Process of health behaviour change: Is Change Talk associated with diabetes outcome? A pilot study of Motivational Interviewing
Degree GrantorUniversity of Canterbury
Degree NameMaster of Science
Motivational Interviewing (MI) is a person-centred and collaborative form of guiding individuals to elicit and strengthen their motivation for change. It has achieved success in the treatment of substance disorders, and has shown promise in several other areas of interest, such as behaviour management in chronic illness. The process through which MI exerts its influence on outcome however, is still in its infancy. This research set out to explore the nature of Type 1 and Type 2 diabetes patients‟ utterances in Motivational Enhancement Therapy (MET) sessions (Change Talk), and the associations between their Change Talk and diabetes outcome (clinically significant change in blood glucose levels). Data for this study was taken from a multiple baseline designed study in a diabetes clinic in Christchurch (Britt, 2008). Nine patients who were referred to the clinic for help with their diabetes self-management were administered MET by Diabetes Nurse Educators (DNEs) which comprised four sessions over a six week period. In the current study participants were divided into those who did (BG Change participants; n = 4) or those who did not (BG No Change participants; n = 5) achieve a clinically significant change in their blood glucose levels (HbA1c) post intervention. All client utterances from the 36 transcripts were coded with the Motivational Interviewing Skills Code, version 2.0 (MISC, 2.0), and data analysed accordingly. This is a unique study in that it investigated both the mean frequency and strength of Change Talk in the different participant sets, as well as their patterns of Change Talk within and across sessions. Trends and directions in data suggest support for parts of the theory of the inner workings of MI. In particular, the BG Change participants uttered stronger Desire Language, a higher frequency of Commitment language, and weaker Ability language than the BG No Change participants. In addition, a general increasing pattern of strength across and within sessions, and frequency across sessions was found for the BG Change participants, while a similar pattern was found for the BG No Change participants regarding strength, but not frequency. The role of Sustain Talk strength and its relationship to the findings is highlighted. Implications of findings, as well as limitations of the current research and suggestions for future areas of research are discussed.