title: Use of motivational interviewing in smoking cessation at nurse-led chronic obstructive pulmonary disease clinics.
abstract: OBJECTIVE
  This paper is a report of a study to describe to what extent Registered Nurses, with a few days of education in motivational interviewing based communication, used motivational interviewing in smoking cessation communication at nurse-led chronic obstructive pulmonary disease clinics in primary health care.
  
  
  BACKGROUND
  For smokers with chronic obstructive pulmonary disease the most crucial and evidence-based intervention is smoking cessation. Motivational interviewing is often used in healthcare to support patients to quit smoking.
  
  
  METHODS
  The study included two videotaped consultations, the first and third of three at the clinic, with each of 13 smokers. Data were collected from March 2006 to April 2007. The nurses' smoking cessation communication was analysed using the Motivational Interviewing Treatment Integrity scale. To get an impression of the consultation, five parameters were judged on a five-point Likert-scale, with five indicating best adherence to Motivational Interviewing.
  
  
  RESULTS
  Evocation', 'collaboration', 'autonomy-support' and 'empathy' averaged between 1·31 and 2·23 whereas 'direction' scored five in all consultations. Of communication behaviours, giving information was the most frequently used, followed by 'closed questions', 'motivational interviewing non-adherent' and 'simple reflections'. 'Motivational int erviewing adherent', 'open questions' and 'complex reflections' occurred rarely. There were no important individual or group-level differences in any of the ratings between the first and the third consultations.
  
  
  CONCLUSIONS
  In smoking cessation communication the nurses did not employ behaviours that are important in motivational interviewing.
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden. eoe@du.se
authors.forename: Eva Österlund
authors.initials: EÖ
authors.lastname: Efraimsson
authors.forename: Bjöörn
authors.initials: B
authors.lastname: Fossum
authors.forename: Anna
authors.initials: A
authors.lastname: Ehrenberg
authors.forename: Kjell
authors.initials: K
authors.lastname: Larsson
authors.forename: Birgitta
authors.initials: B
authors.lastname: Klang
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D002983:Clinical Competence; D037001:Directive Counseling / Q000379:methods*; D005260:Female; D006801:Humans; D007407:Interviews as Topic / Q000592:standards; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009042:Motivation; D009723:Nurse-Patient Relations; D057184:Practice Patterns, Nurses'; D011320:Primary Health Care; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000451:nursing*; D020377:Self Efficacy; D012720:Severity of Illness Index; D012907:Smoking / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology; D000074606:Smoking Prevention; D013548:Sweden; D014741:Video Recording