Lifestyle risk communication by general practice nurses: An integrative literature review

Background: The growth of the general practice nursing workforce, has created opportunities to enhance activities aimed at lifestyle change to optimise health and reduce risk. While health status and risk levels are amenable to behaviour change, a number of complex interrelated factors influence the general practice nurses’ (GPN) role, often resulting in the underutilisation of nurses. This can limit their capacity to respond to patients’ needs, including communication regarding lifestyle risk factors and their chronic health conditions. Understanding GPNs’ views on lifestyle risk communication and factors influencing this can inform improvement in chronic disease management and effectiveness of lifestyle risk communication by GPNs. Aim: To review the literature examining the experiences and perspectives of GPNs regarding communication with patients about lifestyle risk factors. Method: An integrative literature review was conducted using the methods of Whittemore and Knafl (2005). CINAHL, Scopus, MEDLINE, Cochrane Library and Joanna Briggs Institute of Systematic Reviews were searched for articles published in English from January 2006–October 2016. Peer-reviewed papers reporting primary research which focussed on GPNs’ perceptions, attitudes, experiences and/or perspectives of lifestyle risk communication with adults were included. Included papers were assessed for methodological quality and findings extracted for thematic analysis. Results: Fifteen articles were included, yielding four themes; GPNs’ views of the nurse-patient relationship, motivational interviewing (MI), barriers to practice, and role parameters. Data revealed GPNs’ needs relating to role clarity, maintenance of therapeutic relationships, as well as organisational, government policy and technique support. Conclusion: GPNs are increasingly managing and coordinating care for people with, or at risk of, chronic disease. Lifestyle risk counselling effectively supports chronic disease management and lifestyle risk reduction. This review synthesises GPNs’ current experiences and perspectives of lifestyle risk communication, as well as highlighting additional research needs.