Motivational interviewing in brief consultations | BMJ Learning

00:06:51
https://www.youtube.com/watch?v=bTRRNWrwRCo

摘要

TLDRThe video features a healthcare provider engaging with a patient about lifestyle changes, particularly focusing on weight management. The patient, who is self-employed and busy, expresses frustration about waiting times and lack of time for lifestyle changes. They acknowledge the health implications of their weight and express a desire to improve. The provider suggests a follow-up appointment at a convenient time to discuss incorporating healthier habits. The patient agrees, mentioning they will consider their schedule and solutions like exercise and diet. The conversation highlights the challenges of balancing work and health.

心得

  • 🎯 Motivational interviewing can engage patients considered unmotivated.
  • 🕒 Patients with busy lives find it challenging to prioritize health.
  • 📈 There is a clear link between weight and health concerns.
  • ⌛ Waiting times in healthcare can impact patient experience.
  • 📋 Patients are aware of health solutions but struggle with implementation.
  • 💬 Effective communication in healthcare includes empathy and understanding.
  • 🥗 A balanced diet and exercise are acknowledged solutions.
  • 📆 Scheduling and time management are crucial for follow-ups.
  • 👩‍⚕️ Providers can suggest practical solutions to fit health into busy schedules.
  • 💡 A thoughtful approach can address patient resistance effectively.

时间轴

  • 00:00:00 - 00:06:51

    Motivational interviewing suggests that people are not simply motivated or unmotivated. It was developed through challenging conversations with individuals considered resistant to change. The video illustrates this concept with a dialogue between a healthcare professional and Mr. Smith, who is resistant but ultimately open to discussing his health challenges, emphasizing the complexity of motivation.

思维导图

视频问答

  • What is the main focus of the video?

    The main focus is a healthcare conversation regarding lifestyle changes, particularly weight management.

  • How does the healthcare provider address the patient's concerns?

    The provider listens to the patient's busy schedule and proposes a follow-up appointment to discuss feasible lifestyle changes.

  • What does the patient express concern about?

    The patient is concerned about finding time for exercise and meal preparation due to a busy work schedule.

  • How does the patient feel about their weight and health?

    The patient acknowledges that weight affects their health and expresses a desire to lose weight.

  • What solutions does the patient recognize for their weight issue?

    The patient mentions exercise and a balanced diet as potential solutions.

  • What is the purpose of the follow-up appointment suggested by the provider?

    To discuss how the patient feels about lifestyle changes and how to incorporate healthier habits into their busy schedule.

  • How does the patient react to the idea of a follow-up appointment?

    The patient agrees but emphasizes the need for punctuality and efficient use of time.

  • What does the patient use as a reason for poor diet choices?

    The patient blames their busy work schedule for relying on convenience foods.

  • What does the provider suggest for the next meeting?

    The provider suggests setting up an early appointment to minimize waiting time.

  • What commitment does the patient make for the next appointment?

    The patient commits to reviewing their schedule and considering changes to discuss during the next visit.

