Coding Client Language in Motivational Interviewing for HIV Medication Adherence Using Self-Determination Theory.
Coding Client Language in Motivational Interviewing for HIV Medication Adherence Using Self-Determination Theory.
复制标题
使用自我决定理论对艾滋病毒药物依从性动机访谈中的客户语言进行编码。
DOI：
10.1007/s12529-018-09766-z
复制
发表时间：
2019
影响因子：
2.7
通讯作者：
Evangeli,Michael
中科院分区：
文献类型：
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作者：
Hogan,Ailbhe;Catley,Delwyn;Goggin,Kathy;Evangeli,Michael
背景动机访谈(MI)和自我决定理论(SDT)都强调个体自主性的重要性。SDT认为，动机是一个连续体，而自主动机(AM)位于自我决定的一端。然而，客户语音是否反映AM没有在MI过程研究中编码，因为它被归入更广泛的变化谈话(CT)类别。我们的目标是根据表达的动机是自主的还是受控的，在MI会议中编码HIV药物(抗逆转录病毒)坚持的自然主义言论。然后，我们评估了依从性与自主/受控动机言语(AM/CM)和CT之间的关系。方法我们开发了一种新的编码工具(SDT编码系统：SDTCS)，以测量62名成年HIV感染者(16名女性，平均年龄40岁)在针对抗逆转录病毒(ART)依从性的MI会话中自然发生的AM言语和CM言语表达的关系。我们使用动机访谈技能代码(MISC)2.5对相同的会话进行编码，然后检验其与按时艺术坚持的关系。量表具有较好的内容效度，具有较高的信度。在MI会议结束后的一周内，自然发生的AM演讲与ART坚持的关系比CM演讲更强。也有一些证据表明，AM言语和坚持之间的关系强于CT和坚持之间的关系。结论SDTCS的进一步完善和扩展可以允许对现有编码工具所提供的客户动机言语的更细微的理解。
BackgroundBoth motivational interviewing (MI) and self-determination theory (SDT) emphasise the importance of an individual’s autonomy. SDT proposes that motivation is on a continuum with autonomous motivation (AM) at the self-determined end of the spectrum. Whether client speech reflects AM is not coded in MI process studies, however, as it is subsumed under the broader category of change talk (CT). We aimed to code naturalistic speech within MI sessions for HIV medication (antiretroviral) adherence according to whether expressed motivation was autonomous or controlled. We then assessed relationships between adherence and both autonomous/controlled motivational speech (AM/CM) and CT.MethodsWe developed a new coding tool (the SDT coding system: SDTCS) to measure naturally occurring AM speech and CM speech expressed during an MI session targeting antiretroviral (ART) adherence with 62 adults living with HIV (16 female; mean age 40 years). We coded the same sessions using the motivational interviewing skills code (MISC) 2.5 and then examined relationships with on-time ART adherence.ResultsThe SDTCS was developed using a combined inductive and deductive approach. Adequate reliability estimates were achieved and the measure possessed good content validity. Naturally occurring AM speech had a stronger relationship to ART adherence in the week after the MI session than CM speech. There was also some evidence that the relationship between AM speech and adherence was stronger than between CT and adherence.ConclusionFuture refinement and extension of the SDTCS could allow for a more nuanced understanding of client motivational speech that is currently provided by existing coding tools.