Motivational interviewing‐based training enhances clinicians’ skills and knowledge in psoriasis: findings from the Pso Well® study

• Published in: British journal of dermatology (1951) Vol. 176; no. 3; pp. 677 - 686
• Main Authors: Chisholm, A., Nelson, P.A., Pearce, C.J., Littlewood, A.J., Kane, K., Henry, A.L., Thorneloe, R., Hamilton, M.P., Lavallee, J., Lunt, M., Griffiths, C.E.M., Cordingley, L., Bundy, C.
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01-03-2017
• Subjects: Clinical Competence - standards; Communication; Comorbidity; Counseling; Dermatologists - standards; Dermatology - education; Education, Medical - methods; Female; Health Knowledge, Attitudes, Practice; Humans; Inservice Training; Knowledge; Male; Motivational Interviewing - methods; Nurses - standards; Patient Satisfaction; Physician-Patient Relations; Physicians, Primary Care - standards; Psoriasis; Psoriasis - therapy; Risk Factors; Skin; Skin diseases; Smoking; Studies
• ISSN: 0007-0963; 1365-2133
• DOI: 10.1111/bjd.14837

Summary
Background
Psoriasis is a common long‐term, immune‐mediated skin condition associated with behavioural factors (e.g. smoking, excess alcohol, obesity), which increase the risk of psoriasis onset, flares and comorbidities. Motivational interviewing (MI) is an evidence‐based approach to health‐related behaviour change that has been used successfully for patients with long‐term conditions. This study assessed change in clinicians’ MI skills and psoriasis knowledge following Psoriasis and Wellbeing (Pso Well®) training.
Objectives
To investigate whether the Pso Well training intervention improves clinicians’ MI skills and knowledge about psoriasis‐related comorbidities and risk factors; and to explore the acceptability and feasibility of the Pso Well training content, delivery and evaluation.
Methods
Clinicians attended the 1‐day training programme focused on MI skills development in the context of psoriasis. MI skills were assessed pre‐ and post‐training using the Behaviour Change Counselling Index. Knowledge about psoriasis‐related comorbidity and risk factors was assessed with a novel 22‐point measure developed for the study. Interviews with clinicians were analysed qualitatively to identify perceptions about the feasibility and acceptability of the training.
Results
Sixty‐one clinicians completed the training (35 dermatology nurses, 23 dermatologists and three primary‐care clinicians). Clinicians’ MI skills (P < 0·001) and knowledge (P < 0·001) increased significantly post‐training. Clinicians found the training valuable and relevant to psoriasis management.
Conclusions
Attendance at the Pso Well training resulted in improvements in clinicians’ knowledge and skills to manage psoriasis holistically. Clinicians deemed the training itself and the assessment procedures used both feasible and acceptable. Future research should investigate how this training may influence patient outcomes.
What's already known about this topic?
Holistic care of people with psoriasis requires knowledge about and management of comorbidities and associated risk factors.
Motivational interviewing can support people with long‐term conditions to make necessary changes to health‐related behaviours.
What does this study add?
The first evaluation of motivational interviewing skills training for clinicians managing patients with psoriasis.
Psoriasis‐tailored motivational interviewing training assists clinicians to manage psoriasis holistically and support behaviour change.
What are the clinical implications of this work?
The Pso Well® training is acceptable to clinicians and feasible to run within U.K. healthcare settings.
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