How patients with type 2 diabetes mellitus respond to motivational interviewing

Aim: To determine how patients with type 2 DM feel about a motivational interviewing (MI) intervention designed to promote positive behavior change. Method: Qualitative study using focus groups conducted by the same facilitator. Setting: Family or general internal medicine practice clinics affiliated with an academic medical center and a community general hospital. One site consisted of primarily low income Hispanic patients. Participants: Four focus groups consisting of nineteen adult patients with type 2 diabetes mellitus solicited from a large NIH-funded randomized controlled trial on MI and diabetes. Results: Across and within group analysis was performed on transcripts of the taped interviews. Patient perceptions of standard care were largely negative, with several individuals describing paternalistic and demeaning attitudes. Five themes related to MI emerged: Nonjudgmental Accountability, Being Heard and Responded to as a Person, Encouragement and Empowerment, Collaborative Action Planning and Goal Setting, and Coaching rather than Critiquing. Conclusions: Some patients with type 2 diabetes are receptive to motivational interviewing which is a provider approach that is more patient-centered and empowering than traditional care.