The dramatic encounter: experiences of taking part in a health conversation.
OBJECTIVE
The purpose of this study was to describe lived experiences of a health conversation from the perspective of participants who, in the course of a health check, had been informed that they were at increased risk of cardiovascular heart disease.


BACKGROUND
The modern lifestyle has created an increased occurrence of cardiovascular heart disease. Counselling about lifestyle changes to prevent disease is an important duty of nurses in primary healthcare when encountering patients with risk factors such as diabetes, hypertension and hypercholesterolemia. It is well known that accomplishing lifestyle changes is complicated. Research has shown the importance of assuming the patient perspective in pedagogical encounters and that nurses involved in patient teaching need more knowledge about the learning person.


METHODS
Written narratives about the health conversation followed by interviews with open-ended questions. Nine informants from the Skaraborg Project participated.


METHODS
A phenomenological analysis was chosen to describe the participants' experiences and to visualise the meaning of the new knowledge obtained in the encounter.


RESULTS
Three themes were identified; 'The unavoidable message', 'Reflection on the content of the conversation' and 'The pedagogical encounter'. Sub-themes show the variations of meaning owing to the participants' previous life experiences.


CONCLUSIONS
The nurse must be aware of differences in perceptions concerning the health conversation and possible consequences for the life situation. The health conversation encounter requires preparedness and a pedagogical awareness as well as an ability to recognise the person's need for understanding and level of motivation to make lifestyle changes. Relevance to clinical practice. Time and space must be created for health conversations and follow-up of cardiovascular heart disease to achieve a preventive pedagogical encounter in primary healthcare.
Persson
Marianne
M
Billingen Primary Care Centre, Billingen, Skövde, Sweden. marianne.persson@vgregion.se
Friberg
Febe
F
D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D018570:Risk Assessment