Reply to at least two of your classmates on two separate days (minimum) who chose the two other topics that you did not utilizing at least two scholarly references per peer post. What did you learn from your experience with Motivational Interviewing this week that could help your peer better address the preventive guidelines for the women in the scenario?
- A 34-year-old female who is 36 weeks pregnant – G2P1AB0 – presents to your office complaining of shortness of breath and ankle swelling. She states she has had “the flu” for several days and is insistent that this is why she can’t stop coughing. She is obviously short of breath when talking. In reviewing her chart, you can see she has a history of hypertension. She states she “”officially” stopped her blood pressure medications when she found out she was pregnant but admits that she rarely took her pills anyway, so “no big deal.”
POST FOR THE ABOVE SCENARIO- MOTIVATIONAL INTERVIEWING
I NEED A REPLY TO THIS POST
The purpose of this discussion is to determine how to affect the health of a pregnant woman and encourage her to make choices that is better for her baby, while also helping her reach this conclusion herself through motivational interviewing. The scenario that I picked for this was the 34-year-old female that is 36 weeks pregnant. In the scenario, the patient shows signs of preeclampsia, which is a serious condition that can cause issues for both the mother and baby (Aquino et al., 2022). She states that she is short of breath, coughing and has ankle swelling. Preeclampsia is high blood pressure that causes edema in both the lungs and the peripheral limbs (Aquino et al., 2022). While talking to the patient, I would ensure that I would make the patient feel comfortable, while also listening to her communicate her fears. I would also talk about what I am concerned about as a nurse practitioner. For the beginning of the conversation, I would get her take on the situation. I would ask her why she doesn’t take her pills anyway and why she doesn’t feel as though it is a big deal if she misses a dose. The purpose of a motivational interviewing is to allow the patient to come to a conclusion that the risk they are making is not a healthy risk. Because of this, it is good for the patient to come to the conclusion that she is putting her baby at risk and herself at risk and may have more than just a cough.
A pro of using this technique would include motivation to change behaviors would encourage implementing behavior changes because the patient came to the conclusion themselves (Frost et al., 2018). Another pro of using this allowing the patient to “say why and how they might change” (Frost et al., 2018, p. 2). The third pro includes allowing a skilled person to communicate with the patient and allowing for a better patient-provider relationship (Frost et al., 2018). Since this case is more time sensitive, there are some cons that are in this specific case. For example, the patient appears to be having a serious problem that requires medical attention right now since there are significant risks to both the fetus and the mother should this be preeclampsia (Fox et al., 2019). Motivational interviewing is “most effective for stopping or preventing unhealthy behaviors” so this method may not be useful for someone who may not realize they are doing something wrong (Frost et al., 2018).
Because motivational interviewing aims to be “person-centered, goal-oriented, and eliciting a person’s intrinsic motivation and commitment to change”, it can be a useful skill to promote prevention of disease and encourage positive health behaviors (Fortune et al., 2019, p. 694). While employing the motivational interviewing on a family member, I felt very awkward asking the questions in the way that I did because it didn’t feel as natural. I can imagine that becoming more comfortable with the technique would make the conversation flow more easily and create a better overall conversation. When I attempted the motivational conversation, I really had to think about how I would say something or ask a question. I think that a benefit to becoming more comfortable with this style would be utilizing the motivational interviewing when the time called for motivational interviewing. I think that some patients really do benefit by coming to the conclusion of preventing poor behavior themselves so that would be another reason why I should continue to practice motivational interviewing.
Aquino, M., Griffith, J., Vattaparambil, T., Munce, S., Hladunewich, M., & Seto, E. (2022). Patients’ and providers’ perspectives on and needs of telemonitoring to support clinical management and self-care of people at high risk for preeclampsia: Qualitative Study. JMIR Human Factors, 9(1). https://doi.org/10.2196/32545
Fortune, J., Breckon, J., Norris, M., Eva, G., & Frater, T. (2019). Motivational interviewing training for physiotherapy and occupational therapy students: Effect on confidence, knowledge and Skills. Patient Education and Counseling, 102(4), 694–700. https://doi.org/10.1016/j.pec.2018.11.014
Fox, R., Kitt, J., Leeson, P., Aye, C. Y. L., & Lewandowski, A. J. (2019). Preeclampsia: Risk factors, diagnosis, management, and the cardiovascular impact on The offspring. Journal of Clinical Medicine, 8(10), 1625. https://doi.org/10.3390/jcm8101625
Frost, H., Campbell, P., Maxwell, M., O’Carroll, R. E., Dombrowski, S. U., Williams, B., Cheyne, H., Coles, E., & Pollock, A. (2018). Effectiveness of motivational interviewing on adult behaviour change in health and Social Care Settings: A systematic review of reviews. PLOS ONE, 13(10). https://doi.org/10.1371/journal.pone.0204890