Facilitators and Barriers to Effective Smoking Cessation: Counselling Services for Inpatients from Nurse-Counsellors’ Perspectives — A Qualitative Study

Introduction: Physicians in training must be able to counsel their patients on smoking cessation, however, little is known about the barriers that they face to counselling their patients.Aims: The study sought to identify barriers to smoking cessation counselling specific to physicians in training.Methods: Qualitative interviews in the form of focus groups were conducted with 30 medical residents. Focus groups were audio taped, transcribed verbatim and coded by two independent reviewers. Similar codes were grouped to form categories and then aggregated to form themes.Results: Seven themes emerged describing resident barriers to provision of smoking cessation counselling : (1) Lack of self-efficacy for providing counselling; (2) their perception that patients are not willing to change; (3) a lack of available resources/information for providers and patients; (4) differences in supervising physician's recommendations; (5) perceived lack of time; (6) a perception of lack of continuous care; and (7) a lack of practical skills in counselling.Conclusions: This study highlighted residents’ perceived barriers to providing smoking cessation counselling. These barriers are similar to those encountered by other providers. Additional barriers specific to residency exist and more training is necessary.Practice Implications: The barriers that physicians encounter to smoking cessation counselling must be addressed early on in residency training.

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A mountain not too high to climb: a qualitative study exploring facilitators and barriers to smoking cessation in a regional mental health service

Advances in Mental Health ◽

10.1080/18387357.2015.1075355 ◽

2015 ◽

Vol 14 (1) ◽

pp. 26-37 ◽

Cited By ~ 2

Author(s):

Margaret McAllister ◽

Lynne Halliday ◽

Heather Jobson ◽

Terry Jacobs ◽

Trudi Flynn ◽

...

Keyword(s):

Mental Health ◽

Smoking Cessation ◽

Mental Health Service ◽

Health Service ◽

Qualitative Study ◽

Facilitators And Barriers

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Brief preoperative smoking cessation counselling in relation to breast cancer surgery: A qualitative study

European Journal of Oncology Nursing ◽

10.1016/j.ejon.2009.04.006 ◽

2009 ◽

Vol 13 (5) ◽

pp. 344-349 ◽

Cited By ~ 8

Author(s):

Thordis Thomsen ◽

Bente Appel Esbensen ◽

Susanne Samuelsen ◽

Hanne Tønnesen ◽

Ann M. Møller

Keyword(s):

Breast Cancer ◽

Smoking Cessation ◽

Qualitative Study ◽

Cancer Surgery ◽

Breast Cancer Surgery ◽

Smoking Cessation Counselling

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Facilitators and barriers to medication adherence among HIV-positive patients with comorbid depressive disorders: A qualitative study

PsycEXTRA Dataset ◽

10.1037/e690862011-001 ◽

2011 ◽

Author(s):

Angela R. Wendorf ◽

Samantha T. Bilkey ◽

Diana Wollach ◽

Kayla Ehlert ◽

Lorianne Woolverton ◽

...

Keyword(s):

Medication Adherence ◽

Qualitative Study ◽

Depressive Disorders ◽

Hiv Positive ◽

Facilitators And Barriers

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Faculty Opinions recommendation of Promoting patient-centered care: a qualitative study of facilitators and barriers in healthcare organizations with a reputation for improving the patient experience.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.12279957.13454056 ◽

2011 ◽

Author(s):

Janet Wale

Keyword(s):

Qualitative Study ◽

Patient Experience ◽

Patient Centered Care ◽

Healthcare Organizations ◽

Patient Centered ◽

Centered Care ◽

Facilitators And Barriers

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Exploring expected and perceived facilitators and barriers of an indicated prevention strategy to prevent future long-term sickness absence; a qualitative study among employers and employees

BMC Public Health ◽

10.1186/s12889-021-10322-w ◽

2021 ◽

Vol 21 (1) ◽

Cited By ~ 1

Author(s):

Sophie H. Klasen ◽

Ludovic G. P. M. van Amelsvoort ◽

Inge Houkes ◽

Nicole W. H. Jansen ◽

IJmert Kant

Keyword(s):

Qualitative Study ◽

Sickness Absence ◽

Early Treatment ◽

Prevention Strategy ◽

Health Complaints ◽

Health Culture ◽

Indicated Prevention ◽

Work Related ◽

Facilitators And Barriers

Abstract Background An indicated prevention strategy (IPS), consisting of a screening questionnaire and early treatment, was found to be effective for the prevention of future long-term sickness absence (LTSA) in two large Dutch RCT’s. This IPS aims to detect employees who have a high risk to become absent, and subsequently offer them early treatment. Despite the overall effectiveness, only a few companies have implemented this strategy so far. This suggests that companies may not be convinced of the (cost) effectiveness of this strategy yet. In companies where IPS has been implemented, screenings uptake and adherence to early treatment appeared to be moderate, indicating that both employees and employers might perceive barriers. Methods The aim of this qualitative study was to explore the expected and perceived facilitators and barriers for the implementation of the IPS. Semi-structured interviews were conducted with 9 employers and 11 employees (acquainted and unacquainted with IPS) from large companies. Purposive sampling was used to recruit participants. All interviews were transcribed and analyzed thematically. Results The employers believed they were primarily responsible for psychological and work-related health complaints and SA, while the employees felt responsible for health complaints related to their lifestyle. According to the employees, the responsibility of the employer was solely related to work-related health. This finding exposed a relation with the health culture, which was solely based on creating a safe work environment, omitting psychological health issues. The efficacy of this IPS regarding reducing SA was estimated positive, however, the efficacy regarding LTSA was questioned. Fear of a privacy breach was often mentioned by the respondents as an important barrier. Conclusions This study showed that the health culture within a company may be important for the perceived responsibility towards SA and health. A health culture which primarily focuses on physical complaints may raise barriers for the adoption and implementation of this preventive strategy. Participant’ perceptions of the nature of LTSA and the fact that not all participants were familiar with the exact content and phasing of IPS may have doubted the efficacy regarding LTSA. This study provides important clues for future and improved implementation of IPS.

