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Ambivalence related to potential lifestyle changes following preventive cardiovascular consultations in general practice: A qualitative study

DOI: 10.1186/1471-2296-9-50

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Abstract:

Individual interviews with 12 patients at increased risk of CVD within 2 weeks after the consultation. Grounded theory was used in the analysis.Ambivalence related to potential lifestyle changes was the core motivational aspect in the interviews, even though the patients rarely verbalised this experience during the consultations. The patients experienced ambivalence in the form of conflicting feelings about lifestyle change. Analysis showed that these feelings interacted with their reflections in a concurrent process. Analysis generated a typology of five different ambivalence sub-types: perception, demand, information, priority and treatment ambivalence.Ambivalence was a common experience in relation to motivation among patients at increased risk of CVD. Five different ambivalence sub-types were found, which clinicians may use to explore and resolve ambivalence in trying to aid patients to adopt lifestyle changes. Future research is needed to explore whether motivational interviewing and other cognitive approaches can be enhanced by exploring ambivalence in more depth, to ensure that lifestyle changes are made and sustained. Further studies with a wider range of patient characteristics are required to investigate the generalisability of the results.Psychological [1-7], sociological [8-11], medical [12-23], educational [24,25] and anthropological [26,27] traditions have all contributed extensively to our knowledge about lifestyle change processes. They have identified key psychological constructs such as different kinds of resistance mechanisms related to motivation and lifestyle change [28-30]. Since 1999, the Danish College of General Practitioners has dedicated 'preventive consultations' comprising motivational interviewing (MI) [7,31] as an approach in the prevention of lifestyle related diseases such as CVD. The preventive consultation is a scheduled consultation focusing on individual prevention and risk reduction strategies, where the person is aware of the a

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