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  • 00:00:00
    [Music]
  • 00:00:08
    I don't think it's the case that people
  • 00:00:10
    are either not motivated or motivated
  • 00:00:12
    and in fact motivational interviewing
  • 00:00:14
    was born from conversations with very
  • 00:00:18
    very difficult people who are classified
  • 00:00:20
    as not at all motivated to change and
  • 00:00:22
    very resistant to treatment
  • 00:00:32
    [Music]
  • 00:00:38
    [Music]
  • 00:00:48
    well Mr Smith that's your medication
  • 00:00:49
    sorted out good blood pressure is a
  • 00:00:51
    little on the high side yeah okay I
  • 00:00:54
    wonder if I could raise the subject of
  • 00:00:55
    your weight what I wondered if we could
  • 00:00:58
    spend just a couple of minutes talking
  • 00:01:01
    about your weight you are joking aren't
  • 00:01:03
    you I mean look I've made time in my day
  • 00:01:07
    to come here yeah I'm kept in your
  • 00:01:08
    waiting room for 45 minutes it's not
  • 00:01:11
    acceptable you know if I make an
  • 00:01:12
    appointment with a client for 10 I
  • 00:01:13
    expect them to start at 10: not quar to
  • 00:01:16
    11 right and you so you're busy enough
  • 00:01:19
    and yeah I've got other things to do
  • 00:01:20
    I've got accounts to do I've got clients
  • 00:01:21
    to coming in yeah you know and it wasn't
  • 00:01:24
    necessarily easy for you to to make the
  • 00:01:26
    time to come down and you had to wait in
  • 00:01:28
    the waiting room and now I raise the
  • 00:01:30
    subject of weight yeah I mean okay fair
  • 00:01:32
    enough um I've got to have my blood
  • 00:01:34
    pressure medication changed but I really
  • 00:01:36
    haven't got time to talk about my weight
  • 00:01:39
    I mean you know I'm aware of my weight
  • 00:01:41
    I'm aware of the problems and I'm also
  • 00:01:43
    aware of the solutions right um so I
  • 00:01:46
    don't really need a discussion it's it's
  • 00:01:48
    just I've got too much to do at the
  • 00:01:50
    moment you know right and so it's it's
  • 00:01:52
    it's been a bit of a rush for you coming
  • 00:01:54
    in yeah and uh I'm sorry about the
  • 00:01:56
    weight in the waiting room well it's B
  • 00:01:58
    it's bad form you know yeah yeah that's
  • 00:02:01
    and and that that's not easy for you
  • 00:02:02
    because you you'd like to go really soon
  • 00:02:05
    and here I am asking you to spend just a
  • 00:02:07
    couple of minutes with me yeah but
  • 00:02:09
    basically I've got things to do I've got
  • 00:02:10
    to get back to the office I've got a
  • 00:02:12
    pile of work that I've got to deal with
  • 00:02:15
    and every time every moment out of my
  • 00:02:17
    day means I have to work in the evening
  • 00:02:19
    or weekends it counts or when you're
  • 00:02:22
    self-employed you haven't got a choice
  • 00:02:23
    you know exactly exactly it's up to you
  • 00:02:26
    just a couple of minutes well I'm here
  • 00:02:29
    now so yeah okay if it's a couple of
  • 00:02:31
    minutes yeah I promise okay cuz I really
  • 00:02:33
    must get on I want I I want to Simply
  • 00:02:36
    ask you how you feel about it about what
  • 00:02:38
    what losing weight well obviously I I
  • 00:02:41
    want to yeah um yeah I mean who doesn't
  • 00:02:45
    I mean I'm aware that I'm over
  • 00:02:47
    my
  • 00:02:49
    uh balance weight but and I know that
  • 00:02:52
    it's causing problems I mean obviously I
  • 00:02:54
    get out of breath if I have to do
  • 00:02:56
    something a bit hry and I realize that
  • 00:02:58
    I'm on this blood pressure right um and
  • 00:03:01
    and maybe that's probably contributing
  • 00:03:03
    to it right so you can see the links
  • 00:03:04
    between your weight and your health and
  • 00:03:06
    you'd like things to be yeah I mean um
  • 00:03:09
    there are other things but I mean yeah
  • 00:03:12
    the weight is is is a something I would
  • 00:03:14
    like to get hold of get on the handle on
  • 00:03:17
