Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2016-08-30T15:11:07Z No. of bitstreams: 2 Dissertação - Cássia Fernanda de Azevedo - 2015.pdf: 2520197 bytes, checksum: c3a5ae1e0f833571d4b41c8b9a8d0228 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2016-08-30T15:11:37Z (GMT) No. of bitstreams: 2 Dissertação - Cássia Fernanda de Azevedo - 2015.pdf: 2520197 bytes, checksum: c3a5ae1e0f833571d4b41c8b9a8d0228 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2016-08-30T15:11:37Z (GMT). No. of bitstreams: 2 Dissertação - Cássia Fernanda de Azevedo - 2015.pdf: 2520197 bytes, checksum: c3a5ae1e0f833571d4b41c8b9a8d0228 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2015-03-13 / Fundação de Amparo à Pesquisa do Estado de Goiás - FAPEG / Problems involving the consumption of alcohol and other drugs are of a major social and public health problem and its coping requires specialized and assertive actions by the actors involved in these issues. The Motivational Interview is a Brief Intervention strategy, considered effective for the diagnosis and prevention of damages arising. These substances are in agreement with public policy on drugs in Brazil. This is an intervention study, which originated from the project of extension of Federal University of Goias, type descriptive-exploratory, qualitative approach. It had aims to empower students of nursing and Psychology about the handling of the abuse of alcohol and other drugs, in perspective The Motivational Interview. 31, students participated in a course into twenty hours, structured into four theoretical encounters, as well as practical activity a community service for people with the abuse of alcohol and other drugs, located in a small city in the State of Goias. The results show that participants have minimal knowledge about the National policy on drugs and conceive the chemical dependency as an illness, multiple causes, not demonstrating prejudice or stigma with respect to alcohol and other drugs The analysis of the results indicates the need of strengthening this theme in the curriculum of the graduations of the health area, the need for continuous training of professionals In addition to the importance of the integration of University-community-service. / O consumo abusivo de álcool e outras drogas se configuram um grave problema social e de saúde pública e seu enfrentamento requer ações especializadas e assertivas junto aos atores envolvidos nestas questões. A Entrevista Motivacional é uma estratégia de Intervenção Breve, considerada efetiva para o diagnóstico e prevenção dos agravos decorrentes destas substancias e está em consonância com as Políticas Públicas sobre drogas no Brasil. Este é um estudo de intervenção, que se originou a partir de Projeto de extensão da Universidade Federal de Goiás, do tipo descritivo-exploratório, de abordagem qualitativa. Teve como objetivo capacitar graduandos de Enfermagem e Psicologia sobre o manejo do uso abusivo de álcool e outras drogas, na perspectiva da Entrevista Motivacional. Participaram 31 estudantes, num curso de 20 horas, estruturado em quatro encontros teóricos, além de atividade prática num serviço comunitário de atendimento a pessoas com uso abusivo de álcool e outras drogas, localizado em um município do interior do estado de Goiás. Os resultados mostram que os participantes têm conhecimento mínimo sobre a Política Nacional sobre Drogas e concebem a dependência química como uma doença, de multicausalidade, não demonstrando preconceitos ou estigmas com relação ao usuário de álcool e outras drogas. A análise dos resultados sinaliza a necessidade do fortalecimento desta temática nos currículo das graduações da área da saúde, a necessidade da formação contínua dos profissionais além da importância da integração da universidade-serviço-comunidade.

