Factors influencing initiation of health behaviour conversations with patients: Cross‐sectional study of nurses, midwives, and healthcare support workers in Wales

• Published in: Journal of advanced nursing Vol. 77; no. 11; pp. 4427 - 4438
• Main Authors: Bright, Diana, Gray, Benjamin J., Kyle, Richard G., Bolton, Sian, Davies, Alisha R.
• Format: Journal Article
• Language: English
• Published: Oxford Wiley Subscription Services, Inc 01-11-2021; John Wiley and Sons Inc
• Subjects: Barriers; Behavior; communication; Cross-sectional studies; Demographics; Demography; Diet; Health behavior; health behaviour conversation; health education; Health problems; health promotion; healthcare professionals; healthcare support workers; make every contact count; Marital status; Medical personnel; Mental health; Midwifery; Midwives; Nurse led services; Nurses; Nursing; Offending; Organizational factors; Original Research: Empirical Research ‐ Quantitative; Physical activity; Polls & surveys; Research Papers; Smoking cessation; Support workers; Topics; Well being; Workforce; United Kingdom > UK; Wales
• ISSN: 0309-2402; 1365-2648
• DOI: 10.1111/jan.14926

Aim
To identify factors influencing healthcare professionals’ engagement in health behaviour conversations with patients.
Design
Cross‐sectional survey.
Methods
Between April and June 2019, an online survey of 1338 nurses, midwives and healthcare support workers was conducted. The survey assessed whether staff felt comfortable initiating health behaviour conversations with patients about five behaviours (reducing alcohol intake; stop smoking; being more active; reducing their weight; and improving their diet) and barriers to conversation initiation. Health professionals’ own health‐related behaviours, self‐rated health and mental wellbeing, and socio‐demographic characteristics were recorded. Logistic regression models were built to assess factors associated with feeling comfortable initiating health behaviour conversations for each topic.
Result
Less than 50% of respondents reported feeling comfortable initiating health behaviour conversations with patients. Female staff, young professionals (18 to 29 years), those in lower staff grades and those with poorer health and low mental wellbeing were less likely to report feeling comfortable having health behaviour conversations across all topics. Those who did not adhere to physical activity and dietary guidelines were less likely to initiate a conversation about being more active and having a healthy diet, respectively. Not having time to discuss the topic, suitable space to hold a conversation, and feeling worried about offending/upsetting patients were the main barriers reported.
Conclusion
Around 6 in 10 members of the nursing, midwifery and healthcare support workforce in Wales potentially do not feel comfortable to initiate a health behaviour conversation with patients about health and wellbeing. Feeling less comfortable to initiate a conversation was associated with staff demographics and organizational factors.
Impact
We identified those less likely to initiate health behaviour conversations as well as personal and organizational barriers to initiation. This will help to target and tailor interventions to ensure staff are equipped and enabled to hold health behaviour conversations with patients.