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Samtal som stöd för patienters livsstilförändringar: en viktig del av sjuksköterskans hälsofrämjande arbete
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.ORCID iD: 0000-0002-7655-9439
2014 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Place, publisher, year, edition, pages
Örebro: Örebro universitet , 2014.
Series
Örebro Studies in Medicine, ISSN 1652-4063
National Category
Medical and Health Sciences
Research subject
Nursing Science
Identifiers
URN: urn:nbn:se:oru:diva-33934OAI: oai:DiVA.org:oru-33934DiVA: diva2:699017
Public defence
2014-05-23, Hörsal P2, Prismahuset, Örebro universitet, Fakultetsgatan 1, 702 81 Örebro, 13:00
Opponent
Available from: 2014-02-26 Created: 2014-02-26 Last updated: 2016-11-30Bibliographically approved
List of papers
1. Primary healthcare nurses' experiences with motivational interviewing in health promotion practice
Open this publication in new window or tab >>Primary healthcare nurses' experiences with motivational interviewing in health promotion practice
2011 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 20, no 23-24, 3322-3330 p.Article in journal (Refereed) Published
Abstract [en]

Aim. The aim of the study was to describe primary healthcare nurses' experiences with motivational interviewing as a method for health promotion practice. Background. A person's lifestyle has a major effect on his or her health. Motivational interviewing is one way of working with lifestyle changes in health promotion practice. The basic plan of motivational interviewing is to help people understand their lifestyle problems and make positive lifestyle changes. Motivational interviewing has been proven to be more effective than conventional methods in increasing patient motivation. Design. This study has a descriptive design and uses a qualitative method. Methods. Twenty nurses who worked in primary health care and actively used motivational interviewing in their work were interviewed. Qualitative content analysis was used to process the data. Results. The primary healthcare nurses' experiences with motivational interviewing as a method of health promotion practice demonstrate that motivational interviewing is a demanding, enriching and useful method that promotes awareness and guidance in the care relationship. The results also show that motivational interviewing is a valuable tool for primary healthcare nurses' health promotion practice. Conclusion. This study shows that motivational interviewing places several different demands on nurses who use this method. Those who work with motivational interviewing must make an effort to incorporate this new method to avoid falling back into the former practice of simply giving advice. Maintaining an open mind while implementing motivational interviewing in real healthcare settings is crucial for nurses to increase this method's effectiveness. Relevance to clinical practice. The nurses in the study had a positive experience with motivational interviewing, which can contribute to the increased use, adaption and development of motivational interviewing among primary healthcare professionals. Increased motivational interviewing knowledge and skills would also contribute to promotion of health lifestyle practices.

Keyword
content analysis, health promotion practice, interviews, motivational interviewing, primary healthcare nurses
National Category
Nursing
Research subject
Caring Sciences w. Medical Focus
Identifiers
urn:nbn:se:oru:diva-21222 (URN)10.1111/j.1365-2702.2011.03874.x (DOI)000297864500008 ()
Available from: 2012-01-23 Created: 2012-01-20 Last updated: 2016-12-08Bibliographically approved
2. Patients’ experiences of lifestyle discussions based on motivational interviewing: a qualitative study.
Open this publication in new window or tab >>Patients’ experiences of lifestyle discussions based on motivational interviewing: a qualitative study.
2014 (English)In: BMC Nursing, ISSN 1472-6955, Vol. 13, no 13Article in journal (Other academic) Epub ahead of print
Abstract [en]

According to World Health Organization about 75% of cardiovascular diseases and type 2 diabetes and 40% of all cases of cancer could be prevented if the risk factors tobacco use, unhealthy diets, physical inactivity and harmful use of alcohol could be eliminated. Patients often need help in monitoring themselves to make the proper lifestyle changes and it is important that adequate support is provided to enable the patients to take control over their health. Motivational interviewing is a framework that can help to facilitate this movement. The aim of this study was to describe how patients in primary health care settings experience lifestyle discussions based on motivationalinterviewing.

Methods This study has a descriptive design and qualitative content analysis was used as the method. Sixteen patients who had each visited a registered nurse for lifestyle discussions were interviewed.

Results The results show that the lifestyle discussions could enable self-determination in the process oflifestyle change but that certain conditions were required. Mutual interaction between the patient and the nurse that contributes to a sense of well-being in the patients was a necessary condition for the lifestyle discussion to be helpful. When the discussion resulted in a new way of thinking about lifestyle and when patient initiative was encouraged,the discussion could contribute to change. The patient’s free will to make a lifestyle change and the nurse’s sensitivity in the discussions created fertile soil for change.

