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Znyk M, Kostrzewski S, Kaleta D. Nurse-led lifestyle counseling in Polish primary care: the effect of current health status and perceived barriers. Front Public Health 2024; 12:1301982. [PMID: 38439750 PMCID: PMC10910074 DOI: 10.3389/fpubh.2024.1301982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 02/07/2024] [Indexed: 03/06/2024] Open
Abstract
Introduction Our study included counseling on diet and physical activity, smoking, e-cigarette use, and alcohol consumption. The aim was to examine the correlates of counseling provided by primary care nurses with the health status/health behaviors of nurses and the barriers in the advice provided. Materials and methods In 2022, we conducted a cross-sectional survey among 331 nurses employed in the primary care sector in Lodz. The questionnaire consisted of three sections: characteristics of the patient population receiving treatment and provided with healthy lifestyle counseling by nurses, barriers to the process of assessing, controlling, and guiding patients, and health status/health behaviors of nurses. Results Eighty percent of the nurses in our study provided advice on diet and physical activity to primary care patients. Over 70% of the survey participants performed minimal anti-smoking interventions forsmokers, 67.7% for alcohol drinkers, and 56.8% for e-cigarette users. The correlates of counseling in the field of diet and physical activity turned out to be the knowledge and skills, which enabled nurses to provide advice (OR = 2.57, p < 0.01). The correlates of the conducted minimal anti-smoking interventions in smoking patients were: subjective assessment of overweight and obesity in nurses, knowledge and skills in conducting counseling (OR = 1.92, p < 0.05), and measuring body weight, height and BMI (OR = 2.18, p < 0.01). Among the three most common barriers identified by the nurses in the process of assessing, monitoring, and guiding patients were the opinion that patients are not interested in improving their diet, physical activity, and weight loss (60.7%), lack of time (51.4%), as well as the belief that patients find it too difficult to change their current habits (54.1%). Conclusion The results of our survey indicate that nurses' participation in healthy lifestyle counseling in adult patients is unsatisfactory. Interventions in primary care should be designed considering the specific obstacles nurses may face in leading healthy lifestyles. Further training of nursing staff is required to increase their knowledge on healthy lifestyles.
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Affiliation(s)
- Małgorzata Znyk
- Department of Hygiene and Epidemiology, Medical University of Lodz, Lodz, Poland
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Chen HH, Lai JCY, Chiou ST, Huang N, Chien LY. The effect of hospital-based health promotion on the health practices of full-time hospital nurses: a cross-sectional study. Sci Rep 2023; 13:9763. [PMID: 37328544 PMCID: PMC10275936 DOI: 10.1038/s41598-023-36873-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 06/12/2023] [Indexed: 06/18/2023] Open
Abstract
Many studies have reported positive contributions of health promotion on the health behavior of nursing staff working in hospitals, including the maintenance of a regular healthy diet, engagement in physical activity, performance of routine screening practices, and participation in a health examination. Despite being considered a role model for healthy lifestyles, little is known about the effect of health-promoting hospital settings on nursing staff. The aim of this study was to perform a nationwide, hospital-based, cross-sectional, survey comparing health practices between full-time nurses of health-promoting hospitals and those of non-health-promoting hospitals in Taiwan. We conducted a nationwide, hospital-based, cross-sectional, survey in 100 hospitals from May to July 2011 using a questionnaire as the measurement tool. Nurses aged between 18 and 65 years from certified health-promoting hospitals (n = 14,769) were compared with nurses in non-health-promoting hospitals (n = 11,242). A multiple logistic regression model was conducted to estimate the effect of certified HPH status on the likelihood of performing health behavior, receiving general physical examination, undergoing cancer screening, and participating in hospital-based health-promoting activities. All nurses of HPH hospitals were more likely to perform physical activity, practice cancer screening, receive at least one general physical examination in the past 3 years, and had a higher chance of participating in at least one hospital-based health-promoting activity in the past year (particularly weight-control groups and sports-related clubs) than those of non-HPH hospitals. This study suggests the effectiveness of implementing health promotion on the health behavior of full-time nursing staff in hospitals.
