背景：動機式會談是強調以病患為中心的互動模式，於互動過程中重視個
案的需要、想法及感覺，鼓勵個案探討改變遭遇的阻礙並找出解決方
法，但臨床上缺乏運用動機性會談探討腦中風病患連續性照護成效之
研究。
目的：本研究是以初次罹患腦中風三個月內之病患為研究對象，探討運用6
週動機性會談對改善研究對象在接受連續照護服務感受、健康外控、
復健動機及憂鬱程度之成效。
方法：採類實驗性研究設計，收案地點為中部某區域醫院復健科病房診斷
為腦中風之病患，共收案65位。除常規照護外對照組32人接受每週1
次，共6週護理師個別陪伴，而實驗組33位則接受每週1次，為期6週
之動機性會談。兩組在介入前、後及3個月後皆進行病患連續照護服
務感受、健康內外控、復健動機及憂鬱程度的測量。
結果：實驗組病患經實施6次動機性會談，不論在立即後測及3個月後其病
患連續照護服務感受、健康外控、復健動機及憂鬱程度皆有顯著改
變；控制組經6次護理師陪伴，在6週及3個月後其病患連續照護服務
感受、復健動機及憂鬱程度亦有顯著的改變。然在控制前測結果值，
在控制組別與時間的交互作用下，實驗組個案動機性會談在6週介入
後，其連續照護服務感受及復健動機均達統計顯著改善。
結論: 研究結果肯定動機性會談對腦中風病患之病患連續照護服務與復健
動機有提升效益，未來可應用動機性會談之技巧於臨床實務中。

Background: Motivational interviewing (MI) focuses on patient-centered interaction. Through the interaction process, the client’s needs, thoughts, and feelings are valued, and the client is encouraged to discuss the obstacles encountered in order to change and search for solutions. However, there is a lack of relevant empirical studies on the effectiveness of continuity of care for stroke patients discussed by means of motivational interviews.
Objective: The purpose of this study is to explore the effectiveness of 6 weeks of motivational interviews on continuity of care perception, health locus of control, the effects of rehabilitation and depression levels among subjects in an experimental group of subjects within 3 months of their first stroke.
Methods: A quasi-experimental study design was ultilzed in this study. Sixty-five patients diagnosed with stroke and hospitalized in the rehabilitation ward of a regional hospital in Central Taiwan were recruited. On top of routine care, 32 subjects in the control group received individual company from the research nurse once a week for six weeks, while 33 subjects in the experimental group received weekly sessions of MI for six weeks. The patients were tested concerning continuity of care perception (PCCQ), perceived health locus of control (HLC), rehabilitation motivation and degree of depression, where results were collected in both groups before, six weeks after, and three months after the intervention.
Results: Immediate six weeks after as well as three months after the MI intervention, significant changes of the patient’s continuity of care perceptions, health external control, rehabilitation motivation and depression status were observed. After 6 visits from the research nurse, significant changes could be observed in the patient’s continuity of care perception, rehabilitation motivation and the degree of depression both six weeks and three months after the MI intervention. Using the pretest results in the control group as the baseline value, under the interaction of the control and time, statistically significant differences in the patient’s continuity of care perception and rehabilitation motivation were achieved in the experimental group after the six-week intervention.
Conclusions: The results confirmed that motivational interviewing can enhance PCCQ scores and rehabilitation motivation of stroke patients. Therefore, motivational interviewing skills can be applied in clinical practice in the future.

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