control groups. To analyze the data, descriptive and inferential statistics were employed and significance level of less than 0.05 was considered. Results: The findings of this study showed that there was no difference between fatigue before and after the intervention in the experimental (66.32 (10.87)) and control (63.28 (8.29)) groups. However, after the intervention, the fatigue of the experimental (41.75 (14.35)) patients was reduced compared to that of control (62.13 (7.69)) and pre -intervention patients. Conclusions:The findings of the present study showed that implementation of motivational interviewing could alleviate fatigue among patients with multiple sclerosis; therefore, nurses were recommended to give daily care to these patients using this type of interview and to provide the basis for promoting health status of such patients.

Motivational interviewing to promote health outcomes and behaviour change in multiple sclerosis: a systematic review

“…participation in social activities; N studies = 3). 10,11,35 The very large effects reported by Borji et al 35 and Smith et al 11 were unlikely to be undermined by publication bias. Perceived activity and exercise also benefitted from motivational interviewing, leading to improvements in self-reported exertion, intensity and duration of physical activity.…”

“…10,11,16,20,21,36 Attrition bias was a concern, with five studies not reporting why participants were excluded or dropped-out. 15,19,20,32,35 Four studies used data imputation techniques (i.e. intent-to-treat analyses) 10,16,21,36 to minimise detection bias.…”

“…11,20,32 Individual sessions lasted between 10 and 90 minutes over an eight-week period (SD = 4.3; Table 2), with longer sessions provided to those who reported difficulties in meeting their treatment goals. 15,16,21,36 One-to-one counselling ( N studies = 8) 10,11,15,16,20,21,32,35,36 and small group discussions (5–10 participantsper group; N studies = 2), 19,35 delivered in-person ( N studies = 3), 11,19,35 via telephone ( N studies = 4) 15,21,32,36 or in combination, were adopted ( N studies = 3). 10,16,20 Treatment fidelity was monitored by audio-recording therapy sessions or by having expert clinicians rate the degree to which the counsellor’s behaviour met or exceeded established guidelines for practice ( N studies = 6).…”

“…Motivational interviewing was compared with standard medical advice or rehabilitative care ( N studies = 4), 15,20,21,32 wait-list control ( N studies = 2) 10,16 or education and information (relating to multiple sclerosis symptom management; N studies = 3). 19,35,36 A single study compared motivational interviewing to a multi-component programme that combined health coaching with physical exercise. 11…”

“…Less is known about how to apply motivational interviewing in a group setting with this patient cohort: the limited data provided by two studies was characterised by methodological bias. 19,35…”