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Affiliation(s)
- Hung-Hui Chen
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan, ROC
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan, ROC
| | - Jerry Cheng-Yen Lai
- Department of Medical Research, Taitung MacKay Memorial Hospital, Taitung, Taiwan, ROC
- Master Program in Biomedicine, College of Science and Engineering, National Taitung University, Taitung City, Taiwan, ROC
| | - Shu-Ti Chiou
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Cheng Hsin General Hospital, Taipei, Taiwan, ROC
| | - Nicole Huang
- Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Li-Yin Chien
- Institute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University, Yang-Ming Campus, No.155, Sec. 2, Linong St., Beitou Dist., Taipei City, 11221, Taiwan, ROC.
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3
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Okoli CTC, Otachi JK, Seng S, Abufarsakh B, Williams LB. Evaluating Simulation-Based Tobacco Treatment Scenarios for Providers Delivering Treatment for People Living With Mental Illnesses. Front Psychiatry 2022; 13:868550. [PMID: 35463520 PMCID: PMC9019225 DOI: 10.3389/fpsyt.2022.868550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 03/15/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND People living with mental illnesses (PMI) experience elevated tobacco use and related morbidity and mortality. Despite the availability of effective and safe tobacco treatments along with evidence that PMI are motivated and able to quit successfully, few Mental and behavioral healthcare providers (MHPs) engage PMI in such treatment. MHPs may lack the confidence or skills to engage their clients in tobacco treatment. Currently, there are limited training modalities to prepare MHPs in delivering tobacco treatment for PMI. However, animated scenario-based simulated encounters can bridge this gap to effectively provide tailored MHP training to enhance treatment delivery. Hence, the purpose of this study was to evaluate simulated tobacco treatment education scenarios tailored to MHPs. METHODS For this evaluation, we used a pretest-posttest design to assess changes in MHPs tobacco treatment knowledge and behavioral intentions after viewing simulated treatment encounters. We developed four animated scenarios, using brief tobacco treatment interventions, simulating treatment encounters with PMI. MHPs were primarily recruited from mental or behavioral healthcare facilities and were asked to complete a web-based questionnaire. Their knowledge, views, and experiences in providing tobacco treatment were assessed prior to viewing the animated scenarios. Participants were then asked to evaluate the desirability, acceptability, and applicability of the animated scenarios; and thereafter, their knowledge of and intentions to provide evidence-based tobacco treatment (i.e., ASK, ADVISE, ASSESS, ASSIST, ARRANGE) were again assessed. RESULTS Participants (N = 81) were on average 41.0 years of age, mostly female (79.0%), and non-Hispanic White (86.4%). Nearly a quarter endorsed current tobacco use and few had tobacco treatment training (14.8%). Overall knowledge of tobacco treatment scores significantly increased before and after viewing the videos (M = 3.5 [SD = 1.0] to M = 4.1 [SD = 1.0], p < 0.0001). After viewing the simulated scenario videos, participants endorsed moderate to high mean scores (ranging from 4.0-4.2 on a 0 to 5 scale) on the desirability, acceptability, and applicability of the different animated scenarios. In addition, after viewing the scenarios the proportion of participants who endorsed that they intended to occasionally/very often engage clients in evidence based tobacco treatment were high for ASK (94.9%), followed by ADVISE and ASSESS (84.7% each), followed by ASSIST (81.4%), and ARRANGE (74.6%). Evaluation scores significantly differed by type of animated scenario and participants' work settings and discipline. CONCLUSIONS These findings suggest that the use of brief animated scenarios may be a useful modality to enhance MHPs knowledge acquisition and treatment delivery intentions. Such approaches may be integrated into tobacco treatment trainings for MHPs.
