Search

Background: Nurses in hypertension care play an important role in minimising the risk factors for cardiovascular diseases, but this care can be improved. Aim: To evaluate the content of nurses' consultations with hypertensive patients before and after consultation training. Methods: Nineteen nurses from a randomised study of nurse-led hypertension clinics at health centres received three days of residential training in patient-centred counselling and cardiovascular prevention. To assess the result, two consultations with hypertensive patients in clinical practice before and after the training were audio-recorded. Content analysis was used for the analysis. Results: Diet and exercise were the most frequent topics in the consultations both before and after the training. Discussions about alcohol and the patient's responsibility for treatment increased after the training. The time spent talking about various issues, other health problems, history and appointment scheduling decreased in the consultations after the training. Conclusion: After the consultation training, the nurses succeeded in emphasising important issues for risk factor control to a greater extent.

AIM: The purpose of the study was to explore the effects of using a structured nursing intervention programme in hypertension care. BACKGROUND: Counselling on lifestyle changes to address hypertension helps patients reduce risk factors such as smoking, high alcohol consumption, overweight, dyslipidemia, negative stress and physical inactivity. DESIGN: The study was performed as a pre-test-post-test study. METHODS: All 177 patients diagnosed with hypertension visiting a health centre in Southern Sweden were invited to be counselled by a public health nurse about hypertension, cardiovascular risk factors and non-pharmacological treatment with 15 months follow up. RESULTS: One hundred patients participated in the study. Systolic blood pressure decreased overall (p < 0.01), three patients with high alcohol consumption were identified, two smokers stopped smoking, two new diabetics were discovered, physical activity increased (p = 0.035) and one-third of the patients changed their medication. CONCLUSION: The level of exercise increased and a reduction in systolic blood pressure and in women's weight were the most obvious results of this intervention study. The study elucidates the challenge of executing health behaviour changes. RELEVANCE TO CLINICAL PRACTICE: Counselling following a hypertension programme gives hypertensive patients a chance to execute lifestyle changes and have their medication adjusted to achieve goals for blood pressure control. Further prospective studies in this area, with well-defined intervention approaches and several years of follow up, are necessary.

Lifestyle changes are important when it comes to reducing the risk factors for cardiovascular complications. There is evidence that these changes are more successful if counselling is conducted in a patient-centred way. The purpose was to analyse how nurses used patient-centred counselling with hypertensive patients after video-recorded consultation training. Nineteen nurses from nurse-led clinics in hypertension care at Swedish health centres participated in residential counselling. Two audio-recordings with hypertensive patients in regular practice were made before and after the training and analysed with the emphasis on patient centredness. Weighing up the pros and cons, the identification of beliefs about treatment and negotiations about the reasons for and where to begin behavioural change increased. A slight increase in reflections and pauses was observed. Expansive and provocative questions and the identification of goals or goal-setting were used sparsely. As a result of the training, the nurses gave individually-adapted information more frequently.

BACKGROUND: In assisting the nurse's counselling on lifestyle changes in hypertension care a behaviour model can be used. AIM: To analyse the effects of nurses' training on the use of the stages of change model when counselling hypertensive patients to perform lifestyle changes. METHODS: As part of a randomised, controlled trial, 19 nurses belonging to the intervention group took part in video-recorded consultation training with simulated patients. To evaluate the training, the nurses audio-recorded their consultations with two patients before and after the intervention. Analysis focused on the areas of non-pharmacological treatment and the nurses' attention to the patients' readiness for change. RESULTS: Patient participation in the consultations increased after the training. The importance of non-pharmacological treatment was mentioned more frequently for all areas of lifestyle behaviour, exercise, smoking, alcohol consumption, food and stress, and the nurses acquired a more distinct structure for their consultations. The mean length of the recorded consultations increased from 18 min to 20.5 min. All the criteria for fulfillment of attention to patient's readiness to change were met in nine consultations before the training and in seven after it. After the training, attention was paid to support more frequently than before in the action and maintenance stages and a great deal of information was provided.