Conclusions This study focuses on MI-based discussions, and the result shows that a subset of patients, who self reported that they are motivated and aware of their role in making lifestyle changes, appreciate these strategies. However, it is not known whether discussions would be experienced in the same way if RNs used another method or if patients who were less motivated, engaged, or aware of their role in making lifestyle changes were interviewed.

Keyword
Content analysis, Lifestyle discussion, Motivational interviewing, Nurse, Patient experiences, Primary health care
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-35005 (URN)10.1186/1472-6955-13-13 (DOI)
Available from: 2014-05-11 Created: 2014-05-11 Last updated: 2016-12-08Bibliographically approved
3. Health promotion practice and its implementation in Swedish health care
Open this publication in new window or tab >>Health promotion practice and its implementation in Swedish health care
2013 (English)In: International Nursing Review, ISSN 0020-8132, E-ISSN 1466-7657, Vol. 60, no 3, 374-380 p.Article in journal (Refereed) Published
Abstract [en]

Introduction: Health promotion practice is an important work assignment within the entire health and medical care sector. Nurses are important for the development and implementation of health promotion in clinical practice.

Aim: The aim was to describe how district nurses view health promotion practice and how it was implemented in clinical practice following a training initiative.

Design: The study has a descriptive design and a qualitative method.

Methods: The sample consisted of three focus groups with 16 participants. The interviews were conducted as a conversation with focus on the district nurses view of health promotion and its implementation in clinical practice. The data have been processed using manifest qualitative content analysis.

Results: Three categories, titled Training as motivation, Lack of grounding and Lack of scope were identified. The result demonstrated that training provides motivation, but also the importance of grounding in the organization and the need for scope in performing health promotion practice.

Discussion: Our results show that the training initiative has contributed positively to the district nurses' view of health promotion practice, but that they also feel that there are obstacles. The district nurses in our study suggest that health promotion practice should be more visible, and not something that is done when time permits.

Conclusion: The district nurses feel motivated and have an enthusiasm for health promotion practice but more time and resources are required to design successful health-promoting initiatives. Before implementing a major training initiative for healthcare personnel in health promotion, it is essential to examine whether the conditions for this exist in the organization.

Keyword
Content Analysis, Focus Groups, Health Promotion Practice, Implementation, Nurse, Sweden
National Category
Medical and Health Sciences
Research subject
Caring sciences
Identifiers
urn:nbn:se:oru:diva-30784 (URN)10.1111/inr.12041 (DOI)000323317700016 ()23961800 (PubMedID)
Available from: 2013-09-13 Created: 2013-09-13 Last updated: 2016-12-08Bibliographically approved
4. Lifestyle advice and lifestyle change: to what degree does lifestyle advice of healthcare professionals reach the population, focusing on gender, age and education?
Open this publication in new window or tab >>Lifestyle advice and lifestyle change: to what degree does lifestyle advice of healthcare professionals reach the population, focusing on gender, age and education?
2015 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 1, 118-125 p.Article in journal (Refereed) Published
Abstract [en]

Health promotion practice in health care has a high priority in the endeavour to achieve equal opportunities for health and diversity in health among the population. The purpose of the study was to investigate whether there is any connection between the lifestyle advice given by healthcare professionals and the lifestyle change of the population, focusing on age, gender and education level. The study is based on the data from a national population survey in Sweden in which 52 595 patients who had attended health care were interviewed by phone. The participants were asked whether healthcare professionals had raised the subject of lifestyle during the visit and whether the advice they gave had contributed to a lifestyle change. The results indicated that lifestyle issues were raised with 32.2% of those who attended health care, particularly among men, younger patients and those with a high education level. When lifestyle issues were raised, the advice contributed to 39.2% of patients making a lifestyle change, to a higher extent among men, older patients and those with a low education level. The study shows that lifestyle advice given by healthcare professionals, during both emergency and outpatient healthcare visits, is an important contributor to patients' lifestyle change.

Keyword
age, education level, gender, healthcare professionals, lifestyle advice, lifestyle change
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-35004 (URN)10.1111/scs.12139 (DOI)000350285500012 ()24712639 (PubMedID)2-s2.0-84923084695 (Scopus ID)
Note

Funding Agency:

Region Halland

Available from: 2014-05-11 Created: 2014-05-11 Last updated: 2015-04-08Bibliographically approved

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