Principle 3. Use of a Nonjudgmental Approach: Clinicians
more effectively support patient self-management when they
provide evidence-based information with a nonjudgmental
approach. Vogt et al. conducted a systematic review examining
the attitudes of general practitioners (GPs) and family physicians
toward smoking cessation.29 A “sizeable minority” held
negative beliefs about talking to their patients about smoking
cessation, in the belief that it was “too time-consuming” (42%)
and ineffective (38%), and 22% lacked the confidence to discuss
smoking with their patients. The authors concluded that
interventions led by primary care physicians would be more
effective if their own negative beliefs were addressed.
Motivational interviewing is a directive counseling approach
that explicitly avoids contradicting or judging a client.30 Dunn
et al. found that there was substantial evidence that motivational
interviewing led to improved outcomes for patients with substance
abuse and promising, yet inconclusive, evidence for its
efficacy in HIV risk, diet/exercise, and smoking cessation.18 A
meta-analysis of 72 studies revealed a significant effect for motivational
interviewing for body mass index, total blood cholesterol,
systolic blood pressure, and blood alcohol concentration
but not for A1C or the number of cigarettes per day.31
Principle 3. Use of a Nonjudgmental Approach: Clinicians
more effectively support patient self-management when they
provide evidence-based information with a nonjudgmental
approach. Vogt et al. conducted a systematic review examining
the attitudes of general practitioners (GPs) and family physicians
toward smoking cessation.29 A “sizeable minority” held
negative beliefs about talking to their patients about smoking
cessation, in the belief that it was “too time-consuming” (42%)
and ineffective (38%), and 22% lacked the confidence to discuss
smoking with their patients. The authors concluded that
interventions led by primary care physicians would be more
effective if their own negative beliefs were addressed.
Motivational interviewing is a directive counseling approach
that explicitly avoids contradicting or judging a client.30 Dunn
et al. found that there was substantial evidence that motivational
interviewing led to improved outcomes for patients with substance
abuse and promising, yet inconclusive, evidence for its
efficacy in HIV risk, diet/exercise, and smoking cessation.18 A
meta-analysis of 72 studies revealed a significant effect for motivational
interviewing for body mass index, total blood cholesterol,
systolic blood pressure, and blood alcohol concentration
but not for A1C or the number of cigarettes per day.31
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