Motivational interviewing to promote physical activity for people with chronic heart failure

Aim. This paper reports a study comparing, over a 5-month period, two different methods of increasing physical activity: a traditional exercise programme and one based on motivational interviewing. Background. Chronic heart failure is associated with poor quality of life that can be improved by increased physical activity. Patients who are directed to engage in physical activity have a record of low compliance. Method. Sixty older aged heart failure patients were randomly assigned to standard care, motivational interviewing or both treatments. The primary outcome was physical activity (kcal/kg/day), with the 6-minute walk test as a secondary outcome. Findings. At entry, no significant differences were observed between the three groups. Following treatment, the 'motivational interviewing' and 'both treatments' groups reported an increase in their level and type of activities, whereas the 'standard care' group did not. All groups significantly increased their 6-minute walk distance. Conclusions. Motivational interviewing, which incorporates established behaviour change principles and a flexible approach to promotion of activity, increases reported physical activity in older patients with heart failure over a short period. In terms of level and type of activity, this approach gives a better outcome than standard care, and nurses should explore alternative strategies to promote health in this population.