The use of motivational interviews by nurses to promote health behaviors in adolescents: a scoping review protocol

Adolescents - defined as young people between 10 and 19 years of age1 - are, in general, a relatively healthy segment of the population.2 However, the developmental changes that take place during adolescence may affect their subsequent risk for diseases and for a variety of health-related behaviors. In fact, early onset of preventable health problems (e.g. obesity, malnutrition, STDs) and the engagement in health risk behaviors (e.g., sedentary life style, excessive alcohol consumption, unprotected sex) during adolescence, are likely to put them at greater risk for physical and mental health problems at a later stage in life. Moreover, health related problems and health risk behaviors may disrupt adolescents' physical and cognitive development and therefore may affect their ability to think and act in relation to decisions about their health in the future.1 In summary, health-related behaviors in adolescence, apart from their influence on the continuum of "health-disease", they also have the potential to influence future behaviors. In fact, several studies have shown that past behaviors are good predictors of future behaviors .3,4 Thus, promoting healthy practices during adolescence and taking measures to better protect young people from health risks are essential for the prevention of health problems in adulthood.5 According to the World Health Organization, the main problems affecting young people include mental health problems (such as behavioral disorders, eating disorders, suicide, anxiety or depression), the use of substances (illegal substances, alcohol and tobacco), interpersonal violence, nutrition (a proper nutrition consists of healthy eating habits and physical exercise), unintentional injuries (which are a leading cause of death and disability among young people, with road traffic injuries accounting for about 700 deaths per day), sexual and reproductive health (for example, risky sexual behaviors, early pregnancy and childbirth) and HIV (resulting from sexual transmission and drug injection).5,6 On the other hand, the number of children and youth with chronic health conditions has increased dramatically in the past four decades7 as larger numbers of chronically ill children survive beyond the age of 10.8 Despite the lack of data on adolescents' health making it difficult to determine the prevalence of chronic illnesses in this age group9, it is known that one in ten adolescents suffers from a chronic condition worldwide.10 In fact, national population based studies from Western countries show that 20-30% of teenagers have a chronic illness, defined as one that lasts longer than six months.8 The most prevalent chronic illness among adolescents is asthma and the one with the highest incidence is diabetes mellitus, particularly type II.9 Traditionally, healthcare professionals have been mainly investing in health education activities, through the transmission of knowledge with a view to creating habits, customs and behaviors, and promoting healthy lifestyles. However, empowering people does not only consist of giving them the right information11 , i.e. good information is not enough to cause people to make changes.12 The motivation or desire to change unhealthy behaviors and habits depends on many factors, namely intrinsic motivation, control over personal decisions, self-confidence and perception of effectiveness, personal ambivalence, and individualized assistance.12 Many professionals assume that supplying knowledge is sufficient for behavioral changes; however, even very good advice often fails to generate behavioral change. After all, people continue to engage in unhealthy behaviors despite clearly knowing what they should do and how to change. "What is lacking is the motivation to apply that knowledge".13, p.1233 In fact, behavioral change is a complex phenomenon with multiple determinants that also includes motivational variables. It is associated with ambivalent processes expressed in the dilemma between keeping the current status and moving on to new ways of acting. For example, telling adolescents that if they keep on engaging in a certain behavior, they are increasing the risk of developing a long-term condition such as cardiovascular disease, stroke or diabetes is rarely enough to trigger the desired behavioral change; people are more likely to change when they believe that the change is really effective and that they are able to implement it.12 Therefore, it is essential to provide specific training for "healthcare professionals to master motivational techniques, avoid confrontation with the users, and facilitate behavioral changes".14 In this context, motivating patients to make behavioral changes is also an important nursing task where change in lifestyle is a major element of patients' treatment and preventive interventions.15 One of the nurse's goals is to help improve a patient's health or help them to manage existing health conditions. Once nurses are in a position where they have to focus on accomplishing tasks and telling patients what needs to be accomplished16, the role of the nurse is expanding even more into the use of motivational strategies.17 MI is bringing nurses back to therapeutic communication and moving them closer to successful health promotion and disease management, by promoting behavior change and empowering their patients. As the nursing profession evolves, MI is seen as a challenge and the basis of nurse's interactions with individuals, families and communities.16, 17 In the same way, MI may be taken as an essential tool in the provision of nursing care to adolescents, being itself a workspace with possible therapeutic