The purposes of this qualitative study were 1) to describe the nurses’ awareness of smoking and smoking cessation support for hospitalized patients with cardiovascular diseases, 2) to describe the actual smoking cessation support that the nurses are implementing in daily their practice in cardiovascular wards, and 3) to identify the nurses’ learning needs that help to providing better smoking cessation support for the hospitalized patients with cardiovascular diseases.
Methods:
A convenient sample of nurses who have 3-10 years of nursing experience and in addition, the nurses required at least one year of nursing experience in cardiovascular ward were recruited from three general hospitals in Japan. A semi-structured small group interview with open-end question method was used to collected data. The questions were 1) when are you aware of (paying attention to) patients’ smoking status in daily practice, 2) and how those implementation are like, and 3) what would you like to know about smoking or smoking cessation support in order to provide better care for the hospitalized patients with cardiovascular diseases. The data were collected from March 2016 to January 2017. This study was approved the instruction review broad and ethics committees of three participating hospitals in Japan. The set of data from interviews was analyzed through coding and categorization by content analysis method.
Findings:
A convenient sample of 24 nurses from the general or cardiovascular specialized hospital in Japan enrolled. The mean the length of nursing experience was 62.4 (±27.4) months. Of those the mean of period in which practicing in cardiac allied word was 32.5 (±13.6) months. Half (50%) of nurses completed nursing diploma, about 30% of nurses completed 4-year nursing university program, the others completed 3 year-nursing junior college or LPN-RN program.
The nursing practice regarding smoking or quit smoking for cardiovascular patients were characterized by 1) the clues to assess the smoking status for the patients, 2) the contents of assessment of smoking history or smoking pattern, and 3) any strategies that the nurses utilize while they provide any nursing smoking cessation intervention for patients.
The clues to assess the smoking status for the patients were 1) chief assessment at the hospitalization, 2) smelled like smoke, 3) when the review the education leaflet with patients, and 4) when patients mutter about quit smoking.
The contents of assessment of smoking history or smoking pattern were 1) status of smoking, 2) years of smoking, 3) number of smoking per day, 4) number of smoker(s) who live with household, and 5) the past quit attempt of smoking.
The main strategies that the nurses utilize while they provide any nursing smoking cessation intervention for patients were 1) provide information how smoking harm your health, 2) inform smoking cessation program in outpatient setting, 3) reinforce quit smoking after physician’ advice, and 4) involve family members for reinforcement of smoking cessation after discharge. The berries to provide any smoking cessation intervention for hospitalized patients with cardiovascular diseases were 1) difficulty to allocate time to smoking cessation intervention besides the other teaching subjects such as medication, fluid intake, or food consumption, 2) short period of hospitalization or transfer the stepdown unit, 3) not confident to provide smoking cessation counseling for patients, 4) hesitation about pressing a patient for quitting smoke without built trustable relationship, and 5) hesitation about paying too much attention to patients’ intention to smoke. In addition, nurses’ recognized their own learning needs were 1) acquiring communication skills and counseling skills, especially to deal with the difficult patents and 2) acquiring knowledge about benefits of quit smoking especially for cardiovascular health, 3) acquiring knowledge about smoking cessation practice, 4) knowing actual patients’ experiences of struggling, and 5) information about any smoking cessation resources that will be available after discharge.
Conclusion:
The finding identified characteristics of nursing smoking cessation intervention for hospitalized patients with cardiovascular disease in Japan. The berries to provide smoking cessation intervention in inpatients setting and the nurses’ requests that help to providing better smoking cessation support were identified.