General practitioners trained in motivational interviewing can positively affect the attitude to behaviour change in people with type 2 diabetes

Figures & data

Figure 1.  Flowchart of included general practitioners (GPs) and screen-detected Type 2 diabetic patients (T2D).

Figure 2.  Description of “motivational interviewing”.

Table I.  Health Care Climate Questionnaire (HCCQ) and Treatment Self-Regulation Questionnaire (TSRQ) evaluated at one year.

Sum score	I-group mean	C-group mean	▵; (95 CI); p-value	Interpretation of results
HCCQ sum	5.89	5.68	0.19 (−0.14;0.52) 0.26	Patients in both groups were satisfied with their relationship with the GP and the GP's counselling style
TSRQ control	4.95	4.88	0.06 (−0.31;0.43) 0.75	Patients in both groups tended to seek leadership and controlled counselling
TSRQ autonomy	6.50	6.24	0.21 (0.01;0.41) 0.03	Patients in the I-group were more autonomous, i.e. more self-determined and motivated for behavioural change
TSRQ amotivation	2.88	3.43	−0.53 (−0.94; − 0.11) 0.014	Patients in the C-group were more amotivated, i.e. patients in the I-group were more motivated for behavioural change
TSRQ relative autonomic-control index	1.51	1.40	0.08 (−0.08;0.23) 0.34	TSRQ index relates how much self-determination the patients had in relation to how much control/back-up the patients needed. The index did not change statistically significantly between groups

Notes: Sum scores of sub-questions–answers on a seven-item scale, 1 = totally disagree to 7 = fully agree. C-group: Control group of GPs (n for patients = 115), I-group: Intervention group of GPs trained in motivational interviewing (n for patients = 119).

Table II.  Advice giving by the general practitioner to the patient and patients’ self-care activities regarding smoking and alcohol evaluated at one year.*

Advice given by the GP	I-group %	C-group %	I-group vs. C-group p-value
Follow a low-fat eating plan	95.6	87.1	0.025
Follow a complex carbohydrate diet	56.9	41.1	0.01
Reduce the number of calories	81,8	69.4	0.027
Eat lots of food high in dietary fibre	70.8	50.5	0.002
Eat lots (at least five servings per day) of fruits and vegetables	82,5	71.0	0.037
Eat very few sweets, e.g. desserts	78.8	73.4	0.34
You have not been given any advice about your diet	2.9	6.9	0.79
Get low-level exercise (such as walking) on a daily basis	89.1	87.1	0.70
Exercise continuously for a least 20 minutes at least three times a week	38.7	25.8	0.034
Fit exercise into your daily routine	75.2	61.3	0.017
Engage in a specific amount, type, duration, and level of exercise	23.4	8.9	0.002
You have not been given any advice about exercise	4.4	8.4	0.61
Test your blood glucose (sugar) using a drop of blood from finger	60.6	46.8	0.034
Test your blood glucose using a machine to read the results	51.8	34.7	0.006
Test your urine for sugar	30.7	13.7	0.002
You have not been given any advice about testing for glucose	29.2	42.7	0.027
Smoking measurements:
Number of smokers (% of total number of patients)	39,5%	31,3%	0,21
How many cigarettes do you smoke on average per day?	13.2	11.1	0.27
At your last visit to the doctor, did anyone ask about your smoking status? (YES, n/n)	43% (20/47)	19% (7/36)	0.001
At your last visit to the doctor, did anyone counsel you about stopping smoking or refer you to a stop-smoking programme? (Yes, n/n)	43% (20/47)	27% (10/36)	0.046
How motivated are you to stop smoking? (scale: 1 = highly, 2 = to a certain degree, 3 = neither/nor, 4 = to a limited degree, 5 = not at all)	2.42	2.33	0.73
Alcohol measurements:
How many beers do you drink on average per week?	2.10	3.98	0.27
How many glasses of wine do you drink on average per week?	1.97	2.60	0.24
In consideration to your health, do you believe that you should lower your alcohol intake? (Yes, n/n)	79% (108/137)	82% (105/128)	0.27

Notes: *Diabetes Self-Care Activities Questionnaire. Data regarding smoking were analysed according only to smokers, whereas data regarding alcohol intake was analysed on all patients. C-group: Control group of GPs (n for patients = 115), smokers among patients (n=36), I-group: Intervention group of GPs trained in motivational interviewing (n for patients = 119), smokers among patients (n=47).

Table III.  Patients’ views on timeline, control, prevention, threat, and impact of diabetes evaluated at one year by the Diabetes Illness Representation Questionnaire.

Sum score	I-group mean	C-group mean	▵; (95 CI); p-value
Timeline (patient's perception of duration of the illness)	2.41	2.43	−0.04 (−0.23;0.15) 0.70
Control (patient's beliefs about how good recommended treatments are at controlling the illness)	3.90	3.68	0.22 (0.04;0.39) 0.016
Prevention (patient's beliefs about the extent to which the illness is amenable to cure and in which way prevention is possible)	4.16	3.99	0.17 (0.01;0.32) 0.042
Threat (patient's expected outcome of the illness)	2.61	2.58	0.02 (−0.09; − 0.12) 0.67
Impact (patient's expected impact on day-to-day life and in the long term)	3.50	3.47	0.02 (−0.12;0.18) 0.70

Notes: Sum scores on a five-item scale: 1 = no importance to 5 = extremely important. C-group: Control group of GPs (n for patients = 115), I-group: Intervention group of GPs trained in motivational interviewing (n for patients = 119).