effects regarding problems, clarification of doubts, and development of skills.18 In fact, MI may be particularly applicable in work with adolescents because of their specific developmental stage. Adolescents attempt to establish their own autonomy and identity while struggling with social interactions and moral issues, which leads to ambivalence.19 Consistent with the developmental challenges during adolescence, "MI explicitly honors autonomy, people's right and irrevocable ability to decide about their own behavior"20 while allowing the person to explore possibilities for change of risky or maladaptive behaviours.19 MI can be defined as a directive, client-centred counselling style for eliciting behavior change by helping clients to explore and resolve ambivalence. It is most centrally defined not by technique but by its spirit as a facilitative style of interpersonal relationship.21 It is a set of strategies and techniques widely used in clinical practice based on the transtheoretical model of change. The Stages of Change model describes five stages of readiness—precontemplation, contemplation, preparation, action, and maintenance—and provides a framework for understanding behavior change.22 The MI has been widely tested and applied in different areas, such as modification of addictive behaviors, interventions with offenders in the context of justice, eating disorders, promotion of therapeutic adherence among chronic patients, promotion of learning in school settings or intervention with adolescents at risk.18,23 In general, clinical practice has been adopting the perspective of motivation as something relatively immutable, i.e., the adolescent is either motivated for change/treatment and, in these conditions, the professional's role is to help him/her, or the adolescent is not motivated and then change/treatment is not feasible. Alternatively the theoretical model underlying the MI technique postulates that the individual's adherence to change/treatment depends on his/her motivation, which can change throughout the therapeutic intervention. As several studies found positive results for effects of MI24-26 and its use by health professionals is encouraged23,27 nurses may play an important role in patients' process of change. As nurses have a crucial role in clinical contexts, they can facilitate the process of ending risk behaviors and/or adopting positive health behaviors through some motivational techniques, namely with adolescents. A considerable number of systematic reviews about MI already exist pointing to some benefits of its use in the treatment of a broad range of behavioral problems and diseases.13,28,29 Some of the current reviews focus on examining the effectiveness of MI for adolescents with diverse health risks/problems 30-32. However, to date there are no reviews that present and assess the evidence for the use of nurse-led MI in adolescents. Therefore, we have little knowledge of what works for whom (which adolescent subpopulation) under what circumstances (in which setting, for what problem) in relation to motivational interviewing by nurses. There is a clear need for scoping or mapping the use of MI by nurses with adolescents to identify evidence gaps and to inform opportunities for future development in nursing practice. On the other hand, information regarding nurse-led implemented and evaluated interventions, techniques and/or strategies used, contexts of application and adolescents subpopulation groups is dispersed in the literature33-36 which impedes the formulation of precise questions about the effectiveness of those interventions conducted by nurses and therefore the realization of a systematic review. In other words, it is known that different kind of motivational interventions have been implemented in different contexts by nurses, however does not exist a map about all the motivational techniques and/or strategies used. Furthermore the literature does not clarify which is the role of nurses at cross professional motivational intervention implemented programs and finally the outcomes and evaluation of interventions are unclear. Thus, the practical implication of this mapping will be clarifying all these aspects. Without this clarification is not possible to proceed to the realization of a systematic review about the effectiveness of the use of motivational interviews by nurses to promote health behaviors in adolescents, in a particular context and/or health risk behavior; or regarding the effectiveness of certain technique and/or strategy of MI. Consequently, there are important questions about the nature of the evidence in this area that need to be answered before formulating a precise question of effectiveness. This scoping review aims to respond to these questions. An initial search of the JBI Database of Systematic Reviews & Implementation Reports, Cochrane Database of Systematic Reviews, , Database of promoting health effectiveness reviews (DoPHER), The Campbell Library, Medline and CINAHL, has revealed that currently there is no Scoping Review (published or in progress) on the subject. In this context, this scoping review will examine and map the published and unpublished research around the use of MI by nurses implemented and evaluated to promote health behaviors in adolescents; to establish its current extent, range and nature and identify its feasibility, outcomes and gaps in the evidence defining research priorities in this field. This scoping review will be informed by the JBI methodology37 that suggests a five stage methodological framework for conducting scoping reviews which includes: identifying the research question, searching for relevant studies, selecting studies, charting data, collating, summarizing and reporting the results.