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Affiliation(s)
| | - Janet K Otachi
- College of Social Work, University of Kentucky, Lexington, KY, United States
| | - Sarret Seng
- College of Nursing, University of Kentucky, Lexington, KY, United States
| | - Bassema Abufarsakh
- College of Nursing, University of Kentucky, Lexington, KY, United States
| | - Lovoria B Williams
- College of Nursing, University of Kentucky, Lexington, KY, United States
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Zhang S, Jose Duaso M. The delivery of smoking cessation interventions by nurses who smoke: A meta-ethnographic synthesis. J Adv Nurs 2021; 77:2957-2970. [PMID: 33626209 DOI: 10.1111/jan.14783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 12/14/2020] [Accepted: 01/18/2021] [Indexed: 10/22/2022]
Abstract
AIMS To gain new insights into the experiences of nurses who smoke and to understand the impact of those experiences on their delivery of smoking cessation interventions. DESIGN A meta-ethnographic synthesis. DATA SOURCES CINAHL, Embase, MEDLINE, PsychINFO, Web of Science and grey literature databases were searched from their inception to April 2019. REVIEW METHODS Meta-ethnography was employed to synthesize findings from included studies. The CASP qualitative checklist was used to appraise the quality of each study, and the GRADE-CERQual approach to appraise review findings. The synthesis is reported in accordance with the eMERGe reporting guidance. RESULTS From an initial search outcome of 6,019 citations, 13 studies were included detailing the experiences of 195 nurses who were smokers or ex-smokers. Four main themes were identified beliefs, dissonance, coping mechanisms and workplace policies. An integrated conceptual map was proposed on the basis of findings. Nurses who smoke were aware of tobacco harms and their role in addressing tobacco use, which resulted in experiences of guilt and stigma. Workplace policies played a crucial role in the creation of cognitive dissonance. Nurses used different strategies to cope with dissonance such as rationalizing smoking benefits, hiding their smoking behaviour, denial of smoking risks, and failing to engage with smoking cessation interventions. Some nurses expressed more positive aspirations to cope with their dissonance, including a willingness to quit and to embrace smoking cessation interventions with their patients. CONCLUSION Implementing smoke-free policies and supportive interventions targeting nurses' cognitive dissonance may assist them to quit smoking and improve their engagement in smoking cessation practices.
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Affiliation(s)
- Siqi Zhang
- International Nursing School, Hainan Medical University, Haikou, China.,Florence Nightingale Faculty of Nursing, King's College London, London, UK
| | - Maria Jose Duaso
- Adult Nursing, Florence Nightingale Faculty of Nursing, King's College London, London, UK
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5
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Martin-Cantera C, Sanmartín JMI, Martínez AF, Lorenzo CM, Cohen VB, Jiménez MLC, Pérez-Teijón SC, Osca JARI, García RC, Fernández JL, Domenech MAG, Navascues MAM, Chaves ES, Ibañez MLR, Rubio VG, Rayo SM, Otero BM, Lopez LG, Guillem FC, Fuente FM, Ruiz DB, Rodríguez AIH, Caballero JDDG, Moreno CB, Pubil MP, Grau ML. Good practice regarding smoking cessation management in Spain: Challenges and opportunities for primary care physicians and nurses. Tob Prev Cessat 2020; 6:55. [PMID: 33083683 PMCID: PMC7552853 DOI: 10.18332/tpc/126630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 07/27/2020] [Accepted: 08/21/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION We analyze the activities carried out by primary care (PC) physicians and nurses with respect to smoking cessation and evaluate their self-reported training, knowledge, and behavior. METHODS A cross-sectional study was conducted including 1514 PC physicians and nurses from June 2016 to March 2017, in Spain. The main variable was Good Practice (GP) in attention to smokers. To identify associated factors, a multilevel logistic regression model was used adjusted for sex, age, type of center, contract, years of employment, tobacco consumption, and self-reported training/knowledge. RESULTS Of the 792 physicians and 722 nurses, 48.6% referred to GP in smoking cessation management. The finding related to: being a non-smoker (OR=1.8; 95% CI: 1.2–2.5) or ex-smoker (OR=1.4; 95% CI: 1.02–2.1), having a good level of knowledge (OR=1.8; 95% CI: 1.3–2.4) and training (OR=2.4; 95% CI: 1.8–3.2), and, to a lesser extent, being female (OR=1.3; 95% CI: 1.03–1.7), and work experience >10 years (OR=1.4; 95% CI: 1.03–1.9). The main GP barriers were: lack of time (45.5%), organizational problems (48.4%), and 35.4% lack of training. CONCLUSIONS The GP of PC physicians and nurses regarding smoking cessation management is related to being non-smokers or ex-smokers, and having sufficient training and knowledge. Lack of time and organizational problems were considered to be the main barriers. The promotion of training activities in the Spanish National Health Service with the support of scientific societies is required.
