Abstract NS9: The Use of Motivational Interviewing in Maintaining Optimal Blood Pressure Post Stroke

Abstract

Background: Stroke is one of the most preventable causes of chronic illness, yet it ranks as the first leading cause of disability and the fifth leading cause of death worldwide. Stroke patients are at high risk of having recurrent strokes. Strokes are associated with many risk factors, and hypertension is the most consequential modifiable risk factor for the primary prevention of both ischemic and hemorrhagic strokes. The goal for providers is to utilize evidence-based approaches in helping these patients reduce the risk for stroke re-occurrence. Method: A 6- week project was carried out to examine the effectiveness of motivational interviewing (MI) in helping stroke patients with high blood pressure reduce their blood pressure less than 140/90 mm Hg and improve their motivation to maintaining a healthy lifestyle. Twenty stroke patients admitted at the study hospital with past medical history of high blood pressure were recruited in the study and 15 completed the project. After discharge, 20- minute phone calls were made using the MI technique to assess and address their barriers to maintaining optimal blood pressure. Hypertension Self-Care Profile (HBP SCP) questionnaires were given to each of the patients in the hospital and at week 6 during follow-up visit to assess motivation to self-care practices for HBP. At 6 weeks their final blood pressures were obtained at the clinic. Results: A one-sided t-test showed that 60%, N=9 participants systolic blood pressure was less than 140 Hgmm with an ending systolic mean of 133.4 hgmm (p=0.055) and with the diastolic blood pressure, 73% of participants N=11 had a diastolic blood pressure less than 90 Hgmm (p= 0.0049), with the ending diastolic mean of 83.07 hgmm. Sixty percent, N =9 participant’s MI scores improved when comparing the pre and post scores (p=0.005). Conclusions: The findings suggest that MI could be effective in decreasing patients’ blood pressure less than 140/90 mm Hg and in improving their motivation to maintaining a healthy lifestyle. Based on the findings, it was recommended that motivational interviewing be adopted by advanced practice providers and the nurses in the neurology department to make consistent follow-up phone call to all the stroke patients discharged from the hospital.