Magister Curationis - MCur / Background: Motivational interviewing is an approach that relates to a person’s hopes and aspirations. It is individual-focused to enhance intrinsic motivation to change. Over a decade, motivational interviewing has been shown to help achieve positive client outcome regarding substance use at various health settings in high income countries. In the Western Cape, clinical evidence suggests there is increase in number of children born with abnormalities related to prenatal exposure to substance. Anecdotal evidence suggests that the current support system in place for women who have children that are suffering from the effect of prenatal substance exposure seems not to be helping. As agents of change some NGOs in Western Cape are working towards decreasing substance use among pregnant women. Problem statement: The NGOs involve groups of individuals in Cape Town who render their service voluntarily to help pregnant women who have problem of substance use. They help motivate and support pregnant women to live a healthy lifestyle. It is however uncertain if personnel in these NGOs have knowledge of motivational interviewing. Aim: In the absence of the above information, this study is therefore aimed to explore NGO personnel’s knowledge on the use of motivational interviewing in addressing substance use among pregnant women in Western Cape. Method: A quantitative approach using a descriptive design with a non-probability all-inclusive sampling was used. A total of 45 participants were drawn from NGO shelters and day centres working with pregnant women who use substance in the Southern sub-urban district of Cape Town metropolis. Structured questionnaires were given to the participants for data collection and the response rate was 53% (n=24). Data was analysed using descriptive statistics. Results: The results of the study showed that the general performance of the participants on knowledge of motivational interviewing was poor. The score of most participants (i.e. mode) fell within 31 – 40%. Hence, the distribution of the scores was skewed toward the failed side. The percentages of males and females that passed were very low and the values were very close. Hence, gender was found not to influence the performance of the participants in this study. Lack of training in motivational interviewing was found to be responsible for lack of knowledge of the concept. There was no correlation between years of experience and age of participants on performance in the evaluation. The knowledge of participants on characteristics of substance user and the dynamic client-therapist’s interaction was very shallow. Participants who agreed to myths regarding substance users were most likely to exhibit actions that were not consistent with principles of motivational interviewing during their interactions with clients. The participants did not have adequate knowledge of the five basic principles of motivational interviewing. The conclusion of the study was that there was need to train NGO personnel in the concepts of motivational interviewing.

Background: In Canada, only 15% of adults meet the physical activity guidelines (Colley et al., 2011). As regular physical activity has been demonstrated to substantially improve physical and mental health (Naci & Ioannidis, 2013; Schuch et al., 2016), a wealth of physical activity promoting interventions have been developed and evaluated (Kahn et al., 2002; Prince et al., 2014). Physical Activity Counselling (PAC) is one of these and has been shown effective in increasing physical activity motivation and behaviour (Fortier et al., 2011). However, the active ingredients of PAC have never been reported in detail, thus limiting our potential for understanding its effectiveness and to allow for its replication. Recently, taxonomies have been published for characterizing behaviour change techniques (BCTs) and Motivational Interviewing (MI) techniques in interventions (Hardcastle et al., 2017; Michie et al., 2013). Due to its novelty, no studies to date have used the MI technique taxonomy to report interventions. Purpose: To investigate the behaviour change techniques (BCTs) and Motivational Interviewing (MI) techniques applied in PAC sessions delivered by student-counsellors. Methods: PAC 1 and PAC 2 sessions delivered by 11 student-counsellors were double coded for identification of BCTs and MI techniques, for a total of 22 video recorded sessions. Two trained coders rated the presence of BCTs and MI techniques using the Behaviour Change Technique Taxonomy v1 (BCTTv1) and the table of MI techniques. Inter coder agreement was assessed using Cohen’s kappa and the prevalence- and bias-adjusted kappa (PABAK) statistic. Results: Overall, 29 BCTs (on 93) and 27 MI techniques (on 38) were reliably coded across the sampled PAC sessions (Cohen’s k =.81, PABAK=.91). Popular BCTs included 3.1 Social support (unspecified), 1.1 Goal setting (behaviour), 1.4 Action planning, whereas OARS skills (i.e., open-ended questions, affirmations, reflective and summary statements) and 24. Emphasize autonomy were the predominating MI techniques. On average, 5.7 BCTs and 9.5 MI techniques were recorded per session. Conclusions: Findings of this study provide a first detailed report of a PAC intervention and have important implications for PAC training and replication. Future research in this area specifically looking at the quality of application of the techniques and the influence of use and quality on physical activity behaviour over time is recommended.

