饮食临床医生的励志面试

为了帮助临床医生将动机面试付诸实践，特别是帮助他们减少患者的抵抗力，米勒和罗勒尼克²³have summarised some key conversational skills that can help, in the“ OARS”缩写：

O = Open ended questions
a =肯定更改
R = Reflectively listen
S =总结

重要的是要记住，作为临床医生，当您使用励志采访时，您不应该说太多。对话应该来回流动，但不要试图接管。您想唤起病人的信心和技巧，以帮助他们建立动力并帮助他们以积极的方式前进。

Open Ended Questions

Asking open ended questions is phrasing questions in a way that cannot be answered with a simple yes or no but that require a reasoned and developed response. For example:

• “请告诉我一些有关您目前饮食的信息。”
• “How do you feel about your weight at the moment?”
• “What can you tell me about the importance of increasing your physical activity?”
• “How could your life be different if you were to lose some weight?”
• “如果您要对饮食进行一些改变，可能会妨碍什么？”

有效控制重量的肯定

肯定涉及做出支持并专注于个人努力，承诺或力量的积极要素的直接陈述。它鼓励患者尝试继续新的/首选的行为。

肯定有助于向您的患者展示您正在尝试了解他们正在经历的事情，并且您感谢他们的努力²³。

By making an affirmation, it helps to limit the patient’s defensiveness, and helps to promote an accepting and open dialogue. For example:

• “我相信这对你来说是可能的。”
• “很棒，您愿意尝试这种饮食。”
• “因此，听起来您已经真正决心，并致力于减少您曾经在午餐时喝的碳酸饮料。在实现这一目标方面做得很好。”
• “It sounds like the strategies you developed are working well for you! Great work!”

Affirmations made by the clinician need to be genuine and sincere.

反思性聆听

Reflective listening is listening with intent. It can simply involve repeating the patient’s key words or statements, or paraphrasing/rephrasing the patient’s main points, by using your own words or similar words. It allows you to confirm your understanding of what the individual has shared with you and helps to build trust and engagement with them.

反思还可以帮助减少防御能力，迅速或加强，改变谈话。例如：

• “因此，从您的意思来看，听起来您不喜欢承担额外的体重，但是经过漫长的一天，您真正喜欢的只是一顿舒适的一餐，是吗？”
• “It sounds like you want to address/make a change…, but this concern (name it) is getting in the way. Am I hearing that correctly?”

Summarise

在对话和咨询结束时使用摘要来汇总患者提出的内容的不同方面，并开始关闭课程并为未来计划。例如：

• “So, to summarise, you don’t really like being above a healthy weight range and you’ve made some really positive changes reducing your intake of sugary drinks but you’re still having a bit of trouble making healthy choices for dinner after a long day of work. Does that sound right?”

If the patient agrees with your summary, you could then proceed to ask:
“Would you like to talk more about how we could help you overcome that challenge?”