Research and Publication Ethics: This study was ratified by the University Ethics Committee (Decision No: 2020/01-13). Every participant in the study provided their consent to take part. The researchers explained the study's goals to participants who decided to participate, and their informed, written agreements were obtained. The study's volunteers were given the assurance that all information would be kept private, that the information gathered would only be used for research, and that they could withdraw from the study at any moment. The Declaration of Helsinki's guiding principles were followed during the research's execution.
Research Design and Sampling: This study is a quasi-experimental investigation using a control group in the pretest and posttest. It was implemented in a University Hospital in eastern Turkey between January 2020 and June 2022. The target population of the study consists of all patients diagnosed with cancer in General Surgery and Oncology Services wards of the University Hospital. The sample size was calculated as 110 patients (55 experimental groups, 55 control group) using the G Power v3.1.9.7 program with a margin of error of 0.05, an effect size of 0.7, a confidence interval of 0.95, and a power analysis measurement with a 95% power to represent the population11. Patients who met the criteria for inclusion and were chosen at random from the population were included in the sample. Four patients who declined to take part in the trial and three patients who did not meet the inclusion criteria were excluded (Figure 1). The experimental group patients were enrolled in the study first, followed by the control group patients.
Criteria for Inclusion and Exclusion
Inclusion Criteria: (i) no communication problems, (ii) good mental health, (iii) hospitalization planned for at least 12 days
Exclusion Criteria: (i) Patients who did not fulfill the inclusion criteria were excluded.
Data Collection Instruments
Personal Information Form: The form was created by the researcher, and it contains patient-specific descriptive data.
Self-Efficacy Scale (SES): It is a Likert-type scale developed by Sherer and Adams12 (12)(12) to evaluate behaviors and changes in behaviors. The Turkish reliability and validity study was conducted by Gözüm and Aksayan13 (13)(13). It expresses the perception of the ability to perform a certain action successfully, control events, or the perception of the ability to achieve a certain level of performance. On this scale, a score can range from 23 (the lowest possible) to 115 (the highest possible). A high rating on the scale demonstrates a high level of self-efficacy in the subject. The scale's Cronbach's alpha coefficient was determined to be 0.8113 (13)(13). The Cronbach's alpha coefficient for this study was 0.82.
Satisfaction with Life Scale (SWLS): It is a Likert-type scale developed to determine the satisfaction of people with their lives by Diener et al.14(14)(14)(14) Its Turkish reliability and validity were conducted by Köker. The scale consists of 5 items with 7 Likert-type grades. Each item is scored between 1 and 7, with the lowest score being 5 and the highest score being 35, and a high score indicates a high level of life satisfaction. Cronbach's alpha coefficient of the scale was 0.8515 (15)(15). The Cronbach's alpha coefficient for this study was 0.79.
Data Collection: The first author collected the data between October 2021 and April 2022 by means of a face-to-face interview. Since the researcher would conduct 6 motivational interviews every other day, the researcher carried out the study with patients who were planned to be hospitalized for at least 12 days. Self-Efficacy Scale, Personal Information Form, and Satisfaction with Life Scale were filled out by the researcher in the clinic as a pretest for the experimental group of patients. Motivational interviews were applied in every other day as 6 sessions, and the Self-Efficacy Scale and Satisfaction with Life Scale were applied as a posttest the day after the motivational interviews were completed.
Data collection tools were filled in by the author in the clinic as a pretest for the patients in the control group, no intervention was made to this patient group, and 13 days later, the Self-Efficacy Scale and Satisfaction with Life Scale were applied as a posttest. The answers were recorded by the researcher by marking the forms.
Experimental Group Intervention: The first author received training on motivational interviewing techniques before the study started. The experimental groups received six motivational interviews in groups of 10 participants every other day using a face-to-face interview technique. Each session of motivational interviews lasted 40 minutes. The interviews were conducted by the author in the clinic meeting room at noon when the clinic was quieter.
Motivational interview plan;
1. During the motivational interview, the patients were met and information about the application was given.
2. In the motivational interview, patients were listened to with empathy. They were encouraged to ask clearly what they wondered and worried about their diseases. Reflective listening was done by asking open-ended questions to the patients.
3. In the motivational interview, patients were reminded of the positive aspects of treatment compliance and the negative aspects of non-compliance, they were encouraged to talk about their illnesses with each other to make sure that they wanted to get better and to recognize their ambivalence.
4. In motivational interviewing, when patients expressed their dilemmas, they were asked to compare their pre-interview knowledge about the disease, compliance with treatment, and the negative and positive aspects of the behaviors they developed against the disease. Patients were prepared for behavior change.
5. In the motivational interview, patients were told not to see the disease as an obstacle to their lives and to participate in appropriate activities to support change in the desired direction.
6. In the motivational interview, a brief summary of the other interviews was made to ensure the continuity of the positive behavioral changes we achieved in patients. The points they should pay attention to were stated.
Statistical Analysis: The Statistical Package for the Social Sciences (SPSS) v22.0 analysis program was used to analyze the data, and the statistical significance threshold used was p<0.05 16(16)(16)(16). Data were analyzed using normality test was performed using Shapiro-Wilk test, Student's t-tests, descriptive statistics, and correlation analysis tests.
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