Volume 8, Issue 1 (June 2022)                   Elderly Health Journal 2022, 8(1): 4-5 | Back to browse issues page


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Vafaeinasab M, Badieian G, Rajabalipour M. Motivational Interviewing and Health Promotion of Older Adults. Elderly Health Journal. 2022; 8 (1) :4-5
URL: http://ehj.ssu.ac.ir/article-1-267-en.html
Department of Health Education and Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran , mmrr1366@yahoo.com
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Motivational Interviewing and Health Promotion of Older Adults

Mohammadreza Vafaeinasab 1,2, Gholamreza Badieian 1,2, Mohammadreza Rajabalipour 3*


  1. Elderly Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
  2. Department of Ageing and Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
  3. Department of Health Education and Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

Received 25 June 2022


Copyright © 2022 Elderly Health Journal. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cite.
 
    Aging is one of the life courses that more than 60% of people experience as the last stage of their life. This period, which begins at the age of 65, has consequences and characteristics that make the seniors in need of constant care in physical and mental dimensions. The family is the best place to provide comfort for the  aged people (1-3), but often for various reasons including: specialized care, lack of access to necessary resources and equipment, conflict between the value system of the new and old generation, communication problems and Psychological pressures and the existence of specific disorders in older adults, the family will not have the necessary skills to care the seniors, and therefore the undeniable position of specialized interventions to maintain and promote the health of the older adults becomes more apparent (3, 4).
    The nature of these specialized interventions should be focused on changing the behavior of older adults, because almost all disorders of old age are chronic and lifestyle-related problems (3). According to the World Health Organization, regardless of physical disorders, the major problem in aging is related to mental disorders such as anxiety, hopelessness and depression. These disorders provide the basis for many behavioral problems in older adults (5).
    On the other hand, intervention to change behavior in older adults will be a difficult process, this is because older people engage in unhealthy behaviors and habits such as smoking, high sugar intake, and unhealthy diets and are not encouraged to quit voluntarily (5). In addition, older adults are less inclined to start and maintain new behavior due to factors such as duality of thoughts, internalization of some habits, resistance to change, apathy and depression, disability and fatigue, and often even show resistance to change. Therefore, due to age, the need to change the lifestyle of older adults is both inevitable and has special difficulties, which make the use of effective specialized methods to care for them inevitable (4).
    In recent years, several studies have been conducted on the application of traditional methods in various behaviors to improve the mental condition of older adults, which were not very effective and have not been successful in maintaining behavior and improving the quality of life of older adults for a long time. Perhaps the main reasons for this failure can be found in the focus of these methods on external and environmental factors in special interventions for older adults, while there are some pieces of evidence that the behavior of older adults is due to internal factors and their individual motivations. Therefore, a method should be sought that simultaneously affects the internal motivation of older adults and is effective in maintaining behavior for a long time (6).
    Motivational interviewing is a method of counseling and psychological intervention with the aim of creating an internal motivation for change and has a great impact on strengthening a person's behavioral intention. This method is mostly used to help people who are at risk of developing health disorders including older adults (2, 7).
    In the 1980s and 1990s, motivational interviewing was traditionally used for specific behavioral purposes, such as quitting addiction and alcohol, but, with the development of psychological sciences and methodology, researchers and counselors have proposed this method for use in disorders and other mental problems such as stress, anxiety, depression and other behavioral goals of a healthy lifestyle (8). In addition, in recent years, studies on obesity, diabetes, hypertension, and improvement of anthropometric indices in individuals have been used this method, the results of which have been quite effective (9). What is certain is that motivational interviewing is a very powerful way to identify and repair people's thoughts and mindsets to change lifestyle-related behaviors, especially in the challenges of chronic illness. Therefore, it can be a very effective method for interventions to promote the physical and mental health of older adults (10, 11).
    Motivational interviewing is a kind of goal-oriented, person-centered and direct counseling that, by exploring mental ambiguities, promotes older adults person's inner motivation and prepares them for lifestyle changes. In this way, older adults can talk about their inner mindsets and beliefs about quitting a behavior or adopting a new one, and gradually express their conflicting and dual feelings and argue for them (1). Using various communication techniques, the counselor identifies these dual emotions, motivations and sources of internal control of older adults that are revealed during the conversation, and seeks to correct and reposition them in the thoughts of older adults. In fact, the cornerstone of motivational interviewing and the success factor of this method in promoting the health of older adults will be a successful and stable relationship between older adults and the counselor (1, 2, 12).
    A good relationship can easily break older adults' resistance to lifestyle changes (12). In fact, motivational interviewing focuses more on reinforcing intrinsic motivation than persuasion and seeks to explain why the behavior is, instead of how it is. In this way, the counselor helps older adults to express their thoughts about the new behavior, to express the obstacles and reasons for the change, to need the sense of change, to receive guidance to facilitate and eliminate them so that they can voluntarily and confidently accept the new behavior and receive active and continuous support to initiate and maintain new behavior (1, 2, 12).
    Of course, the effective use of motivational interviewing in promoting the health of older adults requires attention to both technical and communication components. Using counseling skills such as empathy in understanding older adults, strengthening the self-efficacy of older adults, facilitating change discourse and setting optimal goals for new behavior, avoiding tensions and interactive challenges between the counselor and older adults, and playing a role in mental and psychological arousal of older adults are other components to make this method more effective in promoting the health of older adults (1). So, the use of motivational interviewing for interventions related to promoting the health of older adults is suggested.

