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您请求的操作仅限于组中的用户:Bundy C. Changing behaviour: using motivational interviewing techniques. J R Soc Med 2004;97 Suppl 44:43-47.. MI is to understand the patients perspective, accepting their motivation, or lack of motivation for changing and helping them find solutions to change Pollak KI, Alexander SC, Coffman CJ, Tulsky JA, Lyna P, Dolor RJ, et al. Physician communication techniques and weight loss in adults: Project CHAT. Am J Prev Med 2010;39(4):321-328.. MI has 5 basic principles that should be undertaken to carry out change. These are: *Expressing empathy – by demonstrating empathy, a real and understanding picture is conveyed of what the person is going through. It shows that you are interested, accepting and understanding to the patient. *Avoiding argument – Arguments are unproductive and need to be avoided, and resistance to change can be increased as a consequence of arguments *Supporting self-efficacy – Believing in ones ability to change *Developing discrepancy – The patient needs to have goals to work towards. These goals shouldn’t be forced on the patient, they should come up with them themselves *Rolling with resistance – a skilful technique that can help change a persons’ perspective. Ideas should be offered, but not imposed, and statements can be lightly challenged but not argued .
Some examples of these can include praising an obese patient that has lost weight or by asking a patient what they can achieve, or what they’d like to achieve from their overall goal . There are several steps of MI that allow the process to work, which includes: *Establishing rapport – this is the basis of trust, an essential element to implement change in someone *Setting the agenda – realistic targets set as chosen, not imposed upon, the patient. Stops them from attempting too much too soon. These change of programmes should be re-visited regularly. *Assess readiness to change – Assessing their eagerness to change, will give an insight into their level of motivation. *Readjust the focus – Identifies exactly what the patient wants help with, or what exactly they want to change *Identify uncertainty - Can help identify areas for and against change *Encourage self-motivation – By implementing a positive attitude in the patient, and encourage them to highlight success.

[[Image:OARS.jpg|frame|left|100x50px]]



OARS,an acronym used for open-ended questions, affirmations, reflective listening and summaries are crucial components of effective communication, and equally important in MI. It has been shown to increase the patient-AHP bond and increase patient adherence, collaboration and satisfaction.Borrelli B, Riekert KA, Weinstein A, Rathier L. Brief motivational interviewing as a clinical strategy to promote asthma medication adherence. J Allergy Clin Immunol 2007;120(5):1023-1030.OARS includes many of the skills and principles outlines above and a good summary can be found in the table below.

[[Image:OARS Table.jpg]] Barriers this tool meets: *Negative stigma *Lack of empathy *Unable to gain rapport

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