Counseling Hypertensive patients: an observational study of 21 public health nurses

Registered nurse-patient communication research: An integrative review for future directions in nursing research

AIM

To explore communication research in nursing by investigating the theoretical approaches, methods, content and perspectives in research on real-time registered nurse (RN)-patient communication.

DESIGN

An integrative review of real-time communication between RNs and patients.

DATA SOURCES

Empirical research papers were searched in PubMed, CINAHL Plus and Medline. The results from the database searches were supplemented with results from manual searches in reference lists.

REVIEW METHODS

A total of 1369 articles published between January 1996 and December 2021 were screened, which resulted in the inclusion of 52 articles.

RESULTS

The integration of various theories, such as nursing or communication theories, is weak in most of the included studies. RN-patient communication appears to influence relationship building. Even when nurses strive to meet patients' needs, they often focus primarily on nursing routines and physical care. The topic of the communication varies depending on the situation and different communication styles are used. When a patient-centred approach is adopted, the interpersonal communication becomes quite symmetrical, with complementary roles of nurses and patients. Within a more asymmetric communication context, nurses dominate communication, choose topics and function as instructors. How the nurses communicated subsequently influenced the patients' communication styles and strategies.

CONCLUSION

Communication is multifaceted, contains different strategies and is important for building trust and facilitating patient-centred care. The importance of RNs' communication for interaction and relationship-building seems to be well established within research, but few studies focused on patients' communication with RNs.

IMPACT

This integrative review gives an overview of the width and depth of observational studies on RN-patient communication research. The variety of studies indicates that this area is a less well-grounded field of research. Future research is warranted to support nurses in their communication, especially regarding the exploration of patients' communication and desired communication skills in nurse-patient interactions.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution was included in this integrative review.

Counselling on Lifestyle Factors in Hypertension Care After Training on the Stages of Change Model

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.

Preventing stroke: a narrative review of community interventions for improving hypertension control in black adults

Incidence rates for stroke and hypertension are higher in black ethnic groups of African descent in the USA and UK than in white groups, suggesting a need for targeted intervention. We conduct a narrative review of published research evidence on community interventions to manage hypertension among black ethnic groups, and explore the concept of cultural sensitivity in these interventions. Data sources comprised computer-aided searches of published studies over the years 1981 to March 2006, on community strategies for improving hypertension control targeting black groups, and further references from these articles. Twenty-seven relevant studies were identified. Health education was associated with improvements in knowledge about hypertension, while education combined with individualised support for patients to self-manage hypertension, including goal setting and monitoring to enhance patient self-management of hypertension, and family support in managing hypertension were associated with reductions in blood pressure levels and improvements in blood pressure control. Collaboration with black communities, using local or minority ethnic staff, conducting preliminary research with target groups to investigate perceptions and canvass ideas for the intervention design were common methods assumed to achieve cultural sensitivity. Studies, however, provided insufficient robust evidence of the effectiveness of these strategies in terms of quantifiable outcomes, although this criterion is contested, with social justice arguments being offered instead. Implicit assumptions about homogeneity and shared interests within the 'community', and representation of 'community' views have implications for the effectiveness of interventions. These findings highlight areas for the future development of interventions to reduce hypertension rates in black groups, and factors that need to be robustly investigated and explicitly addressed in intervention design.

Outcomes following a programme for lifestyle changes with people with hypertension

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.