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Affiliation(s)
- Carlos Martin-Cantera
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, Spain.,Grupo Abordaje al Tabaquismo SemFYC, Barcelona, Spain
| | - Jose M Iglesias Sanmartín
- Unidad Especializada de Tabaquismo del Área Sanitaria IV del Principado de Asturias, Asturias, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Diego Beni Ruiz
- Consultorio de Aldeanueva de Ebro, Centro de Salud Alfaro, La Rioja, Spain
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6
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Králíková E, Pánková A. Barriers to introduction of smoke-free workplaces in Central Europe: example of the Czech Republic. Cent Eur J Public Health 2020; 28 Suppl:S22-S25. [PMID: 33069177 DOI: 10.21101/cejph.a6160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 07/26/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Smoking at the workplace has a negative impact both on employers' economic interests and employees' health. The aim of this study is to describe the current situation, mainly barriers in implementation and resources in the Czech Republic as an example of a Central European country. METHODS We synthesised relevant review papers with our knowledge of the local situation based upon professional experience of both authors. RESULTS Despite smoke-free laws, some EU workers are still exposed to passive smoking during working hours. The main barriers towards smoke-free workplace implementation are the lack of resources, perception of smoking as a norm, and exceptions for leading personalities and their smoking. Social support increases smoking cessation effectiveness. Low availability of local smoking cessation services is an overall problem in Central Europe. CONCLUSIONS The working environment influences smoking habits. Smoking cessation support is cost-effective not only for the smoking employee but for employers as well. Smoking cessation resources should be available during the working day. No exceptions should be made as they serve as barriers to a smoke-free working environment.
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Affiliation(s)
- Eva Králíková
- Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.,Centre for Tobacco Dependence, Third Medical Department, Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Alexandra Pánková
- Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.,Centre for Tobacco Dependence, Third Medical Department, Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
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Bak MAR, Hoyle LP, Mahoney C, Kyle RG. Strategies to promote nurses' health: A qualitative study with student nurses. Nurse Educ Pract 2020; 48:102860. [PMID: 32890934 DOI: 10.1016/j.nepr.2020.102860] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 07/21/2020] [Accepted: 08/13/2020] [Indexed: 10/23/2022]
Abstract
Developing strategies to support student nurses' health is a global priority for healthcare organisations and governments. This is because emerging international evidence indicates that improvements in student nurses' health are required to increase the longevity of careers and reduce the loss of time, skill and financial cost of sickness absence and workforce exit. However, we do not know what intervention strategies student nurses think would support their health. The study aim was to explore student nurses' views on factors that influence health-related behaviours and strategies that could improve health. Data were collected through participatory activities during focus groups with student nurses in Scotland. Analysis was theoretically informed and involved mapping to the Behaviour Change Wheel framework. Students identified several factors that influenced health-related behaviours. Four were ranked most important: knowledge, culture, time constraints, and stress. Strategies student nurses thought should be prioritised to improve nurses' health-related behaviours were: stimulating a health-promoting environment by reviewing shift work, improving workplace support, increasing staffing levels, subsidising and role-modelling of healthy food and exercise; and creating applied health-promoting curricula by integrating time and stress management training and lifestyle advice into nursing education. Educational and environmental interventions are needed to support student nurses' health.
