“It’s not just about walking.....it’s the practice nurse that makes it work”: a qualitative exploration of the views of practice nurses delivering complex physical activity interventions in primary care

BMC Public Health

Research Article

Christina Victor¹  Carole Beighton²  Julia Fox-Rushby³  Alison Woodcock⁴  Rebecca Normansell⁵  Michael Ussher⁵  Derek Cook⁵  Peter Whincup⁵  Tess Harris⁵  Sally Kerry⁶  Steve Iliffe⁷ 

[1] College of Health and Life Sciences, Brunel University London, UB8 3PH, Middlesex, UK;Faculty of Health, Social Care & Education, Kingston & St George’s University of London, SW17 ORE, London, UK;Health Economics Research Group, Brunel University, UB8 3PH, Uxbridge, UK;Independent Psychology Research Consultant, Southampton, UK;Population Health Research Institute, St Georges University of London, SW17 ORE, London, UK;Pragmatic Clinical Trials Unit, Queen Mary’s University of London, E1 2AT, London, UK;Research Department of Primary Care & Population Health, University College, NW3 2PF, London, UK;

关键词: Practice nurse;    Primary care;    Randomised controlled trial;    Walking intervention;    Physical activity;    Behaviour change techniques;   

DOI  :  10.1186/s12889-015-2568-6

 received in 2015-02-27, accepted in 2015-12-04,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundPhysical activity (PA) is important for physical and mental health in adults and older adults. Interventions incorporating theory-based behaviour change techniques (BCTs) can be useful in helping people to increase their PA levels and can be delivered by practice nurses in primary care. We undertook two primary care based complex walking interventions among adults and older adults. Both interventions were underpinned by BCTs and delivered by practice nurses and we sought their views and experiences of delivering over 1400 complex PA consultations.MethodsSemi structured interviews with two practice nurse groups (n = 4 and n = 5) and two individual interviews (total n = 11) were conducted by independent facilitators; audio-recorded, transcribed verbatim and analysed using thematic analysis.ResultsFive key themes emerged as enablers and/or barriers to delivering the intervention: preparation and training; initial and ongoing support; adherence to the protocol; the use of materials and equipment; and engagement of participants. The themes were organised into a framework of ‘pre-trial’ and ‘delivery of the intervention’. Two additional ‘post-trial’ themes were identified; changed practice and the future feasibility of the intervention. Nurses believed that taking part in the trial, especially the BCT training, enhanced the quality and delivery of advice and support they provided within routine consultations, although the lack of time available routinely makes this challenging.ConclusionDelivering an effective behaviour change intervention in primary care requires adequate training and support for practice nurses both initially and throughout the trial as well as adequate consultation time. Enhanced skills from participating in such trials can lead to long-term changes, including more patient-centred consulting.Trial registrationPACE-Lift ISRCTN 42122561, PACE-UP ISRCTN 98538934.

【 授权许可】

CC BY   
© Beighton et al. 2015