Effects of motivational interviewing on cardiovascular patient adherence
Abstract
Objective: To determine the effect of motivational interviewing, a nursing strategy, on adherence to treatment in patients who have suffered acute myocardial infarction and attend phase II in a cardiac rehabilitation program in Bogota.
Method: This research used a quasi-experimental design that had a nursing strategy based on motivational interviewing as its independent variable and adherence to treatment as its dependent variable. The control group (n=22) received the usual intervention in the cardiac rehabilitation program, while the experimental group (n=22) additionally received one weekly nursing intervention session of motivational interviewing during a three-week period. Three measures of adherence to treatment were taken: the first at the beginning of the study, the second, one week after the intervention had finished, and the third, five weeks after the intervention had finished.
Results: Inter-group analysis showed statistically significant changes only in the third measurement of the dimension that refers to the management of tense situations (p=0.013). Nevertheless, intra-group analysis showed statistically significant differences for the experimental group in their global results for treatment adherence (p=0.007) and in the expectations/self-efficacy behavior (p=0.013), as well as for the need of support for treatment adherence (p=0.013) five weeks after the intervention had finished.
Conclusion: Motivational interviewing seems to be a promising strategy for treatment adherence in patients who have suffered acute myocardial infarction. Therefore, it is advisable to continue researching in the field, so that results derived from intervention can be standardized.
Downloads
References
Global Health Data Exchange. Institute for Health Metrics and Evaluation. University of Washington. 2016. Estados Unidos de America [Internet] [Citado 19 de Julio de 2018]. Recuperado a partir de: https://vizhub.healthdata.org/gbd-compare/
Mozaffarian D, Benjamin E, Go A, Arnett D, Blaha M, Cushman M, et al. Heart Disease and Stroke Statistics – 2016. Update. A report from de American Heart Association. Circulation. 2016;133(8):000-000.
Departamento Administrativo Nacional de Estadística. Defunciones no fetales 2015, preliminar. Colombia; [Internet] [Citado 5 de julio de 2017]. Recuperado a partir de: http://www.dane.gov.co/index.php/esp/component/content/article/118-demograficas/estadisticas-vitales/6234-defunciones-no-fetales-2015-preliminar
Rios Oropesa D, Cervera Estrada L, Hernández Riera R. Reincorporación laboral en pacientes con antecedente de infarto del miocardio. AMC. 2013;17(4):419 – 434.
Núñez LY, Vargas González D, Núñez Quintero M. Psicoterapia breve con pacientes infartados en fase extra hospitalaria. Revista Electrónica Dr. Zoilo E. Marínelo Vidaurreta [revista en internet]. 2013 [citado 15 abril 2018];38(IV).
Esquivel Zúñiga MR, Garzona Navas AF, Sauma Webb AJ. Depresión post infarto agudo del miocardio: implicaciones en el manejo y la mortalidad. Revista cúpula. 2015;29(12):23– 31.
Mendoza Franco RA. Prevalencia de la depresión posterior a un episodio de infarto agudo al miocardio en Cartagena. [Tesis en internet]. [Colombia]: Universidad de Cartagena; 2012. [Citado julio de 2017]. Recuperado a partir de: http://190.242.62.234:8080/jspui/handle/11227/1949
Rodríguez Rodríguez CT. Factores emocionales en la prevención, diagnóstico y tratamiento de las enfermedades cardiovasculares. Valoración actualizada desde la psicocardiología. Rev Finlay. 2012;2(3):158–168.
Vargas Toloza R, Ordoñez Pabón E, Montalvo miranda O, Díaz Torres V. Calidad de vida relacionada con la salud de los pacientes postinfarto agudo de miocardio. Revista ciencia y cuidado. 2008;5(1):40 – 50.
Ramos Morales LE. La adherencia al tratamiento en las enfermedades crónicas. Rev Cubana Angiol Cir Vasc. 2015;16(2):175 – 189.
Martin Alfonso LA, Grau Abalo JA, Espinosa Brito AD. Marco conceptual para la evaluación y mejora de la adherencia a los tratamientos médicos en enfermedades crónicas. Rev Cubana Salud Pública. 2014;40(2):225 – 238.
Camacho-Miñano M, Del Campo C. Impacto de la motivación intrínseca en el rendimiento académico a través de trabajos voluntarios: un análisis empírico. Revista Complutense de Educación. 2015;26(1):67 – 80.
Droppa M, Lee H. Entrevista motivacional: un camino para mejorar la salud. Nursing. 2014;31(6):24 – 29.
Sánchez Monfort J. Entrevista motivacional para enfermería y otras profesiones sanitarias. 2017. España [Internet] [Citado 19 de Julio de 2018]. Recuperado a partir de: http://imc-diabetes.es/wp-content/uploads/2017/01/Entrevista-motivacional-para-enfermeri%CC%81a.pdf
Bóveda Fontán J, Perula de Torres LA, Campiñez Navarro M, Bosh Fontcuberta J, Barragán Brun N, Prados Castillejo JA. Evidencia actual de la entrevista motivacional en el abordaje de los probelmas de salud en atención primaria. Aten primaria. 2013; 45(9):486-495.
