Motivational Interviewing–Style History Interview Video transcript – NURS 6512 Module 1 Assignment 1

Motivational Interviewing–Style History Interview Video transcript – NURS 6512 Module 1 Assignment 1

[MUSIC PLAYING]

ALYSSA: Hi, Mr. Johnson, good to see you again.

I’ve been looking over your labs,

and your blood sugar has been running

a bit higher than we’d like.

Before I jump in with questions, what’s

your sense of how things have been going with your diabetes

lately?

DAN JOHNSON: Honestly, not that great.

I know it’s high.

Just got a lot going on.

ALYSSA: It sounds like it’s been a tough stretch,

and you’re aware the numbers aren’t where you want them.

DAN JOHNSON: Yeah, pretty much.

ALYSSA: I’d like to understand what a usual day looks

like for you, especially around eating, being active, and taking

your meds.

Can you walk me through a typical day

from when you wake up to when you go to bed?

DAN JOHNSON: Sure.

Well, I usually skip breakfast, just coffee.

Then I eat a quick lunch, sometimes a burger

or whatever’s close to work.

At night, my wife cooks, but I’m tired, so I eat a big plate

and then just sit on the couch.

ALYSSA: OK, so coffee in the morning, fast food most workdays

for lunch, and then a larger home-cooked dinner

and resting afterward.

DAN JOHNSON: Yeah, that’s about right.

ALYSSA: When you think about your eating pattern

right now, what concerns, if any, do you have?

DAN JOHNSON: I know I eat too much junk–

fast food, soda.

Keeps saying I’ll cut back, but I don’t.

ALYSSA: So you’re noticing that the fast food and soda are

more than you’d like.

And it hasn’t been easy to change that yet?

DAN JOHNSON: Yeah.

ALYSSA: What kind of meals feel both realistic and healthier

for you, either that you’re already doing sometimes

or could imagine doing?

DAN JOHNSON: When my wife bakes chicken instead of frying it,

and when we have veggies, I feel better.

I just don’t always pick that over the other stuff.

ALYSSA: So you actually like the baked chicken and veggies

and you feel better when you eat that way?

DAN JOHNSON: Yeah, I do.

ALYSSA: Yeah.

So on a scale of 0 to 10, where 0 means not at all important

and 10 means extremely important, how important

is it to you to start shifting your eating a bit

to help your blood sugar?

DAN JOHNSON: Probably an 8.

ALYSSA: And 8 is pretty high.

Why an 8 and not say a 3?

DAN JOHNSON: Well, I don’t want to end up like my dad.

He lost his foot and I want to be around for my kids.

ALYSSA: You’re really thinking about your health long-term

and being there for your family.

That’s a big motivation for you.

DAN JOHNSON: Yeah, for sure.

ALYSSA: Given everything on your plate,

what’s one small change in your eating this week that

feels doable?

DAN JOHNSON: Maybe cut out soda during the week

and just have it on the weekend.

ALYSSA: Cutting soda to weekends only, that’s clear and specific.

How confident do you feel about being

able to do that from 0 to 10?

DAN JOHNSON: Maybe 7?

ALYSSA: 7 is solid.

What would help move that closer to an 8 or 9?

DAN JOHNSON: If I had something else to drink at work,

maybe flavored water or something that

just doesn’t taste so plain.

ALYSSA: Planning some flavored water or unsweet tea,

so you’re just not stuck with plain water, that

sounds very workable.

Let’s talk about activity.

What kind of movement or exercise

fits into your week right now, if any?

DAN JOHNSON: Not much, really.

I’m on my feet at work but when I get home, I’m just done.

ALYSSA: So you’re already on your feet at work,

and after that you feel drained?

DAN JOHNSON: Exactly.

ALYSSA: If you were to add just a bit more movement

for your health, what kind of activity

would feel least painful or maybe even enjoyable?

DAN JOHNSON: I don’t mind walking.

My neighbor does a walk in the evening sometimes.

ALYSSA: So walking with your neighbor is something

you could see yourself doing?

DAN JOHNSON: Yeah, maybe.

ALYSSA: What would a realistic starting goal look like?