    you'd like to if you could yeah I mean I
  • 00:03:20
    know
  • 00:03:22
    um the theor is of um a bit of exercise
  • 00:03:25
    on a regular basis um a balanced diet um
  • 00:03:29
    but unfortunately because of my
  • 00:03:31
    lifestyle because of being self-employed
  • 00:03:33
    as an accountant it's finding the time
  • 00:03:37
    uh to exercise but also finding the time
  • 00:03:40
    to sort of think okay I'm going to go
  • 00:03:43
    shopping for this that and the other and
  • 00:03:44
    I'm going to prepare a meal with me it's
  • 00:03:47
    very often ready meals and that sort of
  • 00:03:49
    thing yeah yeah food on the run you know
  • 00:03:51
    okay yeah grazing let me see if I can
  • 00:03:53
    summarize what you've said um and then
  • 00:03:55
    we'll see what next um you lead A busy
  • 00:03:58
    life yeah um you run a busy bus and
  • 00:04:00
    you've got a lot to do yeah yeah um you
  • 00:04:02
    you you you're aware of the of the links
  • 00:04:05
    between your health and your weight and
  • 00:04:07
    you are concerned to some extent about
  • 00:04:09
    that and ideally it sounds like you'd
  • 00:04:12
    like to do something about it it's just
  • 00:04:14
    that your life is busy and rushed and
  • 00:04:17
    you tend to use convenience Foods in
  • 00:04:20
    order to get the work done yeah I mean I
  • 00:04:22
    to a certain extent because of my
  • 00:04:24
    lifestyle food is just fuel yeah yeah
  • 00:04:27
    you know um because I'm juggling all
  • 00:04:28
    these balls and I don't want to drop
  • 00:04:29
    property I get it I get it and so if you
  • 00:04:32
    could fit it in you would like things to
  • 00:04:36
    be different but that's not so easy no
  • 00:04:39
    okay can I suggest that you come back
  • 00:04:42
    and see me in a couple of weeks time
  • 00:04:44
    just to chat about this
  • 00:04:46
    um okay I'm up for that but it's going
  • 00:04:50
    to be the same problem of a finding time
  • 00:04:53
    and B if I make an appointment I don't
  • 00:04:55
    expect to be kept waiting for half an
  • 00:04:56
    hour whatever cuz it's exactly I tell
  • 00:04:59
    you might be a nice solution is if you
  • 00:05:01
    come down first appointment and I give
  • 00:05:03
    you an appointment at 8:30 that then
  • 00:05:06
    there'll be absolutely no waiting and
  • 00:05:07
    the purpose of that of that visit will
  • 00:05:10
    be to have a look at how you really feel
  • 00:05:12
    about how you could move forward and
  • 00:05:14
    somehow fit in a more healthier
  • 00:05:16
    lifestyle into the busy work life that
  • 00:05:18
    you've got I'll maybe have a look at my
  • 00:05:20
    schedule see whether anything can be
  • 00:05:23
    arranged or I can pass something on to
  • 00:05:25
    some and and so that I so it's not a
  • 00:05:28
    wasted interview so I can come here and
  • 00:05:29
    say I've looked at my schedules I've
  • 00:05:30
    looked at things good whatever good and
  • 00:05:33
    see if you can fix it up and also give
  • 00:05:35
    some thought to what we've talked about
  • 00:05:36
    yeah of course good stuff okay okay
  • 00:05:39
    thanks sorry I went off a
  • 00:05:40
    [Music]
  • 00:05:44
    bit a few well chosen words a very
  • 00:05:48
    thoughtful question can be worth more
  • 00:05:51
    than many mouthfuls of busy
  • 00:05:57
    talk well uh
  • 00:06:01
    I want to try to stop smoking uh that's
  • 00:06:04
    quite a decision well it is cuz I've
  • 00:06:06
    been smoking all my
  • 00:06:12
    life we could talk about adjusting your
  • 00:06:15
    diet okay we could talk about adjusting
  • 00:06:18
    your exercise or getting more exercise
  • 00:06:21
    right or perhaps anything else that you
  • 00:06:22
    think is relevant I'm wondering what
  • 00:06:24
    makes the most sense to you
  • 00:06:31
    [Music]
  • 00:06:33
    oh
  • 00:06:36
    [Music]
标签
  • Health
  • Lifestyle
  • Weight management
  • Motivational interviewing
  • Busy Schedule
  • Diet
  • Exercise
  • Patient-provider communication