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Affiliation(s)
- Marieke A R Bak
- Section of Medical Ethics, Department of General Practice, Amsterdam UMC, University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, the Netherlands.
| | - Louise P Hoyle
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, UK.
| | - Catherine Mahoney
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, EH11 4BN, UK.
| | - Richard G Kyle
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, EH11 4BN, UK; Research and Evaluation Division, Public Health Wales, Cardiff, CF10 4BZ, UK.
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8
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Kritsotakis G, Georgiou ED, Karakonstandakis G, Kaparounakis N, Pitsouni V, Sarafis P. A longitudinal study of multiple lifestyle health risk behaviours among nursing students and non-nursing peers. Int J Nurs Pract 2020; 26:e12852. [PMID: 32645751 DOI: 10.1111/ijn.12852] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 04/18/2020] [Accepted: 05/01/2020] [Indexed: 11/30/2022]
Abstract
AIM The aim of this paper is to compare the evolution of health risk behaviours between undergraduate nursing and social work students. BACKGROUND Nursing includes the promotion of health and the shaping of healthy behaviours. An important determinant for providing lifestyle advice is the lifestyle of nurses themselves. DESIGN Longitudinal comparative study. MEASUREMENTS We compared lifestyle risk behaviours (binge drinking, cannabis/hashish/marijuana use, smoking, oral hygiene/toothbrushing, breakfast/fruit/vegetable consumption, physical activity and screen time/sedentary behaviours) using a self-administered standardized questionnaire in nursing (n = 121) and social work (n = 140) students at the beginning (2012) and the end of their studies (2015). Adjusted multivariable logistic/Poisson regression models were performed. RESULTS There were no statistically significant differences between the departments in most risk factors in both assessments. However, in relation to their first year, both nursing and social work students displayed higher relative risk of engaging in more behavioural risk factors at the end of their studies (in delivery/junk food consumption, sunburns, hashish/marijuana use and multiple sexual partners). Social work students displayed better behaviours in physical activity and breakfast intake. CONCLUSION Nursing students share the patterns of their nonnursing peers in behavioural risk factors compromising their future health and health-promoting role. We need strategies to safeguard the professional nursing practice.
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Affiliation(s)
- George Kritsotakis
- Laboratory of Epidemiology, Prevention & Management of Diseases, Nursing Department, Hellenic Mediterranean University, Crete, Greece
| | - Evangelos D Georgiou
- University Centre for Field Studies, Department of Psychology, University of Cyprus, Lefkosia, Cyprus
| | - Georgios Karakonstandakis
- Laboratory of Epidemiology, Prevention & Management of Diseases, Nursing Department, Hellenic Mediterranean University, Crete, Greece
| | - Nikos Kaparounakis
- Laboratory of Epidemiology, Prevention & Management of Diseases, Nursing Department, Hellenic Mediterranean University, Crete, Greece
| | | | - Pavlos Sarafis
- Nursing Department, Cyprus University of Technology, Limassol, Cyprus
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Antoñanzas-Baztan E, Pumar-Méndez MJ, Marín-Fernández B, Redín-Areta MD, Belintxon M, Mujika A, Lopez-Dicastillo O. Design, implementation and evaluation of an education course to promote professional self-efficacy for breastfeeding care. Nurse Educ Pract 2020; 45:102799. [PMID: 32460143 DOI: 10.1016/j.nepr.2020.102799] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 04/23/2020] [Accepted: 05/01/2020] [Indexed: 11/25/2022]
Abstract
The objective of this study was to determine the effect of an education short course on professional' self-efficacy in the area of breastfeeding care. The intervention had a pre-post design. A total of 43 healthcare professionals attended the course. The Kirkpatrick model for the development, implementation and evaluation of education actions was used for a 4.5-h course. The aspects evaluated included professionals' satisfaction and learning regarding confidence to support lactating mothers, perceived transfer of knowledge to the workplace and organizational changes. Data were collected using self-administered questionnaires (participants, unit managers, and education planners), before and after the intervention. Participants' satisfaction with the education action was high in all of the aspects measured (greater than 3.9 in scores of 0-5). Professionals showed a significant increase in self-efficacy levels for supporting breastfeeding (Wilcoxon test p-value = < 0.05, before intervention: median = 55, [IQR] = 11; after intervention: median = 60, [IQR] = 14). Participants, managers and organizers of the course identified changes in the way that professionals cared for breastfeeding mothers. In conclusion, this educational intervention enhanced professional self-efficacy and performance in breastfeeding care.