Rivera Mercado S, Villouta Cassinelli MF, Ilabaca Grez A. Entrevista motivacional: ¿Cuál es su efectividad en problemas prevalentes de atención primaria?. Aten primaria. 2008; 40(5):257-261.
Spoelstra SL, Schueller M, Hilton M, Ridenour K. Interventions combining motivational interviewing and cognitive behavior to promote medication adherence: a literature review. J Clin Nurs. 2015: 24(9-10):1163-73.
Achury- Beltrán LF. Validez y confiabilidad del cuestionario para medir la adherencia al tratamiento de pacientes con enfermedad cardiovascular. Aquichan. 2017;17(4):460-471.
Rivas-Ruiz R, Moreno-Palacios J, Talavera J. Diferencias de medianas con U de Mann-Whitney. Rev Med Inst Mex Seguro Soc. 2013;51(4):414-9.
Chavarriaga J, Beltrán J, Senior J, Fernández A, Rodríguez A, Toro J. Características epidemiológicas, clínicas, tratamiento y pronóstico de los pacientes con diagnóstico de síndrome coronario agudo en unidad especializada. Acta médica colombiana. 2014;39(1):21-28.
Varela Montero I, Barrón López A. La influencia de la pareja en el ajuste a la enfermedad cardiaca. Acta de Investigación psicológica. 2016;.6(2):2459–2468.
Consuegra-Sanchez L, Melarejo-Moreno A, Galcera-Tomás J, Alonso-Fernández N, Díaz-Pastor Á, Escudero-Garcia G, et al. Educational level and long term mortality in patients with acute myocardial infarction. Rev Esp Cardiol. 2015;68(11):935-942.
Hardcastle S, Taylor A, Bailey M, Harley R, Hagger M. Effectiveness of a motivational interviewing intervention on weight loss, physical activity and cardiovascular disease risk factors: a randomised controlled trial with a 12 month post intervention follow-up. Int J Behav Nutr Phys Act. 2013;10(40):2 – 16.
Castilla Nieto R. Entrevista motivacional en el tratamiento de personas con enfermedades crónicas. Rev Esp común Salud. 2016;7(1):113 – 123.
Pietrabissa G, Ceccarini M, Borrello M, Manzoni GM, Titon A, Nibbio F, et al. Enhancing behavioral change with motivational interviewing: a case study in a Cardiac Rehabilitation Unit. Front Psychol. 2015;6:1-9.
Easthall C, Song F, Bhattacharya D. A meta-analysis of cognitive-based behavior change techniques as interventions to improve medication adherence. BMJ open. 2013;3(8):1–17.
Rubak S, Sandbaek A, Lauritzen T, Christensen B. Motivational interviewing: a systematic review and meta-analysis. Br J Gen Pract. 2005;55(513):305 – 312.
Cohen J. The earth is round (p < .05). American psychologist. 1994;49(12):997–1003.
Manterola C, Pineda V. El valor de la “p” y la “significación estadística” aspectos generales y su valor en la práctica clínica. Rev Chil Cir. 2008;60(1):86–89.
Fied R. Calmly coping: a motivational interviewing via co-Active life coaching (MI-via_CALC) interventions for university students suffering from stress. [Tesis en internet]. [Canadá]: University of Western Ontario; 2014. [Citado noviembre de 2017]. Recuperado a partir de: https://ir.lib.uwo.ca/cgi/viewcontent.cgi?referer=&httpsredir=1&article=3772&context=etd
The works published in this magazine are subject to the following terms:
1. The Publications Service of the University of Murcia (the publisher) preserves the copyright of the published works, and encourages and allows the reuse of the works under the license for use stated in point 2.
© Servicio de Publicaciones, Universidad de Murcia, 2011 (© Publications Service, University of Murcia, 2011)
2. The works are published in the electronic edition of the journal under Creative Commons Reconocimiento-NoComercial-SinObraDerivada 3.0 España(texto legal) “ a Attribution-NonCommercial-NoDerivatives 3.0 Spain license (legal text)”. They can be copied, used, broadcasted, transmitted and publicly displayed, provided that: i) the authorship and original source of their publication (journal, publisher and URL) are cited; (ii) are not used for commercial purposes; iii) the existence and specifications of this license is mentioned.
3. Conditions of self-archiving. Authors are allowed and encouraged to electronically disseminate the pre-print (pre-reviewed ) and / or post-print (reviewed and accepted for publication) versions of their works prior to publication, as it ensures a wider circulation and dissemination which may lead to a possible increase in its mention and a higher scope among the academic community. RoMEO color: green.
