Communications and Behavior in Nursing Discussion
Miller, Marolen, & Beech, (2010), presented a study testing the effectiveness of motivational interviewing (MI) among rural African American women with type II diabetes. Subjects, ages 21-50, joined focus groups, where they disclosed the perceptions of physical activity and exercise. Additionally, the women viewed a video illustrating patient-physician dialogue; one, utilizing motivational interviewing techniques (open-ended questioning), the other, a paternalistic approach (closed-ended questioning).
The women disclosed awareness of the health benefits of physical activity and exercise, yet, reported barriers to engaging in physical activity such as, work and family priorities, and lack of seeing instant results from exercising (weight loss). Such barriers are common to many working women, including myself, as it can be quite challenging to set aside time for exercise, while juggling being a mother and a wife, and working full time. Rational strategies including, taking short walks, getting up earlier a few times during the week for a work out session, and avoiding use of elevators to climb stairs, may be implemented to overcome barriers to physical activity.
Overall, the participants expressed positive components of motivational interviewing counseling style, as it promotes patient involvement and provides a comfortable environment. However, Miller, Marolen, & Beech, (2010), revealed, that the majority of participants verbalized preference of a more traditional paternalistic method, in which the provider tells the patient what to do. Such method is familiar to them and is perceived as “good counseling”.
The role of a registered nurse is multifaceted. Nurses perform various functions, including, but not limited to, interpreting patient information, providing health promotion and education, and planning and implementing interventions. It is imperative for nurses to be in tune with patients’ needs and preferred learning and counseling style. Although motivational interviewing promotes patient involvement and empowerment, prudent nurses and providers must recognize the importance of including paternalistic methods, when communicating with patients who are most comfortable with this style of counseling.
