RESUMO
BACKGROUND: Motivational interviewing (MI) offers effective strategies for enhancing behaviour change and is particularly useful for patients who exhibit poor adherence. This study evaluated MI training for cystic fibrosis (CF) teams, which comprised of one 4-hour workshop on MI principles, followed 6 months later by another on applying MI during brief consultations. METHODS: Health professionals (N = 60) from 7 teams completed questionnaires on learning outcomes 6 months after the first workshop, but before the second. Eleven participated in telephone-interview, 3 months after the second workshop. RESULTS: Quantitative analysis showed all participants used MI with a patient at least once after the first workshop and felt the approach was potentially helpful. Although self-appraisal of skill and confidence in MI was 'moderate', all felt confident in their ability to develop their skills and almost all intended to use MI in the future. Qualitative analysis confirmed the positive experiences of training and of using MI in practice, particularly in relationship building. However MI was utilised depending on team support and workload pressures. CONCLUSIONS: This study showed that initial MI training with CF team-members resulted in increased knowledge and confidence about acquiring and applying MI techniques. However, this was balanced with consideration of barriers to application, further training needs and ongoing team-based support.
RESUMO
BACKGROUND: Feeding behavior problems contribute to inadequate dietary intake for many patients with cystic fibrosis (CF). However, to establish effective intervention programs, more needs to be known about the occurrence and distribution of these difficulties. The aims of this study were to establish the prevalence and range of disruptive child behaviors (DCB) in patients with CF and the inappropriate parental responses (IPR) during mealtimes and to compare the results with those of healthy children. METHODS: In study A, parents of 108 patients (aged 1-7 years) completed a Behavioural Paediatric Feeding Assessment Scale comprising two domains: DCBs and IPRs during mealtimes. Parents rated the frequency of the behaviors and responses and identified those they considered problematic. In study B, data from the CF group (n = 69, aged 1-12 years) were compared with 69 age- and sex-matched control subjects. RESULTS: Parents of children with CF aged 5 to 8 years recorded significantly more DCBs than those in all other age ranges. These parents also reported significantly more IPRs than did parents of children aged 9 to 12 years and 13 to 17 years. Parents of children with CF reported significantly more DCBs and IPRs than did those of the control subjects. There were significantly more problematic DCBs and IPRs in the CF group than in the control group for children aged 5 to 8 years and 9 to 12 years but not for those aged 1 to 4 years. CONCLUSIONS: Parents of children with CF report more feeding behavior problems than do those of healthy control subjects. The high prevalence of feeding behavior problems in older children suggests that preventative and reactive interventions must continue throughout childhood and vary according to the child's developmental abilities.