To Succeed Is to Believe: Comparison of Self-Efficacy Beliefs in Language Learning between Learner Groups of English and Swedish in Finland

In this thesis, I studied self-efficacy in the learning of English and Swedish in Finland. The theory of self-efficacy, which was created by Albert Bandura, suggests that the beliefs a person has of his or her capabilities in a certain task affect the person’s performance in the task. My aim was to study whether there are differences in self-efficacy beliefs between the learners of English and Swedish, and whether these beliefs correlate with the performance in the language in question. My hypotheses were that the learners of English have higher self-efficacy beliefs than the learners of Swedish and that self-efficacy beliefs correlate with language performance. The study was quantitative, and it consisted of a self-efficacy questionnaire and a language test which were distributed to students of English and Swedish in an upper secondary school in Rovaniemi. The study was answered by 137 students, of whom 93 were learners of English and 44 were learners of Swedish. The results indicated that the learners of English had a higher sense of efficacy than the learners of Swedish. The analysis proved that there was a significant correlation between English students’ self-efficacy and their performance in the language measured by the test and the grades. In addition, a significant correlation existed between Swedish students’ self-efficacy and their grades. However, there was no correlation between the Swedish students’ self-efficacy and their test results. The difference in the self-efficacy beliefs of the two language groups indicates that people in Finland are more confident in using English than Swedish, which also implies that English is more valued in Finnish society than Swedish. It is important to acknowledge the lower self-efficacy beliefs in Swedish because various studies have proven that self-efficacy affects academic achievement. As a suggestion for further research, the self-efficacy beliefs of different language groups could be compared in a qualitative study in order to understand the development of self-efficacy more profoundly.

Helping you to make the right choice for your web filtering

We have designed this flowchart to help you choose the web filtering option that best suits your needs from three different options: Our free standard web filtering service, enhanced user based filtering or a solution from our framework agreement.

As funções do supervisor do segundo e terceiro ciclos do ensino básico : contributos para o desenvolvimento profissional e institucional numa organização de educação e ensino privada

Dissertação de Mestrado em Ciências da Educação - Especialização em Supervisão Pedagógica, apresentada à Escola Superior de Educação de Paula Frassinetti

A docência enquanto paixão:construção da profissionalidade no 1º e 2º ciclo do ensino básico

Relatório de estágio apresentado à Escola Superior de Educação de Paula Frassinetti para obtenção de grau de Mestre em Ensino de 1º e 2º ciclo do Ensino Básico

Formação e profissionalidade: um estudo na formação inicial de professores do ensino básico em Moçambique

Visando analisar a Formação Inicial de Professores (FIP) do Ensino Básico em Moçambique, no intuito de captar como concorre para a construção da representação de profissionalidade na atividade docente, este estudo descritivo e interpretativo estrutura-se em duas dimensões complementares (extensiva e intensiva). Através dessas duas dimensões procurou-se explicitar os pontos críticos do objeto de estudo e produzir conhecimento sobre o mesmo. E, nessa linha, nas conclusões do estudo ficarão disponíveis possíveis contributos para a melhoria da sustentação e eficácia da formação inicial. Na dimensão extensiva, em função de descritores de profissionalidade associados ao reconhecimento social de uma atividade como profissional, definidos na literatura investigativa da sociologia das profissões e da educação, analisou-se a noção de profissionalidade que norteia a FIP. Essa análise foi desenvolvida com recurso ao estudo de documentos legais e curriculares, inquéritos por questionário a 289 formadores e por entrevista a 7 agentes-chave da formação de professores (gestores, académicos e formadores de professores). Na dimensão intensiva, concretizada num estudo multicaso (4 estudos de caso) envolvendo, essencialmente, 16 formadores de 4 instituições de formação de professores (polos), aprofundou-se a compreensão da visão de formadores de professores sobre profissionalidade, com recurso à observação de atividade docente e respetiva planificação, entrevistas semi-estruturadas a 4 gestores da Prática Pedagógica e estágio nesses polos, à luz do quadro teórico fundamentador dos caraterizadores de profissionalidade referenciais do estudo e dos resultados obtidos na dimensão extensiva. Os resultados do estudo denotam falta de sintonia entre o conceito de ensinar patenteado nos documentos e discursos dos agentes-chave da Formação de Professores (a indicar que ensinar é fazer aprender) e a prática letiva dos formadores, a denunciar que ensinar é entendido como expôr conteúdos/transmitir conhecimentos. Quanto aos caraterizadores de profissionalidade, discursivamente destacam-se como atributos reconhecidos ao professor: ser educador e profissional; possuir conhecimento específico para ensinar; ter a função e a responsabilidade de ensinar; ser inovador e investigador; e agir de acordo com o quadro deontológico associado à profissão. No entanto, estas representações entram em choque com a realidade, marcada por falta de poder dos professores sobre o currículo e sobre o conhecimento profissional, que não produzem nem controlam; baixas qualificações (possuem nível correspondente à 10ª classe); inexistência de um quadro deontológico específico e por uma prática docente dos formadores inscrita na racionalidade técnica e mais alinhada com uma dinâmica de funcionarização do que de profissionalização. Na esteira do isomorfismo pedagógico, da chamada naturalização das práticas de ensino, e da força da gramática escolar, o tipo de prática docente que marca a ação dos formadores tenderá a ser replicada pelos formandos quando professores. Aliás, os documentos curriculares parecem resumir o ser profissional ao facto de se possuir formação para professores. O estudo fundamenta a possibilidade de, nas políticas, se reforçar uma maior coerência entre discursos e práticas na visão de profissionalidade construída na FIP, aprofundar os pontos de descontinuidade detetados no estudo ou outros relevantes e trabalhar no sentido da clarificação do conceito de profissionalidade pretendida na Formação de Professores do Ensino Básico em Moçambique.

