title: Primary care nurses' communication and its influence on patient talk during motivational interviewing.
abstract: OBJECTIVE
  The aim of this study was to describe what verbal behaviours/kinds of talk occur during recorded motivational interviewing sessions between nurses in primary care and their patients. The aim was also to examine what kinds of nurse talk predict patient change talk, neutral talk and/or sustain talk.
  
  
  BACKGROUND
  Motivational interviewing is a collaborative conversational style. It has been shown to be effective, in addressing health behaviours such as diet, exercise, weight loss and chronic disease management. In Sweden, it is one of the approaches to disease prevention conversations with patients recommended in the National Guidelines for Disease Prevention. Research on the mechanisms underlying motivational interviewing is growing, but research on motivational interviewing and disease prevention has also been called for.
  
  
  METHODS
  A descriptive and predictive design was used.
  
  
  METHODS
  Data were collected during 2011-2014. Fifty audio-recorded motivational interviewing sessions between 23 primary care nurses and 50 patients were analysed using Motivational Interviewing Sequential Code for Observing Process Exchanges. The frequency of specific kinds of talk and sequential analysis (to predict patient talk from nurse talk) were computed using the software Generalized Sequential Querier 5.
  
  
  RESULTS
  The primary care nurses and patients used neutral talk most frequently. Open and negative questions, complex and positive reflections were significantly more likely to be followed by change talk and motivational interviewing-inconsistent talk, positive questions and negative reflections by sustain talk.
  
  
  CONCLUSIONS
  To increase patients' change talk, primary care nurses need to use more open questions, complex reflections and questions and reflections directed towards change.
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Sweden . ann-sofi.ostlund@hig.se.|Faculty of Health and Occupational Studies, University of Gävle, Sweden. ann-sofi.ostlund@hig.se.
authors.forename: Ann-Sofi
authors.initials: AS
authors.lastname: Östlund
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Sweden.
authors.forename: Barbro
authors.initials: B
authors.lastname: Wadensten
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Sweden.|Faculty of Health and Occupational Studies, University of Gävle, Sweden.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Häggström
authors.affiliation: Department of Clinical Neuroscience, MIC Lab, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Helena
authors.initials: H
authors.lastname: Lindqvist
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Sweden.|Faculty of Health and Occupational Studies, University of Gävle, Sweden.
authors.forename: Marja-Leena
authors.initials: ML
authors.lastname: Kristofferzon
mesh_terms: D003142:Communication; D006801:Humans; D062405:Motivational Interviewing; D059017:Primary Care Nursing; D011320:Primary Health Care; D013548:Sweden
keywords: behaviour; communication; in-session; motivational interviewing; nurse; primary care; sequential analysis; talk