Details

Autor(en) / Beteiligte

• Engelen, Marscha M.
• van Dulmen, Sandra
• Nijhuis-van der Sanden, Maria W.G.
• Adriaansen, Marian J.M.
• Vermeulen, Hester
• Bredie, Sebastian J.H.
• van Gaal, Betsie G.I.

Titel

Self-management support in cardiovascular consultations by advanced practice nurses trained in motivational interviewing: An observational study

Ist Teil von

• Patient education and counseling, 2020-01, Vol.103 (1), p.159-164

Ort / Verlag

Ireland: Elsevier B.V

Erscheinungsjahr

2020

Quelle

MEDLINE

Beschreibungen/Notizen

• •Biomedical cardiovascular risk factors are discussed in 98% of cardiovascular consultations.•Psychosocial topics are discussed in less than half of cardiovascular consultations.•Advanced practice nurses do not carry out motivational interviewing as intended.•Patients and advanced practice nurses seldom discuss ideas to change behaviour. This observational study explores advanced practice nurses’ (APN) performance in secondary prevention and self-management support in patients with cardiovascular disease. Real-life consultations in three outpatient clinics were recorded on audio and analysed. First, discussed (sub)categories were determined using five categories of self-management: symptom management, treatment, biomedical cardiovascular risk factors, psychosocial consequences, and lifestyle changes. Second, the extent in which motivational interviewing aspects were applied was determined using the Behaviour Change Counselling Index (BECCI). In total, 49 consultations performed by five female APNs were analysed. Physical topics were discussed in 98% and psychological subthemes in 41% of the consultations. Although not all components of motivational interviewing were applied, talking about current behaviour and behaviours that should change were discussed, and information was provided. Especially setting targets and exchanging ideas on how to reach behavioural goals were applied to a small extent. Well-trained APNs in the current study do not carry out motivational interviewing in a structural and complete manner according to BECCI and do not discuss all self-management categories. Psychological topics should be more integrated in providing self-management support by APNs and the application of motivational interviewing should be enhanced by regularly and repeated training.