Bakgrund: Sjuksköterskans fyra grundläggande ansvarsområden är att främja hälsa, förebygga sjukdom, återställa hälsa och lindra lidande. I dagsläget lider ungefär hälften av alla invånare i Sverige mellan 16 och 84 år av övervikt och fetma. Detta kan leda till en så kallad livsstilsrelaterad sjukdom på grund av fel kostvanor och/eller för lite fysisk aktivitet. För att förebygga sjukdom behöver ofta livsstilsförändringar ske och då kan motiverande samtal vara en metod för sjuksköterskan att använda för att hjälpa patienten att öka sin motivation till hälsosammare levnadsvanor. Syfte: Att beskriva effekten av sjuksköterskans nyttjande av motiverande samtal vid rådgivning till patienter i behov av förändrad livsstil relaterad till kost och/eller fysisk aktivitet. Metod: En litteraturöversikt genomfördes och tolv studier inkluderades i resultatet. Tio studier hade kvantitativ ansats och två hade mixad metod. Resultat: Motiverande samtal hade en positiv effekt på livsstilsförändringar i samtliga studier som ingår i resultatet. I vissa studier gjordes även positiva framsteg i kontrollgrupper som inte fått rådgivning med motiverande samtal. Statistiskt signifikanta resultat uppnåddes inte i alla studier. Slutsats: Även om effekterna av motiverande samtal inte var bättre i interventionsgruppen än kontrollgruppen i vissa studier så har heller inga negativa resultat påvisats. Resultatet tyder på att metoden kan användas vid rådgivning om livsstilsförändringar relaterade till kost och fysisk aktivitet. / Background: The nurse’s four basic responsibilities are to promote health, prevent disease, restore health and relieve suffering. At present, about half of all citizens in Sweden between 16 and 84 years suffers from overweight and obesity. This can lead to a so-called lifestyle-related illness due to wrong eating habits and too little physical activity. In order to prevent disease, the lifestyle often needs to change, and motivational interviewing may be a method for the nurse to use to help the patient increase the motivation for healthier living habits. Method: A literature review was conducted and twelve studies were included in the results. Ten studies had a quantitative approach and two had mixed method. Aim: To describe the effect of the nurse's use of motivational interviewing in counseling to patients in need of changing lifestyle related to diet and physical activity. Result: Motivational interviewing had a positive effect on lifestyle changes in all the studies included in the result, but in some studies positive progress was also made in the control groups that did not receive counseling with motivational interviewing. Statistical significant results were not reached in all the studies. Conclusion: Although the effects of motivational interviewing were not better in the intervention group than the control group in some studies, no negative results have been shown. The result indicates that the method can be used for advice on lifestyle changes related to diet and physical activity.

The overall aim of this thesis was to examine the relationship between self-efficacy, individually tailored vocational rehabilitation and transition to work or studies. Study I was a cross-sectional study based on questionnaire- and registry data, investigating whether factors related to sick leave predict self-efficacy in women on long-term sick leave (n= 337) due to pain and/or mental illness. General self-efficacy was low. Anxiety and depression were the strongest predictors for low self-efficacy. Study II used longitudinal data from a randomised controlled trial, comprising partly the same women (n=401) as in Study I. Participants were allocated to either 1) assessment of multidisciplinary team and multimodal intervention (TEAM), 2) acceptance and commitment therapy (ACT), or 3) control group. Self-efficacy increased in the TEAM group in comparison with the control group. Study III had a descriptive qualitative design with individual interviews, studying participants’ (n=14) experiences with an individually tailored vocational rehabilitation project, and encounters with professionals working in it. The participants, who were on long-term sick leave due to mental illness or pain reported overall positive experiences with the project. The project was based on collaboration between authorities and motivational interviewing. The positive experiences were based on four categories: Opportunities for receiving various dimensions of support, Good overall treatment by the professionals, Satisfaction with the working methods of the project, and Opportunities for personal development. Study IV was a prospective cohort study investigating perceived self-efficacy in unemployed young adults (n= 249) aged 19-29 year with disabilities, and the association between self-efficacy and transition to work or studies. The study used questionnaire- and registry data from a vocational rehabilitation project. Higher levels of self-efficacy were associated with increased odds for ‘transition to work’. General self-efficacy was low, and young adults with lower self-efficacy reported worse self-rated health compared with those with higher self-efficacy. This thesis showed that multidisciplinary assessment with a multimodal intervention had positive effects on self-efficacy. Individually tailored vocational rehabilitation, based on cooperation and motivational interviewing, may be beneficial for individuals on long-term sick leave and the interactions between participants and the professionals may affect participants’ self-efficacy positively. Mental health needs to be considered when targeting self-efficacy in vocational rehabilitation. Furthermore, research is needed to a) clarify which components in the multidisciplinary team intervention can increase self-efficacy, b) study the effects of vocational rehabilitation based on an individual design, cooperation and motivational interviewing on self-efficacy, health and transition to work, and c) develop interventions that can increase self-efficacy and support transition to work/ studies in young adults with disabilities.

