title: Perspectives of older people engaging in nurse-led cardiovascular prevention programmes: a qualitative study in primary care in the Netherlands.
abstract: BACKGROUND
  Cardiovascular prevention programmes are increasingly being offered to older people. To achieve the proposed benefits, adherence is crucial. Understanding the reasons for adherence and non-adherence can improve preventive care.
  
  
  OBJECTIVE
  To gain insight into what motivates older people living in the community to partake in a cardiovascular prevention programme, and reasons for subsequent continuation or withdrawal.
  
  
  METHODS
  Qualitative study of current and former participants of the ongoing ≥6 year PreDIVA (prevention of dementia by intensive vascular care) trial in primary care practices in suburban areas in the Netherlands.
  
  
  METHODS
  Semi-structured interviews were conducted with a purposive sample of 15 participants (aged 76-82 years). Interviews were audiorecorded and analysed by two independent researchers using a thematic approach. Participants were asked about their motivation for participating in the programme, along with the facilitators and barriers to continue doing so.
  
  
  RESULTS
  Responders reported that regular check-ups offered a feeling of safety, control, or being looked after, and were an important motivator for participation. For successful continuation, a personal relationship with the nurse and a coaching approach were both essential; the lack of these, along with frequent changes of nursing staff, were considered to be barriers. Participants considered general preventive advice unnecessary or patronising, but practical support was appreciated.
  
  
  CONCLUSIONS
  To successfully engage older people in long-term, preventive consultations, the approach of the healthcare provider is crucial. Key elements are to offer regular check-ups, use a coaching approach and to build a personal relationship with the patient.
authors.affiliation: Department of Medical Ethics.
authors.forename: Suzanne A
authors.initials: SA
authors.lastname: Ligthart
authors.affiliation: Department of Medical Ethics.
authors.forename: Karin D M
authors.initials: KD
authors.lastname: van den Eerenbeemt
authors.affiliation: Department of Medical Ethics.
authors.forename: Jeanette
authors.initials: J
authors.lastname: Pols
authors.affiliation: Department of Neurology.
authors.forename: Emma F
authors.initials: EF
authors.lastname: van Bussel
authors.affiliation: Department of Neurology.
authors.forename: Edo
authors.initials: E
authors.lastname: Richard
authors.affiliation: Department of General Practice, Academic Medical Center, University of Amsterdam, the Netherlands.
authors.forename: Eric P
authors.initials: EP
authors.lastname: Moll van Charante
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000150:complications / Q000517:prevention & control / Q000523:psychology; D003704:Dementia / Q000209:etiology / Q000517:prevention & control; D005260:Female; D016330:Frail Elderly; D006801:Humans; D057187:Independent Living / Q000523:psychology; D008297:Male; D009042:Motivation; D009426:Netherlands; D010349:Patient Compliance / Q000523:psychology*; D010358:Patient Participation; D057184:Practice Patterns, Nurses' / Q000706:statistics & numerical data; D011314:Preventive Health Services / Q000379:methods / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000379:methods; D015397:Program Evaluation; D036301:Qualitative Research; D012307:Risk Factors
keywords: cardiovascular diseases; older people; prevention; primary health care; qualitative research