스트레스연구 (Stress)

  • 제26권4호
  • /
  • Pages.268-276
  • /
  • 2018
  • /
  • 1225-665X(pISSN)
  • /
  • 2234-1668(eISSN)
대한스트레스학회 (The Korean Society of Stress Medicine)
권호 표지
DOI QR코드

DOI QR Code

간호대학생의 의사소통 능력 함양을 위한 동기면담 기반 의사소통 훈련의 효과

An Evaluation of Motivational Interviewing Based Communication Training to Promote Communication Competency for Nursing Students

  • 투고 : 2018.10.03
  • 심사 : 2018.10.22
  • 발행 : 2018.12.31
⟨ 이전 논문 다음 논문 ⟩

초록

간호사의 의사소통은 신뢰관계와 간호의 질 보장을 위한 핵심 능력이다. 본 연구는 간호 대학생 3학년 35명을 대상으로 동기면담기반 의사소통훈련을 시행하였고 훈련 효과를 확인하였다. 4시간 단일 회기 훈련 후 핵심 기술인 반영하기와 반영의 깊이, 의사소통의 걸림돌과 닫힌질문 등에서 훈련의 성과를 확인하였다. 그러나 열린질문에 대해서는 유의미한 효과를 확인하지 못하여 향후 이와 관련한 변수에 대한 연구가 필요하다. 면담에 대한 자신감은 훈련 후 전반적으로 좋은 성과를 얻었는데 반영하기에 대한 자신감은 유의미하지 않아 반영하기에 대한 학생들의 자신감 고양을 위한 전략 마련이 필요하다. 훈련 방법 중에는 개별, 집단 피드백이 가장 큰 도움을 준 것으로 나타나 훈련가들의 피드백 역량에 대한 재고가 필요하다.

Background: The purpose of this study is to evaluate the effects of the Motivational Interviewing (MI) based communication training for third-year nursing students. Methods: This study use a quasi-experimental design with pre and post-test to evaluate a 4-hour MI based communication training. This training was offered to 35 third-year nursing students who were participating in elective psychiatric nursing clerkship course. Each student completed pre and post questionnaire which includes assessment of motivational interviewing skills as measured by Helpful Response Questionnaire (HRQ). Also confidence (5 items) in using MI based communication knowledge and core skills were included. Data were independently analyzed by two coders and blindly rated the pre and post HRQ self-reported responses. Data were analyzed using paired t-test, descriptive analysis. Results: Nursing students showed increasing use of reflection (4.10~5.67, p<.001), decreasing use of closed-ended question (2.00~0.73, p<.001), road blocks (2.94~0.64, p<.001), and improve in depth of reflection (12.79~20.86 p<.001). But they did not show significant changes in open-ended question (2.01~2.33, p=.257). Confidence in the interview has increased overall, except for reflecting. The overall satisfaction with the training was quite high, and the most helpful training method was group and individual feedback. Conclusions: This study provides evidences that 4 hour-training is effective in core skills such as reflection and depth of reflection, and also confidence in interviews. It is necessary to develop step-by-step training modules to enhance undergraduate communication skills. It is necessary to develop an effective training strategy focused on students' confidence in open-ended questions and reflection.

