Implementation of motivational interviewing in the general practice setting: a qualitative study

Area of Science:

• Healthcare delivery
• Behavioral science
• Primary care

Background:

• General Practitioners (GPs) and Practice Nurses (PNs) are key in chronic disease prevention and monitoring.
• Motivational Interviewing (MI) is a communication technique to encourage healthier lifestyles.
• Training in MI does not guarantee its effective implementation in daily practice.

Purpose of the Study:

• To identify factors facilitating or hindering the implementation of MI in General Practice.
• To understand barriers to MI skill application and integration by healthcare professionals.

Main Methods:

• 152 GP and PN trainees completed a questionnaire on MI implementation.
• 17 semi-structured interviews were conducted with GPs and PNs of varying experience levels.
• The Grol and Wensing five-stage implementation model guided the interview process.

Main Results:

• Thirteen factors influencing MI implementation were identified.
• Factors fall into three categories: setting (e.g., time), professional (e.g., self-efficacy), and patient (e.g., cultural background).
• Implementation difficulties were most pronounced in the application and consolidation stages.

Conclusions:

• GPs and PNs view MI as valuable and integral to their roles.
• Effective MI implementation requires addressing barriers beyond skill acquisition.
• Training should incorporate strategies to overcome identified implementation challenges and support skill maintenance.