Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Mar 22;7(3):e014154.
doi: 10.1136/bmjopen-2016-014154.

Understanding Dutch practice nurses' adherence to evidence-based smoking cessation guidelines and their needs for web-based adherence support: results from semistructured interviews

D de Ruijter  1 , E S Smit  2 , H de Vries  1 , L Goossens  1 , C Hoving  1
Affiliations

Understanding Dutch practice nurses' adherence to evidence-based smoking cessation guidelines and their needs for web-based adherence support: results from semistructured interviews

D de Ruijter et al. BMJ Open. .

Abstract

Objectives: Practice nurses in general practices suboptimally adhere to smoking cessation guidelines. Since the effectiveness of their smoking cessation support is greatest when full adherence to these guidelines is achieved, interventions need to be developed to improve practice nurses' guideline adherence, for example, by tailoring their content to adherence determinants. However, the sociocognitive determinants explaining adherence have not yet been investigated. Therefore, this qualitative needs assessment aimed to explore practice nurses' current counselling practices, as well as their sociocognitive beliefs related to their smoking cessation guideline adherence and their needs regarding web-based adherence support.

Setting: Primary care; general practices in the Netherlands.

Participants: 19 practice nurses, actively involved in smoking cessation counselling.

Methods: Semistructured individual interviews, based on the I-Change Model and the Diffusion of Innovations Theory, were conducted from May to September 2014. Data were systematically analysed using the Framework Method and considered reliable (κ 0.77; % agreement 99%).

Results: Respondents felt able to be empathic and collaborative during smoking cessation consultations. They also reported psychological (eg, low self-efficacy to increase patient motivation and arranging adequate follow-up consultations) and practical barriers (eg, outdated information on quit support compensation and a perceived lack of high-quality trainings for practice nurses) to smoking cessation guideline adherence. Most respondents were interested in web-based adherence support to overcome these barriers.

Conclusions: Sociocognitive determinants influence practice nurses' smoking cessation guideline adherence. To improve their adherence, web-based tailored adherence support can provide practice nurses with personally relevant feedback tailored to individually perceived barriers to smoking cessation guideline adherence. More specifically, low self-efficacy levels can be increased by peer modelling (eg, presenting narratives of colleagues) and up-to-date information can be presented online, enabling practice nurses to use it during patient consultations, resulting in more effective communication with their smoking patients.

Trial registration number: NTR4436; Pre-results.

Keywords: PREVENTIVE MEDICINE; PRIMARY CARE; QUALITATIVE RESEARCH; smoking cessation; tailored support.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow chart Dutch smoking cessation guidelines (adapted from guideline treatment tobacco addiction revision 20098).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. WHO. WHO report on the global tobacco epidemic 2013: enforcing bans on tobacco advertising, promotion and sponsorship. Geneva: World Health Organization, 2013.
    1. USDHHS. The health consequences of smoking—50 years of progress. A report of the surgeon general. Atlanta, GA: USA: Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014.
    1. RIVM. Volksgezondheid Toekomst Verkenning (VTV) ‘Een gezonder Nederland’. Bilthoven: 2014.
    1. Stead LF, Buitrago D, Preciado N et al. . Physician advice for smoking cessation. Cochrane Database Syst Rev 2013;(5):CD000165 10.1002/14651858.cd000165.pub4 - DOI - PMC - PubMed
    1. Nederlands Huisartsen Genootschap & Landelijke Huisarsten Vereniging. NHG/LHV Standpunt: Het (ondersteunend) Team in de huisartsenvoorziening. Utrecht: Nederlands Huisartsen Genootschap and Landelijke Huisartsen Vereniging, 2011.

Publication types

Associated data

LinkOut - more resources