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Affiliation(s)
- Elena Antoñanzas-Baztan
- Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain; Public University of Navarra, Faculty of Health Sciences, Department of Health Sciences, Avenida de Barañain s/n, 31008, Pamplona, Spain; IMPULS Research Group, University of Navarra, Irunlarrea 3, 31008, Pamplona, Spain
| | - Maria-J Pumar-Méndez
- Universidad de Navarra. Facultad de Enfermería, Departamento de Enfermería Comunitaria y Materno-Infantil, Irunlarrea 1, 31008, Pamplona, Spain; IdiSNA, Instituto de investigación Sanitaria de Navarra, Irunlarrea s/n, 31008, Pamplona, Spain; IMPULS Research Group, University of Navarra, Irunlarrea 3, 31008, Pamplona, Spain
| | - Blanca Marín-Fernández
- Public University of Navarra, Faculty of Health Sciences, Department of Health Sciences, Avenida de Barañain s/n, 31008, Pamplona, Spain
| | - Maria D Redín-Areta
- Public University of Navarra, Faculty of Health Sciences, Department of Health Sciences, Avenida de Barañain s/n, 31008, Pamplona, Spain
| | - Maider Belintxon
- Universidad de Navarra. Facultad de Enfermería, Departamento de Enfermería Comunitaria y Materno-Infantil, Irunlarrea 1, 31008, Pamplona, Spain; IdiSNA, Instituto de investigación Sanitaria de Navarra, Irunlarrea s/n, 31008, Pamplona, Spain; IMPULS Research Group, University of Navarra, Irunlarrea 3, 31008, Pamplona, Spain
| | - Agurtzane Mujika
- Universidad de Navarra. Facultad de Enfermería, Departamento de Enfermería Comunitaria y Materno-Infantil, Irunlarrea 1, 31008, Pamplona, Spain; IdiSNA, Instituto de investigación Sanitaria de Navarra, Irunlarrea s/n, 31008, Pamplona, Spain; IMPULS Research Group, University of Navarra, Irunlarrea 3, 31008, Pamplona, Spain
| | - Olga Lopez-Dicastillo
- Universidad de Navarra. Facultad de Enfermería, Departamento de Enfermería Comunitaria y Materno-Infantil, Irunlarrea 1, 31008, Pamplona, Spain; IdiSNA, Instituto de investigación Sanitaria de Navarra, Irunlarrea s/n, 31008, Pamplona, Spain; IMPULS Research Group, University of Navarra, Irunlarrea 3, 31008, Pamplona, Spain.
