Faculty-Perceived Barriers and Benefits to Teaching Tobacco Cessation

Article excerpt

R E S E A R C H

ABSTRACT

Aim. The study explored nurse faculty beliefs regarding patient tobacco use and the promotion of patient tobacco cessation. The second aim explored perceived barriers and benefits in teaching baccalaureate students about patient tobacco use and cessation.

Background. Nurse faculty have a role in ensuring that graduates entering the nursing profession are knowledgeable, skillful, and have the self-efficacy needed to take action regarding patient tobacco use and cessation.

Method. Four 90-minute focus group interviews were taped, transcribed, and analyzed.

Results. Two major themes were identified: barriers and opportunities. Barriers included a knowledge deficit about patient tobacco use and cessation, which lagged behind published evidence. Opportunities included perceptions that providing patient tobacco cessation should occur throughout the nursing process during nurse-patient interactions.

Conclusion. Nursing faculty development regarding patient tobacco use and cessation needs to occur as well as the development and dissemination of curriculum resources

Key Words Baccalaureate Nursing Education - Nurse Faculty - Nursing Curriculum - Tobacco Cessation - Tobacco Use

AFTER DECADES OF RESEARCH, EVIDENCE-BASED CLINICAL PRACTICE GUIDELINES REGARDING PATIENT TOBACCO USE HAVE BEEN PUBLISHED (US DEPARTMENT OF HEALTH AND HUMAN SERVICES, 2008). The practice guidelines describe patient tobacco dependence as a chronic condition that requires frequent and repeated interventions by a health professional. As described in the guidelines, even brief interventions, as little as two minutes of time, have proven to be effective in reducing smoking by patients.

As health care professionals, nurses spend more direct time with patients and can reach smokers in a variety of settings when compared to other health professionals. Although research has demonstrated that patient tobacco cessation increased after receiving nursing intervention, a number of barriers have been identified that prevent nurses from delivering tobacco cessation interventions to patients in clinical practice. Frequently cited perceived barriers include lack of time and lack of knowledge and skills about how to help patients quit (Chouinard & Robichaud-Ekstrand, 2005; Green & Briggs, 2006; Sarna & Bialous, 2005; Sarna, Wewers, Brown, Lillington, & Brecht, 2001; Whyte, Watson, & McIntosh, 2006)

A number of research studies have found nursing curricula regarding tobacco-related issues and patient cessation interventions to be limited. In a study of Illinois' traditional baccalaureate programs, Kraatz, Dudas, Frerichs, Paice, and Swenson (1998) reported an average of 2.21 hours on tobacco-related issues in the three years of curricula. Hornberger and Edwards (2004) examined tobacco cessation content in 28 Kansas registered nursing programs. Of the 21 programs that responded, most focused on pathophysiology of tobacco-related diseases; 16 programs did not include information about patient tobacco cessation techniques, and 17 did not require students to practice patient cessation techniques. Nationally, Wewers, Kidd, Armbruster, and Sarna (2004) found that only 45.5 percent (385/545) of the programs included content about clinical smoking cessation interventions. Most respondents reported that tobacco content was taught for less than one hour in undergraduate curricula. In a study of Minnesota baccalaureate nursing programs, Lenz (2009) reported that five of 10 nursing programs taught the lowest level of tobacco-related issues and patient cessation interventions, defined as three or fewer content items out of 12. Students from these programs reported significantly lower levels of knowledge regarding tobacco-related content and patient cessation interventions compared to students who attended programs that taught all 12 content items.

Preparing future nurses to provide patient tobacco cessation interventions begins with nurse faculty. …