title: Nurses' and patients' communication in smoking cessation at nurse-led COPD clinics in primary health care.
abstract: 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' communication was mainly neutral and focusing on reasons for and against smoking. It was uncommon for patients to be committed and take steps toward smoking cessation.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  To make patients more active, the nurses need more education and continuous training in motivational communication.
authors.affiliation: Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.|Centre for Clinical Research, Dalarna, Falun, Sweden.|Dalarna County Council, Norslund Primary Health Care Centre, Falun, Sweden.|School of Health and Social Sciences, Dalarna University, Falun, Sweden.
authors.forename: Eva Österlund
authors.initials: EÖ
authors.lastname: Efraimsson
authors.affiliation: Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.|Red Cross University College of Nursing, Stockholm, Sweden.
authors.forename: Birgitta
authors.initials: B
authors.lastname: Klang
authors.affiliation: School of Health and Social Sciences, Dalarna University, Falun, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Ehrenberg
authors.affiliation: National Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Kjell
authors.initials: K
authors.lastname: Larsson
authors.affiliation: Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.|Sophiahemmet University, Stockholm, Sweden.
authors.forename: Bjöörn
authors.initials: B
authors.lastname: Fossum
authors.affiliation: Centre for Clinical Research, Dalarna, Falun, Sweden.|School of Health and Social Sciences, Dalarna University, Falun, Sweden.|Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine Section, Uppsala University, Uppsala, Sweden; loa@du.se.
authors.forename: Lena
authors.initials: L
authors.lastname: Olai
keywords: change talk; chronic obstructive pulmonary disease; motivational interviewing; nurse-led clinics; smoking cessation; videotaped consultation