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Rojewski AM, Bailey SR, Bernstein SL, Cooperman NA, Gritz ER, Karam-Hage MA, Piper ME, Rigotti NA, Warren GW. Considering Systemic Barriers to Treating Tobacco Use in Clinical Settings in the United States. Nicotine Tob Res 2020; 21:1453-1461. [PMID: 29917118 DOI: 10.1093/ntr/nty123] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 06/14/2018] [Indexed: 01/19/2023]
Abstract
The Comorbidity Workgroup of the Tobacco Treatment Research Network, within the Society for Research on Nicotine and Tobacco, previously highlighted the need to provide tobacco treatment to patients diagnosed with comorbid physical and mental health conditions. Yet, systemic barriers in the United States health care system prevent many patients who present for medical treatment from getting the evidence-based tobacco treatment that they need. The identified barriers include insufficient training in the epidemiologic impact of tobacco use, related disorders, and pharmacological and behavioral treatment approaches; misunderstanding among clinicians about the effectiveness of tobacco treatment; lack of therapeutic support from clinical staff; insufficient use of health information technology to improve tobacco use identification and treatment; and limited time and reimbursement for clinicians to provide treatment. We highlight three vignettes demonstrating the complexities of practical barriers at the health care system level. We consider each of the barriers in turn and discuss evidence-based strategies that could be implemented in the clinical care of patients with comorbid conditions. In addition, in the absence of compelling data to guide implementation approaches, we offer suggestions for potential strategies and avenues for future research. Implications: Three vignettes highlighted in this article illustrate some systemic barriers to providing tobacco treatment for patients being treated for comorbid conditions. We explore the barriers to tobacco treatment and offer suggestions for changes in training, health care systems, clinical workflow, and payment systems that could enhance the reach and the quality of tobacco treatment within the US health care system.
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Affiliation(s)
- Alana M Rojewski
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC
| | - Steffani R Bailey
- Department of Family Medicine, Oregon Health and Science University, Portland, OR
| | - Steven L Bernstein
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT
| | - Nina A Cooperman
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ.,Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Ellen R Gritz
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Maher A Karam-Hage
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Megan E Piper
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, WI
| | - Nancy A Rigotti
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Graham W Warren
- Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC.,Department of Cell and Molecular Pharmacology, Medical University of South Carolina, Charleston, SC
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Aho H, Pietilä I, Joronen K. Practical nursing students' discursive practices on smoking in Finland. Int J Qual Stud Health Well-being 2020; 14:1610274. [PMID: 31107188 PMCID: PMC6534216 DOI: 10.1080/17482631.2019.1610274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Purpose: Based on focus groups, we analyse how practical nursing students deal with being as smokers and future healthcare workers. The way they justify their smoking is discussed within a group of peers. Methods: The study has a qualitative design with an inductive approach using focus group interviews (FGIs) for data collection. A total of 29 students were interviewed in five groups of five and one group of four participants. Results: In the analysis, we found four different discursive practices the students utilized for rationalizing their own smoking and coping with the moral dilemma of smoking in a context of health care where smoking is forbidden: (1) students normalized smoking with references to its prevalence within their social circles, (2) the students asserted that their smoking was under control, (3) students considered themselves responsible smokers, and (4) students identified smoking as a part of their identity. Conclusion: Training should support the growth of professional identity and address the smoker’s identity right from the start of education. Smokers need special attention in the formulation of professional identity, however, without being stigmatized any further.
