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Reply to Morgan Widger

What did you learn from your experience with Motivational Interviewing this week that could help your peer better address the preventive guidelines for the women in the scenario?

The scenario we will be discussing in this post is about Sumar, a 26-year-old female who just found out she is pregnant and who has presented to the local free clinic. Sumar is a G2P0AB1 and is about 12 to 14 weeks pregnant. She has not had an OB appointment yet and is at the clinic complaining about indigestion. As the provider, we notice she smells like cigarette smoke, and while she admits to smoking one pack of cigarettes a day, she also states she is smoking less now since she started vaping.

As an APRN, I can positively affect the health of this women by using motivational interviewing. After watching the provided video, “Motivational Interviewing: Discussing Alcohol Use in Pregnancy,” it is clear that motivational interviewing is a successful tool for providers to use with patients when assessing their knowledge and reasons behind certain decisions. The American College of Obstetrics and Gynecology explains that applying principles of motivational interviewing in patient interactions has proved efficient in provoking behaviors change. Behavior changes have been seen in dietary habits, sexual practices, alcohol use, heart disease, exercise and diabetes mellitus (American College of Obstetrics and Gynecology, 2009). While caring for Sumar, it is not sufficient to only tell her not to smoke and reprimand her for her actions. As the provider, I must approach the subject with sensitivity and empathy, understand her resistance, and recognize her doubts (Lundahl, B. Droubay, B. Burke, B. Butters, R. Nelford, K. Hardy, C. 2019). Like the class video portrayed, I need to ask her questions, summarize and verify her thoughts and concerns, and find out more about her hopes for the future. Also, it is important to identify what Sumar knows about smoking during pregnancy. Chastising this patient for her actions will only make Sumar feel shameful and may or may not change her actions. However, first realizing what Sumar knows and afterward educating her on the harmful impacts of smoking during childbirth in a respectful manner, may convince Sumar to make different health decisions for herself and child. As a future provider, I feel as though the pro to using motivational interviewing in this situation is it would elicit a direct, patient-centered counseling style with the purpose of helping Sumar become aware of her choices and the impact they have on her child. By counseling her, we can help her make the decision to change, rather than simply telling her to change (American College of Obstetrics and Gynecology, 2009). The con to using this approach is it takes time for the provider and patient. This approach cannot be done through a five minutes appointment. Instead, the provider must take the time needed to elicit proper change (Miller, W. Moyers, T. 2017).

I trialled motivational interviewing with my mother-in-law when talking to her about her cholesterol levels and changing her diet and exercise routine. This was an enlightening and educational experience for both of us. We talked about her concerns related to her health, I asked her to tell me how much she knows about atherosclerosis and fatty lipids, and we even watched a couple educational videos together. After trialing motivational interviewing with her, I feel more confident to applying this approach in future situations with patients. I see how this positively impacted my mother-in-law’s knowledge toward her disease and need to change habits, and I look forward to positively changing future patients through motivational interviewing as well.

References

American College of Obstetrics and Gynecology (2009). Motivational Interviewing: A Tool for Behavior Change. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2009/01/motivational-interviewing-a-tool-for-behavior-change

Lundahl, B. Droubay, B. Burke, B. Butters, R. Nelford, K. Hardy, C. (2019). Motivational Interviewing adherence tools: A scoping review investigating content validity. Patient Education and Counseling, 102(12), 2145-2155. https://doi.org/10.1016/j.pec.2019.07.003

Miller, W. Moyers, T. (2017). Motivational Interviewing and the Clinical Science of Carl Rogers. Journal of Consulting and Clinical Psychology, 85(8). 757-766. https://doi.org/10.1037/ccp0000179

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