Em que medida a estimulação cognitiva vertente estimulação sensorial, contribui para o bem estar e qualidade de vida da pessoa idosa com demência

Trabalho de Projeto apresentado à Escola Superior de Educação de Paula Frassinetti para obtenção do grau de mestre em Intervenção Comunitária, especialização em Educação para a Saúde

Religion and narrative in the "Metamorphoses" of Apuleius

In this thesis I explore the narratological paradigm of conversion and its usefulness in interpreting the Metamorphoses of Apuleius. I believe that this paradigm is not useful in exploring the novel. However, a closely related paradigm - which I call a "narrative of metamorphosis" - can in fact help us interpret the novel and make sense of the final book of the novel known as the Isis book, which has generated much scholarly debate.

make half your grains whole : 10 tips to help you eat whole grains

Any food made from wheat, rice, oats, cornmeal, barley, or another cereal grain is a grain product. Bread, pasta, oatmeal, breakfast cereals, tortillas, and grits are examples. Grains are divided into two subgroups, whole grains and refined grains. Whole grains contain the entire grain kernel—the bran, germ, and endosperm. People who eat whole grains as part of a healthy diet have a reduced risk of some chronic diseases

A critical and interpretative investigation of the ethical dimension of policies about school digital technologies

This thesis examines digital technologies policies designed for Australian schools and the ways they are understood and interpreted by students, school staff, teachers, principals and policy writers. This study explores the ways these research participant groups interpret and understand the ‘ethical dimension’ of schools’ digital technologies policies for teaching and learning. In this thesis the ethical dimension is considered to be a dynamic concept which encompasses various elements including; decisions, actions, values, issues, debates, education, discourses, and notions of right and wrong, in relation to ethics and uses of digital technologies in schools. In this study policy is taken to mean not only written texts but discursive processes, policy documents including national declarations, strategic plans and ‘acceptable use’ policies to guide the use of digital technologies in schools. The research is situated in the context of changes that have occurred in Australia and internationally over the last decade that have seen a greater focus on the access to and use of digital technologies in schools. In Australian school education, the attention placed on digital technologies in schools has seen the release of policies at the national, state, territory, education office and school levels, to guide their use. Prominent among these policies has been the Digital Education Revolution policy, launched in 2007 and concluded in 2013. This research aims to answers the question: What does an investigation reveal about understandings of the ethical dimension of digital technologies policies and their implementation in school education? The objective of this research is to examine the ethical dimension of digital technologies policies and to interpret and understand the responses of the research participants to the issues, silences, discourses and language, which characterise this dimension. In doing so, it is intended that the research can allow the participants to have a voice that, may be different to the official discourses located in digital technologies policies. The thesis takes a critical and interpretative approach to policies and examines the role of digital technologies policies as discourse. Interpretative theory is utilised as it provides a conceptual lens from which to interpret different perspectives and the implications of these in the construction of meaning in relation to schools’ digital technologies policies. Critical theory is used in tandem with interpretative theory as it represents a conceptual basis from which to critique and question underlying assumptions and discourses that are associated with the ethical dimension of schools’ digital technologies policies. The research methods used are semi-structured interviews and policy document analysis. Policies from the national, state, territory, education office and school level were analysed and contribute to understanding the way the ethical dimension of digital technologies policies is represented as a discourse. Students, school staff, teachers, principals and policy writers participated in research interviews and their views and perspectives were canvassed in relation to the ethical use of digital technologies and the policies that are designed to regulate their use. The thesis presents an argument that the ethical dimension of schools’ digital technologies policies and use is an under-researched area, and there are gaps in understanding and knowledge in the literature which remain to be addressed. It is envisaged that the thesis can make a meaningful contribution to understand the ways in which schools’ digital technologies policies are understood in school contexts. It is also envisaged that the findings from the research can inform policy development by analysing the voices and views of those in schools. The findings of the policy analysis revealed that there is little attention given to the ethical dimension in digital technologies at the national level. A discourse of compliance and control pervades digital technologies policies from the state, education office and school levels, which reduces ethical considerations to technical, legal and regulatory requirements. The discourse is largely instrumentalist and neglects the educative dimension of digital technologies which has the capacity to engender their ethical use. The findings from the interview conversations revealed that students, school staff and teachers perceive digital technologies policies to be difficult to understand, and not relevant to their situation and needs. They also expressed a desire to have greater consultation and participation in the formation and enactment of digital technologies policies, and they believe they are marginalised from these processes in their schools. Arising from the analysis of the policies and interview conversations, an argument is presented that in the light of the prominent role played by digital technologies and their potential for enhancing all aspects of school education, more research is required to provide a more holistic and richer understanding of the policies that are constructed to control and mediate their use.