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Affiliation(s)
- Hanna Aho
- a Faculty of Social Science , Health Sciences, University of Tampere , Tampere , Finland.,b Department of Musculoskeletal Diseases , Tampere University Hospital , Tampere , Finland
| | - Ilkka Pietilä
- c Faculty of Social Sciences, Social and Public Policy , University of Helsinki , Helsinki , Finland
| | - Katja Joronen
- a Faculty of Social Science , Health Sciences, University of Tampere , Tampere , Finland
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Martínez C, Baena A, Castellano Y, Fu M, Margalef M, Tigova O, Feliu A, Laroussy K, Galimany J, Puig M, Bueno A, López A, Fernández E. Prevalence and determinants of tobacco, e-cigarettes, and cannabis use among nursing students: A multicenter cross-sectional study. NURSE EDUCATION TODAY 2019; 74:61-68. [PMID: 30583124 DOI: 10.1016/j.nedt.2018.11.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 11/03/2018] [Accepted: 11/26/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Nurses are important agents in public health, which includes being active in tobacco control. Studies show that nurses who smoke are less inclined to offer smoking cessation aid. Nursing students, as the future labor force of nursing, are one of the key groups to monitor. OBJECTIVES To identify the prevalence and determinants of use of several tobacco products, e-cigarettes, and cannabis among nursing students in Catalonia. DESIGN Cross-sectional multicenter study. SETTINGS 15 university nursing schools in Catalonia (Spain) in 2015-2016. PARTICIPANTS Nursing students attending class at the day of the survey. METHODS An anonymous, self-administered questionnaire based on the Global Health Professional Survey was designed. The questions included information on consumption of several tobacco products (manufactured cigarettes, roll your own cigarettes, etc.), e-cigarettes, and cannabis. We estimated the prevalence of use (%) and computed multilevel logistic regressions models, at two levels, to calculate the odds ratios (OR) and their corresponding 95% confidence intervals (CI), adjusting for several individual sociodemographic variables and the nursing school as a grouping variable. RESULTS 4381 students participated in the study (57.2% of Nursing students in Catalonia at the time of the survey). 29.7% (95%CI: 27.2-32.2) were smokers (18.4% daily and 11.3% occasionally). 66.4% smoked manufactured cigarettes, 47.0% roll your own cigarettes, 10.0% waterpipe, and 0.4% e-cigarettes. The main predictors of smoking were: being ≥25 years (OR = 2.57, 95%CI: 2.03-3.26) and belonging to other Spanish regions (OR = 1.82, 95%CI: 1.30-2.54). 71.5% had low nicotine dependence as defined by the Heavy Smoking Index. Among 11.5% (95%CI: 10.6-12.4) of students used cannabis (daily or occasionally), and men presented higher odds of use (OR = 2.81, 95%CI: 2.11-3.73) than women. CONCLUSIONS Tobacco and cannabis use is high among nursing students. It is necessary to carry out early tobacco and cannabis cessation programs among young nursing students.
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Affiliation(s)
- Cristina Martínez
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Nursing School of the Medicine and Health Sciences Faculty, Universitat de Barcelona, C. Feixa llarga s/n, 08907 L'Hospitalet del Llobregat, Barcelona, Spain.
| | - Antoni Baena
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Health Sciences Studies Department, Universitat Oberta de Catalunya, Rambla de Poblenou, 156, 08018, Barcelona, Spain
| | - Yolanda Castellano
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Marcela Fu
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Medicine and Health Sciences Faculty, Universitat de Barcelona, C. Feixa llarga s/n, 08907 L'Hospitalet del Llobregat, Barcelona, Spain
| | - Mercè Margalef
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Olena Tigova
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Ariadna Feliu
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Kenza Laroussy
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Nursing School of the Medicine and Health Sciences Faculty, Universitat de Barcelona, C. Feixa llarga s/n, 08907 L'Hospitalet del Llobregat, Barcelona, Spain
| | - Jordi Galimany
- Nursing School of the Medicine and Health Sciences Faculty, Universitat de Barcelona, C. Feixa llarga s/n, 08907 L'Hospitalet del Llobregat, Barcelona, Spain
| | - Montse Puig
- Nursing School of the Medicine and Health Sciences Faculty, Universitat de Barcelona, C. Feixa llarga s/n, 08907 L'Hospitalet del Llobregat, Barcelona, Spain
| | - Albert Bueno
- Nursing Care Management, EAP Roses, Institut Català de Salut, Crta Mas Oliva no 23, 17480 Roses, Alt Empordà, Spain
| | - Antonio López
- Nursing Care Management, EAP Valls urbano, c/ Vallvera no 8, Valls, CP: 43800, Tarragona, Spain
| | - Esteve Fernández
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Medicine and Health Sciences Faculty, Universitat de Barcelona, C. Feixa llarga s/n, 08907 L'Hospitalet del Llobregat, Barcelona, Spain
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