Nursing, which arises from human needs, evaluates the individual, family, and society
with a holistic perspective to protect, maintain, and improve the health of healthy/sick
individuals, families, and communities, and provides the necessary health services. The
primary duty of nurses is to provide care for individuals and improve their quality of
life. In this regard, nurses fulfill their duties by using their roles such as counselor,
educator, decision-maker, manager, researcher, and caregiver. Nurses have significant
responsibilities in the care of chronic diseases that require lifelong care and
follow-up.
One of the major chronic diseases requiring lifelong care is Chronic Obstructive
Pulmonary Disease (COPD). COPD is a progressive, irreversible disease characterized by
airflow obstruction, accompanied by various symptoms, and is a serious health problem
with high mortality and morbidity, commonly encountered worldwide. Approximately 3.2
million people die annually from COPD globally, and it is projected that this disease
will be the third leading cause of death worldwide by 2030. COPD patients experience many
physical and psychological issues that severely affect their quality of life, such as
fear of death, anxiety, cough, dyspnea, fatigue, and loss of appetite . COPD patients are
frequently hospitalized, face difficulties in performing daily activities, encounter
social and economic losses, and experience a significant decline in quality of life due
to the side effects of medications.
Among the long-term management goals of disease control are the reduction of current
symptoms and future risks. These goals require patients to exhibit healthy behaviors.
However, the literature reports that COPD patients have low levels of self-care, poor
adherence to medications, and a lack of awareness regarding preventable and behavioral
causal factors. COPD patients need strategies that will engage them in the treatment
process, motivate them toward healthy habits, and help internalize healthy behaviors.
Compared to other strategies, motivational interviewing (MI) embodies most of these
qualities. MI is defined as "collaborative, person-centered form of guiding and
counseling to elicit and strengthen motivation for change". The MI technique is a
distinctive and superior approach to other interview methods due to its effectiveness in
helping individuals make behavioral changes, its empathetic and collaborative approach,
its ability to increase intrinsic motivation, and its strategies for dealing with
resistance. MI aims to promote change by increasing the patients intrinsic motivation,
making it especially effective for patients with more specific change goals.
The use of nursing models in the care of COPD patients has been associated with better
patient outcomes, higher nurse satisfaction, and lower healthcare costs. Pender's Health
Promotion Model (HPM) provides nurses with a comprehensive framework for conducting
effective care and assessing individuals perceptions of health behaviors. The model
assumes that individuals have a holistic structure in their physical environment and
interpersonal relationships and play an active role in maintaining and promoting their
health. The goal of the model is to explain the components of behaviors necessary for a
healthy lifestyle, evaluate individuals experiences, analyze factors that may affect
their perceptions of health behavior, and guide care providers in planning healthy
lifestyle goals. In light of this information, it is recognized that MI and HPM share
common goals and possess complementary dynamics. Addressing lifestyle changes with
Pender's model and integrating MI for health promotion has been reported to be
more effective in managing COPD patients symptoms. Dişsiz and Çalışkan also suggest that
nurses can use HPM and MI, which are thought to complement each other, while helping
patients acquire healthy lifestyle behaviors.
Patient-reported outcomes are necessary to assess the symptoms, the impact of symptoms on
their lives, and their response to treatment. Patient-reported outcomes provide direct
reports of patients perceived health statuses. While the primary role of nurses is
caregiving, they should also engage in roles such as educator, therapist, counselor, and
researcher to implement interventions that improve the care of COPD patients. Nurses
should support individuals to use their potential strengths and help them adopt health
behaviors through health promotion programs. MI and the Health Promotion Model have been
shown to be effective strategies and models in facilitating health behavior change. Based
on this information, this research was conducted to determine the effect of motivational
interviewing based on Pender's Health Promotion Model on patient-reported outcomes in
COPD patients.