Does gender make a difference? Gender-related fairness of high-stakes testing in A-level examinations in English as foreign language in the German state of North Rhine-Westphalia in the context of Educational Governance

The shift from decentralized to centralized A-level examinations (Abitur) was implemented in the German school system as a measure of Educational Governance in the last decade. This reform was mainly introduced with the intention of providing higher comparability of school examinations and student achievement as well as increasing fairness in school examinations. It is not known yet if these ambitious aims and functions of the new centralized examination format have been achieved and if fairer assessment can be guaranteed in terms of providing all students with the same opportunities to pass the examinations by allocating fair tests to different student subpopulations e.g., students of different background or gender. The research presented in this article deals with these questions and focuses on gender differences. It investigates gender-specific fairness of the test items in centralized Abitur examinations as high school exit examinations in Germany. The data are drawn from Abitur examinations in English (as a foreign language). Differential item functioning (DIF) analysis reveals that at least some parts of the examinations indicate gender inequality. (DIPF/Orig.)

Efeitos da dieta hipoprotéica na formação e composição de estruturas dentárias: estudo experimental em ratos Wistar

Protein and caloric malnutrition has been considered one of the most concerned endemic diseases in Brazil and in the world. It has been known that depletion or reduction of proteins as far as meals are concerned can steer irreversible damages upon several organic systems. This study had as aim evaluate the effects the low-protein diet had over the formation and composition of the teeth components. 18 females and 6 males were used for the experiment. 12 from the 18 females had undertaken the low-protein diet (DH) for 03 weeks and the other 6, which remained, and those males had undertaken a controlled diet (DC) for the same period. All animals had the diets during their mating, pregnancy and lactation cycle. As soon as the offsprings had been born, 10 young males and females of each group faced a disease hood analysis to check the teeth germs of their lower fore teeth. The rest of the group had their lactation cycle normally 60 days. Then they were put to death and had their lower fore teeth removed both to be analyzed through a scanning electronic microscopy (SEM) of the structure alterations and to have their calcium checked by an atomic absorption of the phosphorus vanadate-molibdate method and by other minerals EDX method. The animals livers were removed to have their hepatic proteins analyzed as well. The histopatologic study showed that at first day of birth, all animals had their lower fore teeth come out. It was verified that 90% of the animals teeth were in an apposition and calcification period and it was possible to observe the dentin formation from 60% of the 90% already mentioned. Through the SEM method it could be realized that 90% of the animals of the DH group had their lower fore teeth easily broken and no definite shape. In this same group itself, it was also observed long micro fissures 369,66 nm ± 3,45 while the DC group had fissures of 174 nm ± 5,72. Now regarding the calcium and phosphorus concentration, it could be noticed that there was a great reduction of these components and other minerals in the DH group. Almost all minerals, except for the Cl and K, presented higher levels in the DC group enamel.The reduction of the protein input greatly influenced the offsprings´ weight and height. However the hepatic proteins had no important difference between the groups what can make one believe that those animals suffered from protein malnutrition of marasmic kind

Strategic business plan: Strategies to make coaching for all a successful project

Coaching for all (C4all) is a project created by TESE-Associação para o Desenvolvimento or TESE-Association for development (TESE), aimed at disseminating and democratizing access to coaching methods among people seeking employment and other vulnerable groups of people. The initial results of the C4All project were well below their expectations. Therefore, we developed a Business Plan in order to understand if and how the performance of C4all can be improved. The results of our analysis suggest a number of changes that C4all need to undertake in order to survive and achieve better outcomes in the future

A experiência artística das pessoas com deficiência visual em museus, teatros e cinemas : uma análise pragmaticista

Tese (doutorado)—Universidade de Brasília, Faculdade de Comunicação, Programa de Pós-Graduação em Comunicação, 2016.