[Current evidence on the motivational interview in the approach to health care problems in primary care]. / Evidencia actual de la entrevista motivacional en el abordaje de los problemas de salud en atención primaria.

The motivational interview has been widely used as a clinical method to promote behavioural changes in patients, helping them to resolve their ambivalence to obtain their own motivations. In the present article, a review is made of the main meta-analyses and systematic and narrative reviews on the efficacy of the motivational interview in the primary health care environment.

Measuring the quality of motivational interviewing in primary health care encounters: The development and validation of the motivational interviewing assessment scale (MIAS).

BACKGROUND: Motivational interviewing (MI) is a collaborative, goal-oriented method to help patients change behaviour. Tools that are often used to measure MI are the motivational interviewing skills code' (MISC), the 'motivational interviewing treatment integrity' (MITI) and the 'behaviour change counselling index' (BECCI). The first two instruments have not been designed to be used in primary healthcare (PHC) settings. The BECCI actually is time-consuming. The motivational interviewing assessment scale (MIAS, 'EVEM' in Spanish) was developed to measure MI in PHC encounters as an alternative to the previous instruments. OBJECTIVES: To validate MIAS as an instrument to assess the quality of MI in PHC settings. METHODS: (a) DEVELOPMENT: Sixteen experts in MI participated in the design, face and consensus validity, using a Delphi-type methodology. (b) SETTING: 27 PHC centres located in Spain. SUBJECTS: four experts in MI tested its psychometric properties with 332 video recordings coming from the Dislip-EM study (consultations provided by 37 practitioners). MEASUREMENTS: dimensionality, internal consistency, reliability (intra-class correlation coefficient-ICC), sensitivity to change and convergent validity with the BECCI scale. RESULTS: A 14-item scale was obtained after the validation process. Factor analysis: two factors explained 76.6% of the total variance. Internal consistency, α = 0.99. Reliability: intra-rater ICC = 0.96; inter-rater ICC = 0.97. Sensitivity to change: means before and after training were 23.63 versus 38.57 (P < 0.001). Spearman's coefficient between the MIAS and the BECCI scale was 0.98 (P < 0.001). CONCLUSION: The MIAS is a consistent and reliable instrument to assess the use of MI in PHC settings. [Box: see text].

Effectiveness of a clinical interviewing training program for family practice residents: a randomized controlled trial.

BACKGROUND AND OBJECTIVES: This study evaluated the effectiveness of a clinical interviewing training program for third-year family practice trainees and determined which other factors influence residents' training in clinical communication. METHODS: This was a randomized, multicenter, educational trial involving 193 third-year family practice residents from eight centers in Spain. Centers were randomly assigned to two groups, one of which would undertake a communication skills training program and one of which would not. The program was resident centered, based on residents' practice experience, and provided structured feedback. The main outcome measures were residents' consultation behavior with six standardized patient encounters (three before and three after the training) as measured with the GATHA-RES rating scale by an observer blinded to group assignment of the residents. RESULTS: The intervention group trainees displayed marginally better communication skills at the start of the study than those in the control group. At the end of the study, trainees who had received the training program did not show better communication skills than those who had not received the training program. Factors related to the training center environment, having a teacher trained in clinical interviewing, younger age, and a longer interview duration correlated with better communication skills. CONCLUSIONS: The trial program did not appear to improve the global communication skills of trainees. This study highlights the importance of the trainee's teachers, the residency program environment, and earlier exposure to training in planning future programs to improve residents' communication skills.

Telemedicina, una herramienta también para el médico de familia / Telemedicine, also a tool for the Family Doctor

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Evidencia actual de la entrevista motivacional en el abordaje de los problemas de salud en atención primaria / Current evidence on the motivational interview in the approach to health care problems in primary care

La entrevista motivacional ha sido ampliamente desarrollada como método clínico para promover en los pacientes cambios de conducta, ayudando a resolver su ambivalencia para obtener sus propias motivaciones. En el presente artículo ofrecemos una revisión de los principales metaanálisis y revisiones, tanto sistemáticas como narrativas, sobre la eficacia de la entrevista motivacional, centrándonos en el ámbito de la atención primaria de salud (AU)

The motivational interview has been widely used as a clinical method to promote behavioural changes in patients, helping them to resolve their ambivalence to obtain their own motivations. In the present article, a review is made of the main meta-analyses and systematic and narrative reviews on the efficacy of the motivational interview in the primary health care environment (AU)