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

AU - Cerqueira, Charlotte

AU - Jørgensen, Torben

AU - Lundstrøm, Sanne Lykke

N1 - Copyright © 2021 Elsevier Inc. All rights reserved.

PY - 2021/4

Y1 - 2021/4

N2 - BACKGROUND: Research shows that many people with cardiac disease decline cardiac rehabilitation. There is little or no knowledge on how health professionals respond to these people.OBJECTIVES: To investigate how nurses respond to people who do not wish to participate in cardiac rehabilitation and what influences the nurses´ approach towards these people.DESIGN: A qualitative study involving interviews and video-recordings using an analysis inspired by ethnographic principles and categorisation theory.SETTING: A rehabilitation clinic at a large hospital in the Capital Region of Denmark.PARTICIPANTS: Five cardiac nurses and 28 people with cardiac disease.METHODS: We 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.RESULTS: When 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.CONCLUSION: Even 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 - BACKGROUND: Research shows that many people with cardiac disease decline cardiac rehabilitation. There is little or no knowledge on how health professionals respond to these people.OBJECTIVES: To investigate how nurses respond to people who do not wish to participate in cardiac rehabilitation and what influences the nurses´ approach towards these people.DESIGN: A qualitative study involving interviews and video-recordings using an analysis inspired by ethnographic principles and categorisation theory.SETTING: A rehabilitation clinic at a large hospital in the Capital Region of Denmark.PARTICIPANTS: Five cardiac nurses and 28 people with cardiac disease.METHODS: We 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.RESULTS: When 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.CONCLUSION: Even 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 disease

KW - Cardiac rehabilitation

KW - Denmark

KW - Prevention

KW - Qualitative research

UR - http://www.scopus.com/inward/record.url?scp=85100142267&partnerID=8YFLogxK

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

M1 - 151397

ER -