Refrences
  1. Bundy C. Changing behaviour: using motivational interviewing techniques. Journal of the Royal Society of Medicine. 2004; 97(Suppl 44): 43-7.
  2. Lilienthal KR, Pignol AE, Holm JE, Vogeltanz-Holm N. Telephone-based motivational interviewing to promote physical activity and stage of change progression in older adults. Journal of Aging and Physical Activity. 2014; 22(4): 527-35.
  3. Bloom DE, Canning D, Lubet A. Global population aging: facts, challenges, solutions & perspectives. Daedalus. 2015; 144(2): 80-92.
  4. Bengtson V. Global aging and challenges to families. Routledge; 2018.
  5. Partridge L, Deelen J, Slagboom PE. Facing up to the global challenges of ageing. Nature. 2018; 561(7721): 45-56.
  6.  Moral RR, de Torres LA, Ortega LP, Larumbe MC, Villalobos AR, García JA, et al. Effectiveness of motivational interviewing to improve therapeutic adherence in patients over 65 years old with chronic diseases: a cluster randomized clinical trial in primary care. Patient Education and Counseling. 2015; 98(8): 977-83.
  7. D'Amico EJ, Parast L, Shadel WG, Meredith LS, Seelam R, Stein BD. Brief motivational interviewing intervention to reduce alcohol and marijuana use for at-risk adolescents in primary care. Journal of Consulting and Clinical Psychology. 2018; 86(9): 775-86.
  8. Lindson N, Thompson TP, Ferrey A, Lambert JD, Aveyard P. Motivational interviewing for smoking cessation. Cochrane Database of Systematic Reviews. 2019; 7: CD006936.
  9. Ekong G, Kavookjian J. Motivational interviewing and outcomes in adults with type 2 diabetes: a systematic review. Patient education and counseling. 2015; 99(6): 944-52.
  10. Frost H, Campbell P, Maxwell M, O’Carroll RE, Dombrowski SU, Williams B, et al. Effectiveness of motivational interviewing on adult behaviour change in health and social care settings: a systematic review of reviews. PLoS One. 2018; 13(10): e0204890.
  11. DiClemente CC, Corno CM, Graydon MM, Wiprovnick AE, Knoblach DJ. Motivational interviewing, enhancement, and brief interventions over the last decade: A review of reviews of efficacy and effectiveness. Psychology of Addictive Behaviors. 2017; 31(8): 862-87.
  12. Serdarevic M, Lemke S. Motivational interviewing with the older adult. International Journal of Mental Health Promotion. 2013; 15(4): 240-9.
Type of Study: Applicable | Subject: Special
Received: 2022/06/25 | Accepted: 2022/06/25 | Published: 2022/06/29

References
1. Bundy C. Changing behaviour: using motivational interviewing techniques. Journal of the Royal Society of Medicine. 2004; 97(Suppl 44): 43-7.
2. Lilienthal KR, Pignol AE, Holm JE, Vogeltanz-Holm N. Telephone-based motivational interviewing to promote physical activity and stage of change progression in older adults. Journal of Aging and Physical Activity. 2014; 22(4): 527-35.
3. Bloom DE, Canning D, Lubet A. Global population aging: facts, challenges, solutions & perspectives. Daedalus. 2015; 144(2): 80-92.
4. Bengtson V. Global aging and challenges to families. Routledge; 2018.
5. Partridge L, Deelen J, Slagboom PE. Facing up to the global challenges of ageing. Nature. 2018; 561(7721): 45-56.
6. Moral RR, de Torres LA, Ortega LP, Larumbe MC, Villalobos AR, García JA, et al. Effectiveness of motivational interviewing to improve therapeutic adherence in patients over 65 years old with chronic diseases: a cluster randomized clinical trial in primary care. Patient Education and Counseling. 2015; 98(8): 977-83.
7. D'Amico EJ, Parast L, Shadel WG, Meredith LS, Seelam R, Stein BD. Brief motivational interviewing intervention to reduce alcohol and marijuana use for at-risk adolescents in primary care. Journal of Consulting and Clinical Psychology. 2018; 86(9): 775-86.
8. Lindson N, Thompson TP, Ferrey A, Lambert JD, Aveyard P. Motivational interviewing for smoking cessation. Cochrane Database of Systematic Reviews. 2019; 7: CD006936.
9. Ekong G, Kavookjian J. Motivational interviewing and outcomes in adults with type 2 diabetes: a systematic review. Patient education and counseling. 2015; 99(6): 944-52.
10. Frost H, Campbell P, Maxwell M, O’Carroll RE, Dombrowski SU, Williams B, et al. Effectiveness of motivational interviewing on adult behaviour change in health and social care settings: a systematic review of reviews. PLoS One. 2018; 13(10): e0204890.
11. DiClemente CC, Corno CM, Graydon MM, Wiprovnick AE, Knoblach DJ. Motivational interviewing, enhancement, and brief interventions over the last decade: A review of reviews of efficacy and effectiveness. Psychology of Addictive Behaviors. 2017; 31(8): 862-87.
12. Serdarevic M, Lemke S. Motivational interviewing with the older adult. International Journal of Mental Health Promotion. 2013; 15(4): 240-9

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