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Self-determination theory in health care and its relations to motivational interviewing: a few comments

机译:卫生保健中的自决理论及其与动机面试的关系:几点评论

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摘要

The papers of this special issue have the dual focus of reviewing research, especially clinical trials, testing self-determination theory (SDT) and of discussing the relations between SDT and motivational interviewing (MI). Notably, trials are reviewed that examined interventions either for behaviors such as physical activity and smoking cessation, or for outcomes such as weight loss. Although interventions were based on and intended to test the SDT health-behavior-change model, authors also pointed out that they drew techniques from MI in developing the interventions. The current paper refers to these studies and also clarifies the meaning of autonomy, which is central to SDT and has been shown to be important for effective change. We clarify that the dimension of autonomy versus control is conceptually orthogonal to the dimension of independence versus dependence, and we emphasize that autonomy or volition, not independence, is the important antecedent of effective change. Finally, we point out that SDT and MI have had much in common for each has emphasized autonomy. However, a recent MI article seems to have changed MI's emphasis from autonomy to change talk as the key ingredient for change. We suggest that change talk is likely to be an element of effective change only to the degree that the change talk is autonomously enacted and that practitioners facilitate change talk in an autonomy supportive way.
机译:本期特刊的论文具有双重重点:审查研究,尤其是临床试验,测试自决理论(SDT)以及讨论SDT与动机访谈(MI)之间的关系。值得注意的是,对试验进行了审查,这些试验检查了干预措施,包括体育锻炼和戒烟等行为,或减肥等结果。尽管干预措施基于并旨在测试SDT健康行为改变模型,但作者还指出,他们在制定干预措施时借鉴了MI的技术。当前的论文参考了这些研究,并阐明了自治的意义,这对于SDT至关重要,并且已经证明对于有效的变革很重要。我们阐明,自治与控制的维度在概念上与独立与依赖性的维度正交,并且我们强调自治或自愿而非独立是有效变革的重要前提。最后,我们指出,SDT和MI在强调自治性方面有很多共同点。但是,MI最近的一篇文章似乎已将MI的重点从自主性转变为改变言论,成为改变的关键要素。我们建议,只有在自动执行变更对话并且从业人员以自治支持的方式促进变更对话的程度时,变更对话才可能是有效变更的要素。

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