Telephone-Delivered Lifestyle Support With Action Planning and Motivational Interviewing Techniques to Improve Rehabilitation Outcomes

被引:35
作者
Doebler, Andrea [1 ,2 ]
Belnap, Bea Herbeck [3 ,4 ]
Pollmann, Hartmut [5 ]
Farin, Erik [1 ,2 ]
Raspe, Heiner [6 ]
Mittag, Oskar [1 ,2 ]
机构
[1] Univ Freiburg, Sect Hlth Care Res & Rehabil Res, Med Ctr, Hugstetter St 49, D-79106 Freiburg, Germany
[2] Univ Freiburg, Fac Med, Hugstetter St 49, D-79106 Freiburg, Germany
[3] Univ Pittsburgh, Sch Med, Ctr Behav Hlth & Smart Technol, Pittsburgh, PA 15260 USA
[4] Univ Goettingen, Med Ctr, Dept Psychosomat Med & Psychotherapy, Gottingen, Germany
[5] Niederrhein Clin, Bad Neuenahr Ahrweiler, Germany
[6] Univ Lubeck, Inst Social Med & Epidemiol, Lubeck, Germany
关键词
motivational interviewing techniques; HAPA; action planning; telephone; QUALITY-OF-LIFE; PHYSICAL-ACTIVITY; BEHAVIOR-CHANGE; DISEASE MANAGEMENT; CARDIOVASCULAR-DISEASE; SECONDARY PREVENTION; MEDICATION ADHERENCE; DIABETES TREATMENT; METABOLIC-CONTROL; RANDOMIZED-TRIAL;
D O I
10.1037/rep0000224
中图分类号
B849 [应用心理学];
学科分类号
040203 ;
摘要
Objective: In this randomized controlled trial, we evaluated the effectiveness of a telephone-delivered intervention based on the Health Action Process Approach (HAPA) after discharge from inpatient rehabilitation to address behavior change. emotional status, and glycemic control in patients with Type 2 diabetes. Design: In a German rehabilitation center. 249 patients with Type 2 diabetes were separated into randomized groups, either a 12-month telephone follow-up support group or the usual care group. The counselor identified personal target areas and intervention modules and developed with the patient an individualized action plan for the telephone support. To enhance motivational processes, they used motivational interviewing techniques. Counselors called patients monthly to support the implementation of the personal plans into the patients' daily routines and to screen for emotional problems. Assessments measured exercise, diet, medication adherence, psychological variables, body mm index, HbA1c, and cardiovascular risk. Results: Twelve months after inpatient rehabilitation, the telephone group's rate of physical activity rose by 26% compared with the usual care group's 10%. Patients in the intervention group exhibited greater improvements in terms of their illness burden, psychological well-being, and depression. HbA1c fell in the telephone amp but increased in the usual care group (-0.68% vs. 0.12%). The intervention group's cardiovascular risk fell. whereas the usual care group's rose (-0.57 vs. 0.231. Conclusion: A theory-based telephone-delivered follow-up intervention utilizing motivational interviewing techniques and focusing on personalized action planning demonstrated improvements in patients' level of activity and health status 12-months postrehabilitation discharge and may be a beneficial supplement to rehabilitation programs.
引用
收藏
页码:170 / 181
页数:12
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