Although previous studies have considered the factors affecting other certification exam outcomes, they have not examined those that are related to performance on the Professional in Human Resources (PHR) exam. In response to that need, this study specifically investigates technology and training factors that affect self-efficacy and self-set goals, and through them, influence PHR certification exam results. The target population for the study consisted of recent examinees who had taken a formal PHR examination preparation class or used another form of exam preparation training. The survey results were analyzed using partial least squares modeling techniques, and mediation effects were then tested. The results demonstrated that PHR training self-efficacy affected PHR exam self-efficacy and self-set goals. These factors then had an impact on PHR exam scores. Also, the results of task-technology fit were indirectly related to PHR training self-efficacy through a multiple mediation model that included the instructional factor of time on task and the technology factor of perceived usefulness. Surprisingly, time spent on practice exam questions was found to be negatively related to PHR certification exam scores. Finally, instructional feedback indirectly affected outcomes through its positive relationship to self-set goals. The results of the research should help training professionals and examinees in structuring PHR exam training and preparation activities. They also suggest avenues for improving outcomes in other similar types of training.

Abstract: Purpose: Effective interventions are needed to help adolescents with T1D develop independent self-management skills to prevent commonly observed deterioration of disease self-management resulting in poor health outcomes. Using a prospective RCT design, we assessed the impact of a nurse-led education program based on motivational interviewing (MI) in youth with Type 1 diabetes (T1D). Design and methods: After parental consent and youth assent, we prospectively randomized 66 adolescents 13-18 years old with T1D to either usual care (every 3 months visit with pediatric endocrinologist) or usual care supplemented by 2 in-person and 4 follow-up phone calls with a nurse educator in a pediatric endocrinology clinic of the University Hospital Farhat Hached, Sousse, Tunisia. We used MI sessions to support youth general and disease specific self-management skills. Outcomes were change, between baseline and 6 months, in TRAQ (a validated measure of youth self-management) scores and HbA1c values. Results: Mean TRAQ scores (based on a 5-point Likert scale) increased by 1.44 points (s.d. = 0.56) in the Intervention Group versus 0.26 points (s.d.= 0.34) in the control group (p < 0.001). The mean HbA1C value decreased in the intervention group by 0.95 units versus a decrease of 0.12 units in the control group (p=0.047). Conclusion: We found that a brief, nurse-led MI-based educational intervention, integrated into specialty pediatric care, resulted in a significant improvement in both self-reported self-management skills and in HbA1c values. Trial registration: Registered in ClinicalTrials.gov Identifier: NCT04798937

Recently, the skill to play games has led to the professionalization of the activity in the form of “eSports” (electronic sports). Despite the popularity of eSports, little is known about its professional players from a psychological perspective. Given the importance of the coach-created environment in the athletes’ motivational processes, this study aimed to investigate the key psychological dimensions of the coach-created climate in 75 Brazilian professional players of League of Legends (LoL) considering the Self-Determination Theory (SDT) and Achievement Goal Theory (AGT). Fourteen hypotheses were tested, of which seven were confirmed. The empowering climate was a predictor of basic psychological-needs satisfaction and indirectly influenced autonomous motivation. The need satisfaction had a significant impact on both autonomous motivation and on lack of motivation, which, in turn, explained 56% of the variance in well-being and the intention to keep playing eSports. The disempowering climate was a predictor of psychological-needs thwarting but had no significant impact on autonomous motivation or lack of motivation. The results obtained support SDT and AGT in the context of eSports and were similar to those conducted with athletes from traditional sports, indicating that the empower-ing-and-disempowering-coaching-climates conceptualization applies not only to traditional sports athletes but also to professional eSports players. / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Indiana University-Purdue University Indianapolis (IUPUI) / Health care reform emphasizes prevention of chronic disease through the reduction of modifiable risk factors as a way to reduce health care costs, morbidity, and mortality. Motivational interviewing (MI) is an effective method of health behavior counseling. It has been used successfully applied in health related behavior change and self- management of chronic disease. The knowledge, skills, and attitude of MI are acquired through learning as other techniques used in the health professions. Nurse practitioner faculty need guidance on how to design instruction in MI that incorporates competencies and utilizes innovative strategies. Prescriptive instructional design theory utilizes knowledge from educational research to establish the steps in the design process. The purpose of this research was to apply prescriptive instructional theory to the design of effective, efficient, and engaging instruction in MI resulting in beginning proficiency in the NP students. A formative design was used for this study. The First Principles of Instruction served as the prescriptive design theory used in the design of instruction in MI. Data sources included the researcher’s design journal, observation during interaction with the instance, demographics of authentic users, authentic user reaction, and knowledge testing. Four cycles of design-redesign were completed. Results of the study point to improvements in the First Principles of Instruction. The instruction was effective, based on the improved scores from pretest to posttest on the Helpful Response Questionnaire. The improved scores also indicated an increase in knowledge of MI. Efficiency was not improved from pretest to posttest. The definition of efficiency as less time to completion of the task did not apply to MI communication skills. The First Principles of Instruction were useful in the design of the techniques of MI. However, there is little guidance for the affective component of MI such as empathy. The prescriptions of the First Principles of Instruction were useful in designing the instruction in MI. NP students indicated in post instruction interviews that engagement in the instruction was related to the relevance of the subject matter to practice and interactive exercises.

