MI Flashcards
Definition
- Motivational Interviewing is a client-centered communication technique aimed at supporting behavior change.
- Emphasizes collaboration, acceptance, compassion, and evocation to elicit the patient’s own motivations.
- Used to encourage intrinsic motivation, helping patients see behavior change as personally rewarding.
Key Concepts of MI
- Partnership:
o Nurse and patient work collaboratively. The patient is the expert on their own life.
o Avoids an authoritative approach. - Acceptance:
o Respect the patient’s autonomy, strengths, and perspective.
o Non-judgmental attitude is crucial. - Compassion:
o Focus on the patient’s best interests with a caring and understanding demeanor.
o Be comfortable with the patient’s distress. - Evocation:
o Change ideas and motivations should come from the patient, not the nurse.
o Patients are more likely to act on their own ideas than external advice.
Principles of MI
- Show Empathy:
o Listen attentively and reflect back to show understanding.
o Avoid judgment or criticism. - Point Out Differences:
o Highlight discrepancies between current behaviors and desired goals.
o Use facts about consequences to gently motivate change. - Handle Resistance Gently:
o Avoid arguing. Acknowledge the patient’s feelings and barriers.
o Resistance is a sign to explore more, not to push harder. - Discover Motivations:
o Ask questions to understand the patient’s personal reasons for change.
o Use these reasons to guide the conversation. - Boost Confidence:
o Reinforce the patient’s belief in their ability to change.
o Highlight past successes to build self-efficacy.
Stages of Behavior Change
- Precontemplation: Not considering change.
- Contemplation: Thinking about change but uncertain.
- Preparation: Taking initial steps toward change.
- Action: Actively working on behavior change.
- Maintenance: Sustaining new behavior.
* Key Tip: Patients may move back and forth between stages, and this is normal.
Acronyms for MI
RULE (Guiding Principles)
1. Resist: Avoid imposing your own solutions or the “righting reflex.”
2. Understand: Explore the patient’s own motivations for change.
3. Listen: Use active listening with empathy to show understanding.
4. Empower: Encourage the patient to take charge of their decisions.
PACE (Mindset During MI)
1. Partnership: Work as a team with the patient.
2. Acceptance: Be non-judgmental about their choices.
3. Compassion: Understand and validate their struggles.
4. Evocative Discussion: Guide the patient to find their internal motivators.
OARS (Core Techniques)
1. Open-Ended Questions:
o Encourage narrative responses to understand their story.
o Example: “What motivates you to want this change?”
2. Affirmation:
o Support the patient’s efforts and acknowledge their strengths.
o Example: “It’s impressive that you’ve reduced your smoking.”
3. Reflective Listening:
o Repeat or paraphrase to clarify understanding and show empathy.
o Example: “It sounds like you’re excited about the possibility of quitting but also worried it will be difficult.”
4. Summarizing:
o Recap key points at the end of the session.
o Example: “Today, we discussed your goal of quitting smoking and some steps you can take.”
Practical Example
- Scenario: A patient says, “I want to lose weight, but I love eating out with friends.”
o Reflective Listening: “It sounds like spending time with friends is important to you, but you also care about your health.”
o Open-Ended Question: “What are some ways you could enjoy meals with friends while working toward your health goals?”
Evaluating Effectiveness
- Look for “Change Talk”:
o When patients begin discussing their intentions or plans for change, it’s a positive sign MI is working.
o Example: “I’ve cut back on smoking from 7 packs a week to 2. I still have work to do, but I feel good about my progress.”
Why MI is Effective
- Focuses on the motivation gap, not just providing information.
- Encourages the patient to take ownership of their decisions.
- Builds trust and rapport, fostering long-term behavior change.
