Strategies in health-promoting dialogues--primary healthcare nurses' perspectives--a qualitative study

Scand J Caring Sci. 2014 Jun;28(2):235-44. doi: 10.1111/scs.12045. Epub 2013 Apr 17.

Abstract

Aim and objectives: The aim of this study was to describe dialogic strategies about health and lifestyle used by primary healthcare nurses (PHNs) in the Västerbotten Intervention Programme (VIP) in Sweden.

Background: The VIP offers all citizens aged 40, 50 and 60 in Västerbotten County an individual health check-up followed by a health-promoting dialogue with a specialist PHN. Inconsistencies in previous reports of the effects of lifestyle counselling and health promotion suggest that it is important to study dialogues about health and lifestyle to understand health-promoting strategies and to highlight aspects important to improving their effects.

Method: In 2010, we conducted in-depth interviews with ten experienced PHNs working with the VIP at eight healthcare centres in Västerbotten County, Sweden. Qualitative content analysis was used to illuminate the nurses' strategies in health-promoting dialogues. The Regional Ethics Board (Dno 06-126M) approved the study.

Results: The PHNs used various strategies in dialogues about health and lifestyle that fell under the five themes 'Guiding patients vs. pressuring them; Adjusting to patients vs. directing the conversation; Inspiring confidence vs. instilling fear; Motivating and supporting patients vs. demanding responsibility; and lastly, Introducing emotionally charged subjects or avoiding them'.

Conclusions: The results of this study may add knowledge about the difficulties and opportunities in health counselling. In the discussion, we suggest professional reflection as a means to increase knowledge and awareness about the self and context in the process of health counselling.

Keywords: health promotion; lifestyle counselling; nurse-centred; patient-centred; primary health care; qualitative content analysis; strategies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Health Promotion / organization & administration*
  • Nurse-Patient Relations*
  • Nursing Staff*
  • Primary Health Care*
  • Qualitative Research
  • Workforce