Bakgrund Alkoholbruksyndrom är ett stort hälsoproblem som leder till allvarliga konsekvenser både på individs- och samhällsnivå. Alkoholintag i okontrollerade mängder är en bidragande faktor till den globala sjukdomsbördan. Sjuksköterskor kommer, oavsett arbetsplats, att möta personer som har ett riskbruk av alkohol eller som redan utvecklat alkoholbrukssyndrom. Brief Motivational Intervention (BMI) är framtaget som en behandlingsmetod för personer med riskbruk av alkohol och alkoholbrukssyndrom. Syfte Syftet med studien var att undersöka effekten av Brief Motivational Intervention vid minskning av alkoholintag hos patienter med alkoholbrukssyndrom. Metod Metoden som använts till detta arbete är en litteraturöversikt. Databassökningen genomfördes i PubMed och PsycINFO samt sökmotorn Google Scholar. Femton artiklar av kvantitativ studiedesign svarade på syftet och inkluderades i resultatet. Samtliga artiklar kvalitetsgranskades utifrån Sophiahemmet högskolas bedömningsunderlag. Analys av materialet genomfördes med inspiration från innehållsanalys med femstegsmodell. Resultat Vi fann att olika faktorer spelar in i effekten av BMI. Behandlingsmetoden kan ha en god effekt i minskning av alkoholintag om mottagaren av interventionen har en vilja att genomgå en beteendeförändring. Screening av alkoholintag i form av bland annat AUDIT är en viktig metod för sjuksköterskan i syfte att identifiera individer i behov av hjälp. Slutsats BMI och screening av alkoholvanor kan ha en god effekt hos patienter som har en vilja och motivation till att göra en beteendeförändring. BMI är kostnadseffektivt och metoden SBIRT är en bevisad bra metod att leverera BMI på. I SBIRT ingår även screening av alkoholvanor vilket också är en viktig komponent i behandlingen av alkoholbrukssyndrom. Nyckelord: Alkoholbrukssyndrom, Brief Motivational Intervention, Effekt, Empowerment, Motivation

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AbstractCharlotta Moritz och Hanne Kirsten 2016 Motiverande samtal i skolan (School based Motivational interviewing). Specialpedagogprogrammet, Lärande och samhälle – Skolutveckling och ledarskap, Malmö högskola.Den svenska skolan idag lider brist på motivationskapital. Det leder till att elevernas resultat sjunker och lärarnas sjukskrivningar ökar. Skoldebatten har en tendens att inta problemfokus istället för att finna lösningar. Det är därför viktigt att skolutveckling handlar om att försöka hitta, eller utveckla och anpassa, sätt att möta de problem som finns i skolvardagen.Vi vill undersöka om samtalsmetoden MI kan vara ett användbart redskap för specialpedagoger när de möter behovet av motivation hos pedagoger och elever i skolan. Vidare vill vi problematisera kring arbetets empiri med hjälp av motivationsteori kompetensutvecklingsteori och KASAM. Detta för att, med vetenskapligt förhållningssätt, kunna bidra med underlag för överväganden kring MI i en skolkontext.Arbetet har tre huvudsakliga frågeställningar:•Vilka erfarenheter har de intervjuade specialpedagogerna av metoden MI?•Har MI bidragit till kompetensutveckling hos specialpedagogerna?•Finns skillnader mellan specialpedagogernas uppfattning av MI och upphovsmännens definition av metoden, och vad gör det i så fall med användbarheten i en skolkontext?Arbetets upplägg är induktivt. Kvalitativa intervjuer utgör empirin. Tre specialpedagoger intervjuades i ett inledningsskede, därefter intervjuades en utbildare av metoden MI. Noggranna jämförelser mellan empiri och forskning ligger till grund för resultaten. Som analysverktyg i arbetet används dels Dreyfus och Dreyfus ”Skill Acquisition” modell dels motivationsteorier: Rogers ”Client Centered Therapy”, Deci och Ryans ”Self Determination Theory”, och Banduras ”Self-efficacy Theory".Resultaten visar på breda möjligheter för användandet av MI i skolan. Resultaten visar också att skolans praktiska aspekter gör att möjligheterna kan begränsas.Kompetensutvecklingen inom MI har bidragit till en upplevd förstärkning av relations-kompetensen hos specialpedagogerna. Den tekniska delen av MI-kompetensen hos informanterna förblir, i vårt arbete, till viss del otydlig.MI som metod och förhållningssätt rimmar väl med KASAM vilket kan sägas vara en del av kärnan i specialpedagogens yrkesutövande. De specialpedagogiska implikationerna blir följaktligen att ta ställning till om den egna verksamheten har, eller kan skapa, förutsättningar som gör att MI kan leda till positiva resultat.Elevers och lärares motivation i svensk skola är ett relativt outforskat område. Kontextbunden forskning inom både motivation och MI är därför angeläget.Nyckelord: Motivation, Motivational Interviewing, samtal, relationskompetens, kompetensutveckling.