Motivational interviewing as a smoking cessation strategy with nurses: an exploratory randomised controlled trial.

BACKGROUND: Despite the important role that health professionals have in reducing tobacco use, many have a smoking habit themselves. The prevalence of smoking is particularly high among nurses. OBJECTIVE: To test the efficacy, acceptability and feasibility of a motivational interviewing (MI) based smoking cessation intervention with nurses. DESIGN: Two group parallel experimental design with random allocation to groups. SETTING: A large teaching hospital in the North of Spain. PARTICIPANTS: Nurses who smoked (n=30) were randomised into two groups: motivational interviewing based intervention (n=15) and usual care (n=15). METHODS: Motivational interviewing based intervention consisted of four individual MI sessions. Usual care consisted of brief advice. Variables considered to assess efficacy were biochemically verified smoking cessation, mean cigarettes smoked, stages of change, self-efficacy and depression score. Variables to assess acceptability and feasibility included participant satisfaction, adherence to MI, and duration of sessions. Data were collected at: baseline, end of intervention and three months after the end of the intervention. RESULTS: At three month follow up, compared with the control group, more nurses in the intervention group had quit (absolute difference 33.3%; 95% confidence interval [CI] 2.6-58.2). In the nurses who did not quit, there was no significant difference between the intervention and control groups in the number of cigarettes smoked per day, although progress in the stages of change was greater in the intervention group compared to the control group. Measures of acceptability and feasibility indicated good satisfaction with the intervention, with high levels of attendance and completion. CONCLUSION: This study found a beneficial effect of motivational interviewing on nurses' smoking cessation. The intervention was acceptable for nurses and a number of aspects were identified that need to be considered prior to conducting a larger scale in order to optimise the intervention. Using MI might be a novel approach to the problem of health professionals who smoke.

The psychosocial impact of recurrence on cancer survivors and family members: a narrative review.

AIM: This paper is a report of a review undertaken to identify, critically analyse and synthesize the psychosocial experience of cancer recurrence for survivors and family members. BACKGROUND: Recurrence of cancer is an event after which life changes for families. Individuals move from being short- or long-term survivors of cancer to being patients once more. Families move from a state of fear of recurrence to one of uncertainty and distress as a result of the new crisis. DATA SOURCES: MEDLINE, CINAHL and CancerLit databases were searched for the period January 1980-2007. Reference lists of papers were conducted for relevant studies. The search terms recurrence, recurrent cancer, experience, survivor and family were searched for separately and in combination. REVIEW METHODS: A narrative review was conducted. Data were categorized in terms of issues during survivorship and concerns after recurrence. RESULTS: Three main categories were identified that explained survivors' and families' experiences of recurrent cancer: (1) fear of recurrence during survivorship, (2) when cancer recurs: families facing new challenges and (3) distress because of recurrence. CONCLUSION: Recurrence is a distressing experience for survivors and families because they have to face again psychosocial effects of cancer, such as uncertainty, distress and concerns about death. Care should not be addressed simply to survivors, but should include the general well-being of families beyond their survivorship and support to manage better psychosocial issues occurring when a member has a recurrence of cancer.

Health-related beliefs and behaviours of health visitors in Scotland.

There is some evidence that health professionals' performance of health promotion activities is strongly influenced by their own health beliefs and health-related behaviours. In the light of the current trend in health policies in Scotland and elsewhere towards a health promotion focus, this study sought to gain a description of, and to identify an association between, health beliefs and health-related behaviours among a sample of Scottish health visitors. A questionnaire was sent to randomly selected health visitors in a large Scottish city. Respondents reported behaviours they believed to be important to health, e.g. not driving under the influence of alcohol, dental care and smoking. While the health visitors' own performance of some health-related behaviours, such as smoking, was associated with their health beliefs, others such as drinking coffee, were not. Health visitors could be advised to reconsider some of their health beliefs, in particular those related to areas where the government has focused its attention.