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Facilitators and barriers to healthy eating in a worksite cafeteria: a qualitative study

BMC Public Health ◽

10.1186/s12889-021-11004-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Dalia Stern ◽

Ilian Blanco ◽

Lucy A. Olmos ◽

Joel J. Valdivia ◽

Archana Shrestha ◽

...

Keyword(s):

Qualitative Study ◽

Mexico City ◽

Healthy Eating ◽

Working Hours ◽

Sales Managers ◽

Healthy Foods ◽

Nutrition Interventions ◽

Group Discussions ◽

Facilitators And Barriers ◽

Job Category

Abstract Background Worksite-based nutrition interventions can serve as access points to facilitate healthy eating and translate existing knowledge of cardiometabolic disease prevention. We explored perceptions, facilitators, and barriers for healthy eating in a cafeteria at a large worksite in Mexico City. Methods We conducted an exploratory qualitative study in a large department store in Mexico City with ~ 1500 employees. We conducted eight focus group discussions (FGD) with 63 employees stratified by job category (sales, maintenance, shipping, restaurant, cafeteria, administrative staff, and sales managers). Employees were invited to participate in the FGD if they were at the store at the day and time of the FGD for their job type. FGDs were audio-recorded, transcribed verbatim and analyzed using the thematic method. This process involved the researches´ familiarizing themselves with the data, generating initial codes, searching for themes, reviewing the themes, defining and naming themes, and then interpreting the data. Results Employees defined healthy eating as eating foods that are fresh, diverse, and prepared hygienically. The most commonly reported facilitators of healthy eating at the worksite were availability of affordable healthy food options and employees’ high health awareness. Major barriers to healthy eating included unavailability of healthy foods, unpleasant taste of food, and preference for fatty foods and meat. For lower-wage workers, affordability was a major concern. Other barriers included lack of time to eat work and long working hours. Conclusion A broad range of factors affect healthy eating at the cafeteria, some related to nutrition and some related to the employees type of job. Availability of healthy, hygienic, and tasty food at an affordable price could lead to healthier food choices in the worksite cafeteria. These strategies, along with work schedules that allow sufficient time for healthy eating, may help improve dietary behaviors and health of employees.

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P016: Feasibility of a nurse-led smoking cessation intervention in the emergency department

CJEM ◽

10.1017/cem.2020.224 ◽

2020 ◽

Vol 22 (S1) ◽

pp. S70-S70

Author(s):

A. Tolmie ◽

R. Erker ◽

A. Donauer ◽

E. Sullivan ◽

T. Graham ◽

...

Keyword(s):

Emergency Department ◽

Smoking Cessation ◽

Cigarette Smoking ◽

Thematic Analysis ◽

Smoking Prevalence ◽

Community Support ◽

Support Programs ◽

Written Responses ◽

Smoking Cessation Counselling ◽

Community Support Programs

Introduction: Cigarette smoking is a leading global cause of morbidity and mortality. Multiple studies internationally have established that cigarette smoking prevalence is higher in emergency department (ED) patients than their respective communities. Previously, we demonstrated the smoking prevalence among Saskatoon ED patients (19.6%) is significantly higher than the provincial average (15.1%), and over 50% of smoking patients would be receptive to ED-specific cessation support. The purpose of this project was to identify nurses’ beliefs regarding smoking cessation in the ED, and barriers to implementing it in the department. Methods: A questionnaire was administered to all nurses employed at St. Paul's Hospital ED in Saskatoon assessing attitudes towards ED cessations, as well as the benefit and feasibility of three potential interventions: brief cessation counselling, referral to community support programs, and distributing educational resources. The questionnaire included Likert scale numerical ratings, and written responses for thematic analysis. Thematic analysis was performed by creating definitions of identified themes, followed by independent review of the data by researchers. Results: 83% of eligible nurses completed the survey (n = 63). Based on Likert scores, ED nurses rarely attempt to provide cessation support, and would be minimally comfortable with personally providing this service. Barriers identified through thematic analysis included time constraints (68.3%), lack of patient readiness (19%), and lack of resources/follow-up (15.9%). Referral to community support programs was deemed most feasible and likely to be beneficial, while counselling within the ED was believed to be least feasible and beneficial. Overall, 93.3% of nurses indicated time and workload as barriers to providing ED cessation support during the survey. Conclusion: Although the ED is a critical location for providing cessation support, the proposed interventions were viewed as a low priority task outside the scope of the ED. Previous literature has demonstrated that multifaceted ED interventions using counselling, handouts, and referrals are more efficacious than a singular approach. While introduction of a referral program has some merit, having professionals dedicated to ED cessation support would be most effective. At minimum, staff education regarding importance of providing smoking cessation therapy, and simple ways to incorporate smoking cessation counselling into routine nursing care could be beneficial.

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