PEBC MCQ Communication, Collaboration & Documentation question: exhausted after work.

PEBC MCQCommunication, Collaboration & Documentation

LJ, 54, has type 2 diabetes with an A1C of 8.1% and works long shifts in a warehouse. At a medication review she says: 'I know I should walk more, but I am exhausted after work.' Which response best reflects motivational interviewing?

a. 'Why do you think you haven't managed to walk more?'
b. 'You want to be more active, but tiredness gets in the way.'
c. 'Could you try a 10-minute walk at lunch instead?'
d. 'Many people find that walking actually gives them more energy.'

Show the answer and explanation

Answer: b. 'You want to be more active, but tiredness gets in the way.'

Motivational interviewing starts with reflective listening: reflecting both sides of the ambivalence ('you want to... but...') helps the patient voice their own reasons for change. Offering a solution straight away or persuading with information is the 'righting reflex', which tends to provoke 'yes, but' resistance, and 'why' questions invite the patient to defend the status quo. Advice can follow later, with permission. Source: Miller WR, Rollnick S. Motivational Interviewing, 3rd ed. (Guilford, 2013); Diabetes Canada CPG ch. 18 Self-management education and support (2018).

Common mistake

Lecturing or warning instead of reflecting ambivalence.

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