TY - JOUR

T1 - Taking no for an answer. Nurses' consultations with people with cardiac disease about rehabilitation

T2 - A qualitative study

AU - Andersen, Julie Høgsgaard

AU - Burns, Karin

AU - Guassora, Ann Dorrit Kristiane

AU - Cerqueira, Charlotte

AU - Jørgensen, Torben

AU - Lundstrøm, Sanne Lykke

PY - 2021

Y1 - 2021

N2 - BackgroundResearch shows that many people with cardiac disease decline cardiac rehabilitation. There is little or no knowledge on how health professionals respond to these people.ObjectivesTo investigate how nurses respond to people who do not wish to participate in cardiac rehabilitation and what influences the nurses´ approach towards these people.DesignA qualitative study involving interviews and video-recordings using an analysis inspired by ethnographic principles and categorisation theory.SettingA rehabilitation clinic at a large hospital in the Capital Region of Denmark.ParticipantsFive cardiac nurses and 28 people with cardiac disease.MethodsWe video-recorded the first consultation people with cardiac disease attended regarding cardiac rehabilitation, where the nurses followed up on these people's recovery, medication, lifestyle and need for rehabilitation. We conducted semi-structured interviews with the cardiac nurses. We asked the nurses about the purpose of the first rehabilitation consultation and how they handle people with cardiac disease who say no to rehabilitation. The nurses were shown video-clips with the people they had talked to in their consultation in order to facilitate a dialogue.ResultsWhen people with cardiac disease were reluctant to participate in rehabilitation, the nurses made an individual assessment of how much effort to put into motivating them, taking a complex range of factors into account. The effort among the nurses towards people with cardiac disease who decline rehabilitation was smaller in cases when the nurses believed an individual would benefit less from rehabilitation or have difficulty participating. It was important for the nurses to balance their motivational efforts with showing respect for people's autonomy.ConclusionEven when nurses endorse rehabilitation, some people with cardiac disease decline rehabilitation. The nurses' recommendation of the rehabilitation programme is influenced by the knowledge they obtain about the people with cardiac disease during consultations.

AB - BackgroundResearch shows that many people with cardiac disease decline cardiac rehabilitation. There is little or no knowledge on how health professionals respond to these people.ObjectivesTo investigate how nurses respond to people who do not wish to participate in cardiac rehabilitation and what influences the nurses´ approach towards these people.DesignA qualitative study involving interviews and video-recordings using an analysis inspired by ethnographic principles and categorisation theory.SettingA rehabilitation clinic at a large hospital in the Capital Region of Denmark.ParticipantsFive cardiac nurses and 28 people with cardiac disease.MethodsWe video-recorded the first consultation people with cardiac disease attended regarding cardiac rehabilitation, where the nurses followed up on these people's recovery, medication, lifestyle and need for rehabilitation. We conducted semi-structured interviews with the cardiac nurses. We asked the nurses about the purpose of the first rehabilitation consultation and how they handle people with cardiac disease who say no to rehabilitation. The nurses were shown video-clips with the people they had talked to in their consultation in order to facilitate a dialogue.ResultsWhen people with cardiac disease were reluctant to participate in rehabilitation, the nurses made an individual assessment of how much effort to put into motivating them, taking a complex range of factors into account. The effort among the nurses towards people with cardiac disease who decline rehabilitation was smaller in cases when the nurses believed an individual would benefit less from rehabilitation or have difficulty participating. It was important for the nurses to balance their motivational efforts with showing respect for people's autonomy.ConclusionEven when nurses endorse rehabilitation, some people with cardiac disease decline rehabilitation. The nurses' recommendation of the rehabilitation programme is influenced by the knowledge they obtain about the people with cardiac disease during consultations.

KW - Cardiac rehabilitation

KW - Qualitative research

KW - Cardiac disease

KW - Prevention

KW - Denmark

U2 - 10.1016/j.apnr.2021.151397

DO - 10.1016/j.apnr.2021.151397

M3 - Journal article

C2 - 33745551

VL - 58

SP - 151397

JO - Applied Nursing Research

JF - Applied Nursing Research

SN - 0897-1897

ER -