Falls and injuries related to falls are one of the most common health problems among older people and are becoming increasingly more frequent. Regular exercise has been identified as one of the most effective fall-prevention activities for older people; however, awareness of the impact of exercise programmes and adherence to recommended exercise among the elderly population is generally low. Research examining how an exercise programme is administered to and experienced by elderly community-dwelling people is needed. The overall aim of this thesis was to investigate the feasibility, experiences and effects of and adherence to the fall-preventive Otago Exercise Programme (OEP) with or without motivational interviewing (MI) among community-dwelling people aged 75 years or older. Four studies were performed from October 2012 to May 2016 in a sample of 175 people. Both quantitative and qualitative research methods were used. The methods included the feasibility for conducting a randomized controlled trial (RCT) (I), individual face-to-face interviews (II), an RCT (III) and a prospective cohort study (IV). The intervention was given to two groups. The participants who received OEP with or without MI were compared with a control group that received standard care. The feasibility of performing an exercise intervention with or without MI was acceptable from the perspective of the participating physiotherapists. From the perspective of the older participants performing the exercise with behavioural change support, the inclusion of monitored exercises in everyday life and daily routines was important. The participants also expressed experiencing more strength, improved physical functioning and greater hope for an extended active life during old age. From the short-term perspective, there were significant improvements within the OEP combined with MI group in terms of physical performance, fall self-efficacy, activity level, and handgrip strength. Improved physical performance and fall self-efficacy were also found within the control group; however, corresponding differences did not occur in the OEP group without MI. There were no significant differences between the study groups after 12 weeks of regular exercise. Adherence to the exercises in the pooled exercise group was 81% at the 12-week follow-up. At the 52-week follow-up, the behavioural factors being physically active and obtaining behavioural support in terms of MI had a significant association with adherence to the exercise programme. These studies provide some support for the combination of OEP with MI as the addition of MI was valuable for achieving adherence to the exercise programme over time in older community-dwelling people.

Bakgrund: Mer och mer forskning kommer fram som styrker fördelarna med regelbunden fysisk aktiv (FA). Ändå har många svårt att röra på sig tillräckligt. I tidigare forskning har interventioner med ett webbaserat program (WBP) och interventioner med coaching fått positiva resultat med att främja FA. Syfte: Syftet med litteraturöversikten var att undersöka effekten av ett webbaserat program tillsammans med coaching för att främja FA hos individer som är i behov av ökad FA. Metod: För att besvara syftet har en litteraturöversikt gjorts med sammanställning av 8 vetenskapliga originalartiklar. Sökningen gjordes med Databasen PubMed. Artiklarna granskades med hjälp av ”Oxford Levels of Evidence 2011” evidensmetod. Resultat: Majoriteten av studierna (n=6 av 8) visade en positiv effekt av WBP och coaching på FA. Två artiklar såg ingen signifikant förbättring. Slutsats: Utifrån den granskade litteraturen så finns det skäl till att använda ett webbaserat program tillsammans med coaching för att främja FA. Mer forskning kräves för att säkerställa effekten av ett WBP och Coaching på FA samt specifikt effekten på den yngre och äldre befolkningen. / Background: More and more research is emerging that demonstrates the benefits of regular physical activity (FA). Still, many have difficulty being physically active. In previous research, interventions with a web-based program (WBP) and interventions with coaching have had positive results in promoting FA. Aim: The purpose of the review is to investigate the effect of a web-based program together with coaching to promote FA in individuals who are in need of increased FA. Method: In order to answer the purpose, a literature review has been compiled with the compilation of 8 scientific original articles. Articles were found using the PubMed database. The articles were reviewed using the "Oxford Levels of Evidence 2011" evidence method. Results: The majority of studies (n = 6 of 8) showed a positive effect of WBP and coaching on FA. Two articles saw no significant improvement. Conclusion: Based on the literature reviewed, there is positive evidence to suggest usage a web-based program together with coaching to promote FA. More research is needed to ensure the effect of a WBP and Coaching on the FA and specifically the effect on the younger and older population.

