Nurses’ and patients’ communication in smoking cessation at nurse-led COPD clinics in primary health care

Background: Smokers with chronic obstructive pulmonary disease (COPD) have high nicotine dependence making it difficult to quit smoking. Motivational interviewing (MI) is a method that is used in stimulating motivation and behavioral changes. Objective: To describe smoking cessation communication between patients and registered nurses trained in MI in COPD nurse-led clinics in Swedish primary health care. Methods: A prospective observational study with structured quantitative content analyses of the communication between six nurses with basic education in MI and 13 patients in non-smoking consultations. Results: Only to a small extent did nurses’ evoke patients’ reasons for change, stimulate collaboration, and support patients’ autonomy. Nurses provided information, asked closed questions, and made simple reflections. Patients’ communicationwasmainly neutral and focusing on reasons for and against smoking. It was uncommon for patients to be committed and take steps toward smoking cessation. Conclusion: The nurses did not adhere to the principles of MI in smoking cessation, and the patients focused to a limited extent on how to quit smoking. Practice implications: To make patients more active, the nurses need more education and continuous training in motivational communication.

Att iscensätta apokalypsen : zombiemetaforer i den samtida katastrofberedskapen

Enacting the apocalypse: zombie metaphors in contemporary disaster preparedness Since the turn of the millennium, enactment of possible emergencies and catastrophes has become a most common way of producing knowledge about events yet to occur. Preparedness exercises are frequently performed by public authorities at local and regional levels. Collaborative approaches among relevant actors are enhanced and evaluated through simulated accidents and acts of terror as well as school shootings and epidemic outbreaks. Due to the incalculability of many modern threats, enactment is employed as a method for rendering potential future events available as empirical phenomena. However, sometimes these potential futures are represented in ways that correspond only to imagined and fictional worlds. The aim of this article is to explore the enactment of unreal possibilities in contemporary preparedness exercises. The empirical material employed for this purpose consists of crisis plans and exercise guides used in public and official institutions in the United States as well as qualitative interviews with municipal safety coordinators in Sweden.