W#13 Health Promotion replies

POST # 1 CHIYONNE

The purpose of this discussion is to present a 19-year-old female for STI screening. When reviewing her health and sexual history to determine her risk, she indicates she has had several new partners over the past six months and that she has not been using condoms but does have an IUD. She has started smoking marijuana and has dabbled with some other prescription medications over the previous two months. She is worried about having contracted an STI because she has noticed some “cauliflower” type bumps “down there” and would like to be tested.

Motivational interviewing is a technique that has been gaining attention in the healthcare field. It is an effective and efficient way to facilitate behavior change. According to Bundy (2004) the goal of motivational interviewing is to help patients identify and change behaviors that place them at risk of developing health problems or that may be preventing optimal management of a chronic condition. Using this technique will be beneficial with the woman in this scenario because it gives the provider a chance to educate the patient on the effects of unhealthy sexual behavior and the dangers of smoking and allows the patient to express their reasons for engaging in such activities and help the provider better understand and listen to their viewpoints. Motivational interviewing has been used in the general population to aid in counseling for effective contraception use and to reduce the risk of sexually transmitted diseases (American College of Obstetricians and Gynecologists, 2009). However, there are cons to utilizing this technique. An ineffective motivational interview can generate hostility because it involves using a direct approach and patients may view this as invasive or brash. Some patients may not be willing to open up, provide useful answers that is needed to better assess them or may become defensive because they feel the clinician is getting too personal.

As an Advanced Practice Registered Nurse, I can positively affect the health of this woman by providing resources for smoke cessation and sexual health in addition to educating the patient. Also scheduling more frequent follow-ups with this patient will help keep the patient accountable, on track and increase the likelihood of positive behavior change.

I applied this technique with a coworker, and it was surprisingly an uplifting and comfortable experience. I expressed empathy when speaking with my coworker through reflective listening. I see many benefits of this technique after using it firsthand and now understand how useful it can be in clinical practice. Building a trusting relationship, showing empathy by accepting an individual’s wishes and focusing on positive desires are all important when applying motivational interviewing. Continuous practice of this technique will beneficial in becoming more comfortable with this technique. According Walker et al., (2020) the motivational interviewing approach is nonjudgmental, empathic, strength based, and individualized and emphasizes the client’s autonomy. 

References

American College of Obstetricians and Gynecologists. (2009). Motivational Interviewing: A Tool for Behavior Change. Retrieved July 28, 2020, from  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2009/01/motivational-interviewing-a-tool-for-behavior-change Bundy C. (2004). Changing behaviour: using motivational interviewing techniques. Journal of the Royal Society of Medicine, 97 Suppl 44(Suppl 44), 43–47. Walker, D. D., Jaffe, A. E., Pierce, A. R., Walton, T. O., & Kaysen, D. L. (2020). Discussing substance use with clients during the COVID-19 pandemic: A motivational interviewing approach. Psychological Trauma: Theory, Research, Practice, and Policy, 12(S1), S115–S117.  https://doi.org/10.1037/tra0000764