Bakgrund: Diabetes mellitus typ 2 är en kronisk systemsjukdom och en av de stora folksjukdomarna i världen och i Sverige. Diabetes typ 2 karakteriseras av förhöjd glukoshalt i blodet vilket på sikt kan orsaka komplikationer i blodkärlen. Utvecklingen av diabetes typ 2 påverkas av individens levnadsvanor så som ohälsosam kost, rökning och fysisk inaktivitet. Fysisk aktivitet är en central del i diabetesbehandlingen där effekten både förebygger uppkomsten av diabetes typ 2 och förbättrar metabol kontroll. Processen att gå från att vara fysiskt inaktiv till att vara fysisk aktiv är dock svår. Trots att det länge varit välkänt att fysisk aktivitet har både kortsiktiga och långsiktiga positiva effekter, har det varit svårt att motivera personer med diabetes typ 2 att förändra sitt beteende och öka sin fysiska aktivitetsnivå. Syfte: Syftet var att undersöka effekten av motivationshöjande metoder för att öka den fysiska aktivitetsnivån hos vuxna med diabetes typ 2. Metod: I arbetet användes en beskrivande design med allmän litteraturöversikt som datainsamlingsmetod med kvantitativ ansats. Litteraturöversikten är baserad på vetenskapliga kvantitativa originalartiklar publicerade mellan år 2011–2021. Sökningen utfördes med databaserna PubMed och CINAHL. Resultat: Interventioner med olika motivationshöjande metoder ökar fysisk aktivitet hos personer med diabetes typ 2. Både motiverande samtal och mobilhälsa som intervention visade en statistiskt signifikant skillnad på antal steg per dag, antal minuter total fysisk aktivitet samt olika intensitet av fysisk aktivitet. Slutsats: Motiverande samtal och mobilhälsa som intervention visade en god effekt på fysisk aktivitetsnivå. Mer forskning behövs i framtiden som undersöker effekten av andra motivationshöjande metoder, samt olika interventionsperioder / Background: Type 2 diabetes is a chronic disease and one of the major public diseases in the world as well as in Sweden. Type 2 diabetes is characterized by elevated levels of glucose in the blood, which leads to complications in the blood vessels. Development of type 2 diabetes is affected by the individual’s lifestyle habits such as unhealthy diet, smoking and physical inactivity. Physical activity is a central part in the treatment of diabetes, where the effect prevents the development of type 2 diabetes and improves metabolic control. The process of changing a habit of being physically inactive to physically active is difficult. Although it has been well known that physical activity has both short- and long-term positive effects, it has been difficult to motivate people with type 2 diabetes to change their behavior and be more physically active. Aim: The aim of the study was to examine the effect of motivation enhancing methods on the physical activity level in adults with type 2 diabetes. Method: A descriptive design with a general literature overview as a data collection method was used with a quantitative approach. The general literature overview is based on scientific quantitative original article’s, published between 2011–2021. The search was performed with PubMed and CINAHL databases. Result: Intervention with different motivation enhancing methods increases physical activity in people with type 2 diabetes. Both motivational interviewing and mobile health interventions showed a statistically significant difference regarding the number of steps per day, total minutes of physical activity and intensity of physical activity. Conclusion: Motivational interview and mobile health interventions elicit a good effect on physical activity. Further research is needed in the future which examines the effectiveness of other motivational enhancing methods as well as different intervention periods.

Bakgrund: Typ 2 diabetes mellitus är en av de stora folksjukdomarna och förekomsten av sjukdomen ökar i hela världen. Typ 2 diabetes mellitus kan medföra allvarliga komplikationer om sjukdomen inte behandlas korrekt. Det går inte att bli frisk från sjukdomen, men genom livsstilsförändringar kan blodsockret sänkas till normala nivåer. Detta innebär att vården har en stor uppgift att hantera för att främja hälsan hos dessa patienter. För att stödja patienten i att hantera sin situation kan sjuksköterskan använda sig av motiverande samtal. Syfte: Beskriva effekten av motiverande samtal hos patienter med typ 2 diabetes mellitus gällande levnadsvanor. Metod: En kvantitativ litteraturöversikt med 14 vetenskapliga artiklar. Resultat: Motiverande samtal visar en varierad effekt. Positiv effekt kunde ses på egenvård, midjemått samt fysisk aktivitet. Ingen effekt kunde påvisas gällande övriga utfallsmått. Vid summering av samtliga utfallsmått från artiklarna visade motiverande samtal endast ha 35% signifikant effekt. Konklusion: Trots varierande effekt av motiverande samtal kan det vara en möjlig metod för sjuksköterskor i mötet med patienter med typ 2 diabetes mellitus för att minska risken för komplikationer.Sjuksköterskan kan med hjälp av motiverande samtal främja motivation, men för att detta ska ha effekt krävs att patienten själv har motivationen att förändra sin livsstil. / Background: Type 2 diabetes mellitus is one of our primary public diseases, and the incidence of the disease is increasing worldwide. Type 2 diabetes mellitus can lead to severe complications if the disease is not controlled. It is not possible to cure the disease, but blood sugar can be lowered to normal levels through lifestyle changes. This means that healthcare has a major task to handle to promote the health of these patients. To support the patient in managing their situation, the nurse can use motivational interviewing. Aim:To describe the effect of motivational interviewing in patients with type 2 diabetes mellitus regarding lifestyle. Method: A quantitative review with 14 scientific articles. Result: Motivational interviewing showed a varying effect. The positive effects could be seen onself-care, waist measurements, and physical activity. No effect is shown regarding other outcome measures. When summarizing all outcome measures from the articles, motivational interviewing showed only a 35% significant effect. Conclusion: Despite the varying effect of motivational interviewing, it may be possible for nurses to use in care for patients with type 2 diabetes mellitus to reduce the risk of complications. With the help of motivational interviewing, the nurse can promote motivation, but for this to have an effect,the patient himself must have the motivation to change his lifestyle.

