Motivational interviewing in a nurse-led outpatient clinic to support lifestyle behaviour change after admission to a stroke unit: a randomized controlled trial

Dorien Brouwer-Goossensen*, Maaike Scheele, Lenneke van Genugten, Hester F. Lingsma, Diederik W.J. Dippel, Peter J. Koudstaal, Heleen M. den Hertog

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

AIMS: Modification of health behaviour is an important part of stroke risk management. However, the majority of people with cardiovascular disease fail to sustain lifestyle modification in the long term. We aimed to evaluate the effectiveness of motivational interviewing to encourage lifestyle behaviour changes after transient ischaemic attack (TIA) or minor ischaemic stroke. METHODS AND RESULTS : We performed a randomized controlled open-label phase II trial with blinded endpoint assessment. The intervention consisted of three 15-minute visits in 3 months by a motivational interviewing trained nurse practitioner. Patients in the control group received standard consultation after 1 and 3 months by a nurse practitioner. Primary outcome was lifestyle behaviour change, defined as smoking cessation and/or increased physical activity (30 min/day) and/or healthy diet improvement (5 points at the Food Frequency Questionnaire) at 6 months. We adjusted for age and sex with multivariable logistic regression. Between January 2014 and February 2016, we included 136 patients (of whom 68 were assigned to the intervention group). Twenty-five of 55 patients in the intervention group (45%) and 27 of 61 patients in the control group (44%) had changed their lifestyle at 6 months. We found no effect of motivational interviewing on lifestyle behaviour change after 6 months (aOR 0.99; 95% confidence interval: 0.44-2.26). CONCLUSION : Our results do not support the effectiveness of motivational interviewing in supporting lifestyle behaviour change after TIA or ischaemic stroke. However, the overall lifestyle behaviour change was high and might be explained by the role of specialized nurses in both groups.

Original languageEnglish
Pages (from-to)36-45
Number of pages10
JournalEuropean journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology
Volume21
Issue number1
DOIs
Publication statusPublished - Jan 2022

Bibliographical note

Funding:
This study was funded by the Evidence Based Care for Nurses fund of the Erasmus University Medical Hospital.

Publisher Copyright:
© The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.

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