Something small enough that you’re likely to stick with it.

DAN JOHNSON: Maybe walking with him a couple days

a week, 20 minutes.

ALYSSA: Yeah, a two 20-minute walks a week with your neighbor.

On a 0 to 10 confidence scale, how sure

are you that you can do that this week?

DAN JOHNSON: I’d say an 8.

If I tell him, he’ll bug me to go.

ALYSSA: Yeah, great idea.

Using your neighbor for a little accountability.

Let’s talk about your medications.

Tell me in your own words how you’re taking your diabetes

meds right now.

DAN JOHNSON: I’m supposed to take metformin twice a day

and then insulin at night.

I do pretty well, but sometimes I miss the second metformin.

And if I’m busy, a couple of times

I’ve fallen asleep before taking the insulin.

ALYSSA: So you’re taking them most of the time.

And you’ve noticed that evenings can be tricky,

especially the second metformin dose and sometimes the insulin?

DAN JOHNSON: Yeah, that’s it.

ALYSSA: So what tends to get in the way on those evenings?

DAN JOHNSON: I just forget.

I fall asleep in front of the TV or I’m running around

and it just slips my mind.

ALYSSA: So it’s more about forgetting than not wanting

to take them?

DAN JOHNSON: Right, I mean, I don’t mind taking them.

ALYSSA: What’s worked for you in the past when

you’ve wanted to remember something important every day?

DAN JOHNSON: I put it by my toothbrush

or set an alarm on my phone.

ALYSSA: Those are good strategies.

How might you use those for your evening meds?

DAN JOHNSON: I could set an alarm at 8:00 PM and put

the pills next to the TV remote.

I mean, I always see that.

ALYSSA: Yeah, that sounds like a strong plan.

An alarm, plus a visual reminder where you’ll definitely look.

So I also want to check in about flu shots.

What have your experiences been with the flu vaccine

in the past?

DAN JOHNSON: I used to get it sometimes,

but I skipped it last year.

And I’m not really sure I even need it.

ALYSSA: You’ve gotten it before, but you’re not

sure how important it is now?

DAN JOHNSON: Yeah.

ALYSSA: OK.

Would it be OK if I shared why we push it

so much for people with diabetes,

and then hear your thoughts?

DAN JOHNSON: Sure.

ALYSSA: Because of the diabetes, your body

has a harder time fighting infections.

The flu can land people with diabetes in the hospital

more often and make blood sugars really hard to control.

The shot doesn’t guarantee you won’t have the flu,

but it lowers your chances of getting very sick.

Hearing that, what’s your reaction?

DAN JOHNSON: I honestly didn’t realize

it affected diabetes like that.

I just thought it was for old people.

ALYSSA: A lot of people think that.

Given what you said about wanting

to stay healthy for your kids, where does getting the flu shot

fit in?

DAN JOHNSON: It makes sense.

I guess I should probably get it.

ALYSSA: So it sounds like you’re leaning toward getting

it to protect your health?

DAN JOHNSON: Yeah, I’ll get it.

ALYSSA: So let me make sure I’ve got this right.

You’re really wanting to avoid complications like your dad had

and be there for your kids.

To move toward that, you’ve decided to cut soda during

the week and only have it on weekends,

walk with your neighbor about 20 minutes, two days a week,

set an 8:00 PM phone alarm and keep your meds by the TV remote

so you remember your evening doses,

and getting your flu shot today.

Did I miss anything important?

DAN JOHNSON: No, that sounds about right.

ALYSSA: Yeah.

How does this plan feel to you?

Too much?

Too little?

Just about right?

DAN JOHNSON: I mean, it feels doable.

It’s nothing crazy.

ALYSSA: Great.

I’m here to support you, not to judge.

At your next visit, we’ll check in

on how these changes went, what worked,

what didn’t, and adjust together.

Any questions or worries before we wrap up?

DAN JOHNSON: No, I think I’m good.

I appreciate you listening.

ALYSSA: Cool.

Thank you for being open.

Let’s get that flu shot and set you up

for success with these changes.

[MUSIC PLAYING]