Motivational interviewing is a widely used psychosocial intervention, both in general and more specifically in Swedish social services. It was developed within the substance abuse field and has later been adapted to many other fields, for example domestic violence. Up to this point there has been some research about MI in this context, but there is a lack of knowledge about how social workers working with domestic violence use and perceive the method in their practical work. This qualitative interview study explores seven Swedish social workers’ perception of this within the theory of affordances. The results have been thematically analyzed and shows that MI is viewed as a flexible, versatile and useful method within domestic violence. The results also show three themes which are called The learning process of MI as an affordance in itself, MI as a useful method in the work with domestic violence and MI applied partially in relation to contextual circumstances. The results further implicate more extensive future studies with a quantitative approach.

Failure accompanies most organizational change efforts. Change agents' efforts focus on employee resistance or readiness to change without considering employee ambivalence. Motivational interviewing (MI) may reduce ambivalence and improve the success rate of organizational change initiatives. The purpose of this experimental research was to evaluate the effectiveness of MI to increase readiness to organizational change, to assess the influence of MI on change-related beliefs, and to investigate the relationship between beliefs and readiness to change. The theoretical framework was the transtheoretical model of change, the theory of planned behavior, and social cognitive theory. Through random assignment, 56 employees of a company undergoing change and located in the Midwest region of the United States populated the experimental and control groups. Members of the experimental group participated in 3 motivational interviewing sessions over a 30-day period. Participants indicated their readiness and underlying change-related beliefs by completing the Job Change Ladder and the Organizational Change Recipients' Belief Scale. Within and between group differences from a mixed ANOVA revealed that MI significantly increased readiness to change. There was not a significant difference between the beliefs of both groups as indicated by the results of the MANOVA test. Participants' beliefs explained readiness to change as evidenced by the results from the use of multiple regression. The findings indicate that leaders of organizational and societal change initiatives could incorporate MI to prepare individuals and groups to embrace the change process, thereby improving the chances that the change initiative will be successful.

Introduktion: Övervikt och fetma är ett växande problem i världen. Även hos barn har det ökat under de senaste 25 åren. Övervikt och fetma hos barn kan leda till ökad risk för ohälsa i vuxen ålder, till exempel diabetes typ 2. För att förebygga detta är det viktigt att barnets familj är delaktiga och får en förståelse för hur hög vikt kan vara förknippat med eventuella hälsoproblem hos barnet senare i livet. Syfte: Syftet var att med en struktuerad litteraturöversikt undersöka barn och föräldrars upplevelser av motiverande samtalsteknik som använts i beteendeinterventioner för att behandla eller förebygga övervikt och fetma. Metod: En strukturerad litteraturöversikt genomfördes där tio kvantitativa och kvalitativa vetenskapliga artiklar analyseras med en tematisk analys för att svara på syftet. Resultat: Flera av studierna påvisade att barn med övervikt eller fetma samt deras föräldrar upplevde nöjdhet med MItekniken. De huvudteman som framkom var barns inre faktorer både motverkar och främjar ökad motivation samt barns yttre faktorer verkar ha en avgörande roll för faktisk beteendeförändring. Slutsats: MI-tekniken verkar vara en bra strategi ur ett deltagarperspektivunder en beteendeförändringsprocessen. Stöd från barnens omgivning lyftes som viktigt. En beteendeförändring upplevs dock vara en stor utmaning av många där faktorer inverkar som brist på motivation, intresse och tid. Mer forskning behövs där motiverande samtal tillämpas som interventionsmetod för fortsatt utveckling av samhälleliga insatser för barn med övervikt och fetma. / Introduction: Overweight and obesity are a growing problem in the world and also increased among children over the past 25 years and can lead to an increased risk of ill-health in adulthood, such as diabetes type 2. To prevent this, it is important that the child’s family is involved and gain understanding of the association between a higher body weight and health problems later in the child’s life. Aim: The purpose of this study was conduct a structured literature review to examine childrens and parents experiences of motivational interviewing in behavioral interventions to treat or prevent overweight and obesity. Methods: A structured literature review was conducted where ten quantitative and qualitative scientific articles within the subject were analysed with a thematic analysis to answer the study aim. Results: Several of included studies showed that children with overweight or obesity and their parents experienced satisfaction with the MI-technique. The main themes were childrens internal factors both counteracts, promotes an increased motivation and childrens external factors seems to have a crucial role in an actual behaviour change. Conclusion: Participant experienced The MI-technique to be a good behavorial strategy. Support from the child’s surrounding seemed as important. A behaviour change was experienced as a challenge where factors like lack of motivation, interest or time impact. To reach better society efforts for children with overweight and obesity, more research is needed where motivational interviewing is used as an intervention method also to be used to support the development of societal effort.