Determinants of Cardiac Nurses' Intentions Towards Initiating Smoking Cessation Care to Their Patients

Abstract

Background: Although nurses are in an ideal position to offer smoking cessation interventions during hospitalization, they perceive challenges in providing this care. The Ask-Advise-Refer (AAR) strategy may be a feasible approach since the actual counseling delivered at the outpatient setting. This study identified determinants of cardiac nurses' intentions towards providing the AAR strategy. Methods: A cross-sectional survey was conducted among randomly selected nurses in all Dutch cardiac wards, of whom 165 (35%) responded. Regression analyses were used to determine correlates of the intention towards providing the AAR strategy. Current provision of smoking cessation care was also assessed. Findings: The current delivery of smoking cessation care was low, though the majority of the cardiac nurses had a strong intention to work with the AAR strategy. Familiarity with smoking cessation guidelines, positive attitudes, high self-efficacy expectancies, social modeling, and social support by cardiologists were significantly associated with increased intentions to apply the AAR strategy. These factors explained 65% of the intentions. Discussion: The AAR strategy may improve smoking cessation care for cardiac patients. Nurses should be familiarized and be encouraged towards working with this strategy, and be able to practice its delivery to enhance their attitudes and self-efficacy.