Marscha M Engelen1, Sandra van Dulmen2, Maria W G Nijhuis-van der Sanden3, Marian J M Adriaansen4, Hester Vermeulen3, Sebastian J H Bredie5, Betsie G I van Gaal6. 1. Radboud university medical center, Radboud Institute for Health Science, IQ healthcare, Nijmegen, The Netherlands; HAN University of Applied Science, Faculty of Health and Social Studies, Institute of Nursing, Nijmegen, The Netherlands. Electronic address: Marscha.Engelen@radboudumc.nl. 2. Radboud university medical center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Nijmegen, The Netherlands; NIVEL (Netherlands institute for health services research), Utrecht, The Netherlands; Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway. 3. Radboud university medical center, Radboud Institute for Health Science, IQ healthcare, Nijmegen, The Netherlands. 4. HAN University of Applied Science, Faculty of Health and Social Studies, Institute of Nursing, Nijmegen, The Netherlands. 5. Radboud university medical center, Department of Internal Medicine, Nijmegen, The Netherlands. 6. Radboud university medical center, Radboud Institute for Health Science, IQ healthcare, Nijmegen, The Netherlands; HAN University of Applied Science, Faculty of Health and Social Studies, Institute of Nursing, Nijmegen, The Netherlands.
Abstract
OBJECTIVE: This observational study explores advanced practice nurses' (APN) performance in secondary prevention and self-management support in patients with cardiovascular disease. METHODS: 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). RESULTS: 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. CONCLUSION: 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. PRACTICE IMPLICATIONS: 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.
OBJECTIVE: This observational study explores advanced practice nurses' (APN) performance in secondary prevention and self-management support in patients with cardiovascular disease. METHODS: 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). RESULTS: 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. CONCLUSION: 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. PRACTICE IMPLICATIONS: 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.
Authors: Ad A Kaptein; Pim B van der Meer; Barend W Florijn; Alexander D Hilt; Michael Murray; Martin J Schalij Journal: Philos Ethics Humanit Med Date: 2020-02-13 Impact factor: 2.464
Authors: Marscha M Engelen; Sandra van Dulmen; Saskia Puijk-Hekman; Hester Vermeulen; Maria Wg Nijhuis-van der Sanden; Sebastian Jh Bredie; Betsie Gi van Gaal Journal: J Med Internet Res Date: 2020-07-24 Impact factor: 5.428
Authors: Eleanor M Whittaker; Andrew R Levy; Bashir Matata; Florence E Kinnafick; Adrian W Midgley Journal: Int J Environ Res Public Health Date: 2022-02-10 Impact factor: 3.390