Tinkering and tailoring individual consultations: how practice nurses try to make cardiovascular risk communication meaningful
Tinkering and tailoring individual consultations: how practice nurses try to make cardiovascular risk communication meaningful
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DOI：
10.1111/j.1365-2702.2012.04167.x
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发表时间：
2012-09-01
影响因子：
4.2
通讯作者：
Cohn, Simon
中科院分区：
文献类型：
--
作者：
Boase, Sue;Mason, Dan;Cohn, Simon
目的和目标。探讨实习护士在向患者传达心血管风险方面的作用。背景初级保健护士与患者进行心血管风险讨论已有一段时间。随着最近NHS健康检查的引入，对这项工作的关注将增加。设计使用框架方法定性。方法.对从初级保健工作人员中有目的地抽样的护士进行了两个焦点小组和16次半结构化访谈。结果护士的叙述表明，在讨论心血管风险时，需要建立信任关系，并与每个患者建立一定程度的相关性。这些讨论的可能方面如下：在高度结构化的数据收集任务范围内开展工作;时间限制和考虑个人背景。我们使用定制的想法来描述护士如何导航，并不断修改和推销他们的方法，为他们看到的每一个病人，以应对这些限制。结论我们建议，为了使风险有意义的病人，实践护士认识到需要这样的信息嵌入在更互惠的动态的护患磋商。从他们的角度来看，成功往往是不说什么，或以一种特定的方式说，因为说什么准确或一致。与临床实践相关。对于实践护士是在成功地提供健康预防政策的举措，如NHS健康检查，重要的是要承认他们的意见和观点，在开展这项工作。这项研究表明，护士认识到需要进一步的技能和完善的方法，为那些卫生专业人员参与。
Aims and objectives. To explore the perspectives of practice nurses in their role of communicating cardiovascular risk to patients. Background. Nurses in primary care have for some time been engaged in cardiovascular risk discussions with patients. With the recent introduction of the NHS Health Checks, the focus on this work is set to increase. Design. Qualitative using a framework approach. Methods. Two focus groups and 16 semi-structured interviews were conducted with nurses purposively sampled from those working in primary care. Results. The nurses accounts revealed the need to develop a relationship of trust and establish a level of relevance with each individual patient whilst discussing cardiovascular risk. Potential aspects of these discussions were as follows: working within a highly structured data-collecting task; time constraints and consideration of the individuals context. We used the idea of tailoring to describe how nurses navigate and constantly modify and pitch their approach for each patient they see in response to these constraints. Conclusion. We suggest that in order for risk to be made meaningful to patients, practice nurses recognise the need for such information to be embedded in the more reciprocal dynamics of nurse-patient consultations. From their perspective, success is often as much about not saying something, or saying it in a particular way, as saying anything accurately or consistently. Relevance to clinical practice. For practice nurses to be instrumental in the successful delivery of health prevention policy initiatives such as the NHS Health Checks, it is important to acknowledge their views and perspectives in undertaking this work. This study suggests that the nurses recognised the need for further skills and a refinement of approach for those health professionals involved.