키워드

참고문헌

  1. Bell K, Cole BA. (2008). Improving medical students' success in promoting health behavior change: a curriculum evaluation. J Gen Intern Med. 23(9): 1503. doi: 10.1007/s11606-008-0678-x
  2. Black B, Lucarelli J, Ingman M et al. (2016). Changes in Physical Therapist Students' Self-Efficacy for Physical Activity Counseling Following a Motivational Interviewing Learning Module. J Phys Ther Educ. 30(3): 28-32. doi: 10.1097/00001416-201630030-00006
  3. Bohman B, Forsberg L, Ghaderi A et al. (2013). An evaluation of training in motivational interviewing for nurses in child health services. Behav Cogn Psychother. 41(3): 329-343. doi: 10.1017/S1352465812000331
  4. Childers JW, Bost JE, Kraemer KL et al. (2012). Giving residents tools to talk about behavior change: A motivational interviewing curriculum description and evaluation. Patient Educ Couns. 89(2): 281-287. doi: 10.1016/j.pec.2012.08.001
  5. Cho IY. (2015). The Relationship of Communication Skill, Communication Self-Efficacy and Communication Related Educational Needs. Journal of the Korea Academia-Industrial cooperation Society. 16(4): 2593-2601. doi: 10.5762/KAIS.2015.16.4.2593
  6. Gecht-Silver M, Lee D, Ehrlich-Jones L et al. (2016). Evaluation of a Motivational Interviewing Training for Third-Year Medical Students. Fam med. 48(2): 132-135.
  7. Gordon T. (1974). Teacher effectiveness training. PH Wyden New York: Crown.
  8. Grant VJ, Hawken SJ. (2009). What do they think of it now? Medical graduates' views of earlier training in communication skills. Med Teach. 22(3): 260-264. doi: 10.1080/01421590050006223
  9. Hall K., Gibbie T, Lubman DI. (2012). Motivational interviewing techniques: Facilitating behaviour change in the general practice setting. Aust Fam Physician. 41(9): 660.
  10. Kazis LE, Anderson JJ, Meenan RF. (1989). Effect sizes for interpreting changes in health status. Medical care. S178-S189. doi: 10.1097/00005650-198903001-00015
  11. Kim CS, Lee MO, Lee SB. (2016). Effects of Nonviolent Communication(NVC) Program consist of Communication Competency, Communication Self-Efficacy and Stress in Nurses. Health Service Management Review. 10(3):09-17. doi: 10.18014/hsmr.2016.10.3.09
  12. Kim HJ. (2017). Evaluation of Motivational Interviewing Training to Promote Client-centered Communication Competency for Nurses. J Korean Acad Psychiatr Ment Health Nurs. 26(4): 362-373. doi: 10.12934/jkpmhn.2017.26.4.362
  13. Kim SA, Park JH, Lee HH. (2004). The Development and Effects of a Comprehensive Communication Course for Nursing Students. J Korean Acad Nurs. 34(3): 412-420. http://uci.or.kr/I410-ECN-0102-2009-510-002629071 https://doi.org/10.4040/jkan.2004.34.3.412
  14. Lloyd M, Bor R. (2009). Communication skills for medicine E-book. Philadelphia, PA: Elsevier Health Sciences.
  15. Martino S, Haeseler F, Belitsky R et al. (2007). Teaching brief motivational interviewing to year three medical students. Med Educ. 41(2): 160-167. doi: 10.1111/j.1365-2929.2006.02673.x
  16. Miller WR, Moyers TB. (2006). Eight stages in learning motivational interviewing. Subst Abus. 5(1): 3-17. doi: 10.1300/J188v05n01_02
  17. Miller WR, Hedrick KE, Orlofsky DR. (1991). The Helpful Responses Questionnaire: A procedure for measuring therapeutic empathy. J Clin Psychol. 47(3): 444-448. doi: 10.1002/1097-4679(199105)47:3<444::AID-JCLP2270470320>3.0.CO;2-U
  18. Miller WR, Rollnick S. (2013). Applications of Motivational Interviewing: Motivational Interviewing: Helping People Change. New York: The Guilford Press.
  19. Miller WR, Sorensen JL, Selzer JA et al. (2006). Disseminating evidence-based practices in substance abuse treatment: A review with suggestions. J Subst Abuse Treat. 31(1): 25-39. doi: 10.1016/j.jsat.2006.03.005
  20. Mounsey AL, Bovbjerg V, White L et al. (2006). Do students develop better motivational interviewing skills through role‐play with standardized patients or with student colleagues? Med Educ. 40(8): 775-780. doi: 10.1111/j.1365-2929.2006.02533.x
  21. Moyers TB, Martin T, Manuel JK et al. (2010). Revised global scales: Motivational interviewing treatment integrity 3.1. 1 (MITI 3.1. 1). Unpublished manuscript, University of New Mexico, Albuquerque, NM.
  22. Nesbitt BJ, Murray DA, Mensink AR. (2014). Teaching motivational interviewing to nurse practitioner students: a pilot study. J Am Assoc Nurse Pract. 26(3): 131-135. doi: 10.1002/2327-6924.12041
  23. Oh YJ. (2008). Development and Effectiveness of the Communication Empowerment Program for Nursing Students: based on the Theory of Transfer of Learning. (Doctoral dissertation). Korea University, Seoul. Retrieved from http://www.riss.kr/link?id=T11559818
  24. Park YS, Im SB, Kim HS. (2009). The Effects of Reinforced Self-understanding in Nursing Communication Curriculum. J Korean Acad Psychiatr Ment Health Nurs. 18(3): 361-368. http://uci.or.kr/I410-ECN-0102-2012-510-001167984
  25. Poirier MK, Clark MM, Cerhan JH et al. (2004). Teaching motivational interviewing to first-year medical students to improve counseling skills in health behavior change. Mayo Clin Proc. 79(3): 327-331. doi: 10.4065/79.3.327
  26. Roman B, Borges N, Morrison AK. (2011). Teaching motivational interviewing skills to third-year psychiatry clerkship students. Acad Psychiatry. 35(1): 51-53. doi: 10.1176/appi.ap.35.1.51
  27. Seo NH, Kim HJ. (2018). Exploring the Experience of Motivational Interviewing Training for Improving Communication Skills in Parents with Adolescent child. J Korean Acad Psychiatr Ment Health Nurs. 27(3): 252-263. doi: 10.12934/jkpmhn.2018.27.3.252
  28. Shin SK, Cho SH. (2016). Motivational interviewing easy to learn. Seoul: Hakjisa.
  29. Song EJ. (2006). The Effects of a Communication Training Program on Communication and Interpersonal Relationship for Student Nurses in Clinical Practice. J Korean Acad Soc Nurs Edu. 17(3): 424-432. http://uci.or.kr/I410-ECN-0101-2012-512-004207630
  30. Son HM, Kim HS, Koh MH et al. (2011). Analysis of the Communication Education in the Undergraduate Nursing Curriculum of Korea. J Korean Acad Soc Nurs Edu. 17(3): 424-432. http://uci.or.kr/I410-ECN-0102-2012-510-002609296 https://doi.org/10.5977/JKASNE.2011.17.3.424
  31. Won JS, Shin HS. (2008). The Effect of Small Group Based Communication Training Program on the Competency of Communication and the Human Relationship in Nursing College Students. JEWNR. 14(2): 60-66. http://uci.or.kr/G704+INS000003928-ART001464788