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- Bengtson, Ann, 1947, et al.
(författare)
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The nurse's role and skills in hypertension care: a review.
- 2003
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Ingår i: Clinical Nurse Specialist. - 0887-6274. ; 17:5, s. 1-5
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this review was to examine studies on nursing in hypertension care to find out the nurse's role and skills. Articles were searched during the period 1966-1997. About 650 abstracts were read, and 148 were selected for examination. Forty-two articles were judged to be relevant for the study. The role of the nurse in programs was described as that of a team member, an educator in nonpharmacological treatment, and a translator for the physician with a holistic and psychosocial approach. A nurse participating in hypertension care promoted blood pressure reductions as the patients decreased their weight and sodium intake, stopped smoking, increased their physical activity, took their medication more correctly, and returned for follow-up visits more frequently, and the cost of drugs and visits to the physician decreased. Local programs for hypertension care should be developed with nurses' holistic and psychosocial approach and skills taken into account. More well-designed studies are needed to develop nursing care for hypertensive patients.
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- Drevenhorn, Eva, 1954, et al.
(författare)
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A content analysis of patient-centredness in hypertension care after consultation training for nurses .
- 2007
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Ingår i: The Internet Journal of Advanced Nursing Practice. - : Internet Scientific Publications. - 1523-6064. ; 8:2
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Tidskriftsartikel (refereegranskat)abstract
- 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.
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- Drevenhorn, Eva, 1954, et al.
(författare)
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Assessment of hypertensive patients' self-care agency after counseling training of nurses
- 2015
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Ingår i: Journal of the American Association of Nurse Practitioners. - : Ovid Technologies (Wolters Kluwer Health). - 2327-6886 .- 2327-6924. ; 27:11, s. 624-630
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Tidskriftsartikel (refereegranskat)abstract
- PurposeThe aim of the study was to assess hypertensive patients' self-care agency and any correlation with the patient's lifestyle changes and the nurse's degree of patient centeredness after counseling training. Data sourcesNurses in the intervention group (IG; n = 19) working at nurse-led clinics at health centers were trained in patient centeredness (motivational interviewing) and the stages of change model and included 137 patients. Nurses in the control group (CG; n = 14) included 51 patients. The Exercise of Self-Care Agency (ESCA) instrument was used. There was a significant difference from baseline to the 2-year follow-up in the ESCA score (IG, p = .0001). An increase in ESCA score was correlated with an increased level of physical activity after 2 years (IG, p = .0001; CG, p = .040). ConclusionsThe counseling training gave an increase in the patients' self-care agency scores, which was significantly correlated with increased physical activity. Implications for practiceIn clinical practice it is important for nurses to be patient centered in their counseling to affect patients' self-care agency in a positive direction.
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- Drevenhorn, Eva, 1954, et al.
(författare)
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Counselling on lifestyle factors in hypertension care training on the Stages of Change-model
- 2007
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Ingår i: European Journal of Cardiovascular Nursing. - 1474-5151. ; 6:1, s. 46-53
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Tidskriftsartikel (refereegranskat)abstract
- 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. PMID: 16698320 [PubMed - as supplied by publisher]
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- Drevenhorn, Eva, 1954
(författare)
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Counselling Patients with Hypertension at Health Centres - a Nursing Perspective
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Counselling in hypertension care relating to lifestyle changes, i.e. non-pharmaco-logical treatment regarding smoking, alcohol, weight, diet, physical activity and stress, aims to reduce complications such as stroke and myocardial infarction. Many patients have several risk factors to deal with. There are few studies of nursing in hypertension care in Sweden and this issue therefore needs to be investigated in greater detail. The aims of this thesis were to analyse the communication between patients and nurses about lifestyle changes in hypertension care at health centres and to evaluate the effects of nursing interventions. In the first study, the Nurse Practitioner Rating Form was used to explore what 21 randomised public-health nurses discussed with hypertensive patients and their communication. In the second study, variables from 100 patients were collected to explore the effectiveness of using a hypertension nursing programme at a nurse-led clinic. The third study comprised consultation training for 19 randomised nurses, at nurse-led clinics in southern Sweden, with audio-recorded consultations with 36 patients before the training and 35 after the training. The recordings were analysed using content analysis. The results reveal that non-pharmacological treatment was not provided to any great extent during visits for blood pressure measurement with public-health nurses at open hours, but a great deal of information and advice was provided. One significant correlation was, however, found. The more years the nurses had been working, the more likely it was that their health promotion was psychosocially oriented in the consultations. The patients and nurses generally met at an equal communication level in their conversations. Starting a nurse-led hypertension clinic following a hypertension nursing programme resulted in many medication adjustments when assessing the patients? treatment and blood pressure levels. The most positive changes were seen in blood pressure, blood lipids and exercise. Consultation training on the stages of change model and patient centredness resulted in the nurses acquiring a more distinct structure for their consultations and relevant information was supplied in a more individually adapted way. The number of words and turns increased in the consultations. The nurses paid attention to support more frequently, irrespective of the stage of behavioural change the patient had reached. Negotiations about reasons for and where to begin behavioural change increased in the consultations. A model for nurses counselling patients in hypertension care was suggested, applying Orem?s self-care deficit theory of nursing. It is concluded that public-health nurses in normal practice at health centres did not perform counselling on non-pharmacological treatment to any great extent. Applying a hypertension nursing programme resulted in positive changes in patients? blood pressure, blood lipids and exercise. After consultation training, the nurses acquired a more distinct structure for their counselling, with more words and turns, and negotiations about reasons for and where to begin behavioural change increased. The results of this thesis could be of help when planning and starting nurse-led clinics in hypertension care and when developing a national hypertension nursing program. To improve the care for hypertensive patients it is suggested that nurses at nurse-led clinics should have the opportunity for recurrent counselling training and education in the cardiovascular area.
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