Smoking cessation care in cardiothoracic surgery: a qualitative study exploring the views of Australian clinicians

Nia A. Luxton, Ross MacKenzie, Patti Shih

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Smoking cessation (SC) care in the perioperative period of cardiothoracic surgery is important to reduce surgical risk and help achieve long-term smoking abstinence in patients who continue to smoke. The implementation of clinical guidelines for SC care in the perioperative period has proved challenging, yet little is known of what influences the inter-disciplinary team involved in the cardiothoracic area. This qualitative study explored the views of the clinicians involved in perioperative period of cardiothoracic surgery in Australia on their SC advice and support. Methods: Semi-structured interviews were conducted with 52 cardiothoracic surgeons, anaesthetists, nurses and physiotherapists in three public tertiary referral hospitals and three private hospitals in New South Wales (NSW). Data was thematically analysed, and categorised using the Behaviour Change Wheel “Capabilities, Opportunity, Motivation & Behaviour” (COM-B) analysis framework to understand the factors that influence clinicians’ views and perceived abilities to provide SC care. Results: Barriers and facilitators to providing SC care were identified. The most commonly identified barriers in capability were the lack of knowledge, training and institutional engagement. Opportunity was hindered by lack of time, hospital support and resources, yet facilitated by the existence of a collaborative, multidisciplinary team and the ability to follow-up patients long term. In motivation, clinicians’ attitudes and experience negatively influenced the initiation of the cessation conversation, while intrinsic attributes of empathy and positivity were drivers to provide SC care. Conclusions: Clinicians’ views, together with inadequate SC training, resources and engagement to implement clinical guidelines, contribute to inconsistent SC care. There is a need for hospitals to provide adequate SC resources and training to all clinicians to improve SC care to cardiothoracic surgery patients throughout the perioperative period.
LanguageEnglish
Pages1246-1252
Number of pages7
JournalHeart, lung and circulation
Volume28
Issue number8
DOIs
Publication statusPublished - Aug 2019

Fingerprint

Smoking Cessation
Perioperative Period
Aptitude
Motivation
Nurse Anesthetists
Guidelines
Private Hospitals
New South Wales
Physical Therapists
Public Hospitals
Tertiary Care Centers
Smoke
Smoking
Interviews

Keywords

  • surgeons
  • anaesthetists
  • physiotherapists
  • nurses
  • preoperative
  • tobacco
  • lung cancer
  • hospital
  • coronary artery disease

Cite this

@article{89042270de1b44d69214142879a3c907,
title = "Smoking cessation care in cardiothoracic surgery: a qualitative study exploring the views of Australian clinicians",
abstract = "Background: Smoking cessation (SC) care in the perioperative period of cardiothoracic surgery is important to reduce surgical risk and help achieve long-term smoking abstinence in patients who continue to smoke. The implementation of clinical guidelines for SC care in the perioperative period has proved challenging, yet little is known of what influences the inter-disciplinary team involved in the cardiothoracic area. This qualitative study explored the views of the clinicians involved in perioperative period of cardiothoracic surgery in Australia on their SC advice and support. Methods: Semi-structured interviews were conducted with 52 cardiothoracic surgeons, anaesthetists, nurses and physiotherapists in three public tertiary referral hospitals and three private hospitals in New South Wales (NSW). Data was thematically analysed, and categorised using the Behaviour Change Wheel “Capabilities, Opportunity, Motivation & Behaviour” (COM-B) analysis framework to understand the factors that influence clinicians’ views and perceived abilities to provide SC care. Results: Barriers and facilitators to providing SC care were identified. The most commonly identified barriers in capability were the lack of knowledge, training and institutional engagement. Opportunity was hindered by lack of time, hospital support and resources, yet facilitated by the existence of a collaborative, multidisciplinary team and the ability to follow-up patients long term. In motivation, clinicians’ attitudes and experience negatively influenced the initiation of the cessation conversation, while intrinsic attributes of empathy and positivity were drivers to provide SC care. Conclusions: Clinicians’ views, together with inadequate SC training, resources and engagement to implement clinical guidelines, contribute to inconsistent SC care. There is a need for hospitals to provide adequate SC resources and training to all clinicians to improve SC care to cardiothoracic surgery patients throughout the perioperative period.",
keywords = "surgeons, anaesthetists, physiotherapists, nurses, preoperative, tobacco, lung cancer, hospital, coronary artery disease",
author = "Luxton, {Nia A.} and Ross MacKenzie and Patti Shih",
year = "2019",
month = "8",
doi = "10.1016/j.hlc.2018.04.293",
language = "English",
volume = "28",
pages = "1246--1252",
journal = "Heart, lung and circulation",
issn = "1443-9506",
publisher = "Elsevier",
number = "8",

}

Smoking cessation care in cardiothoracic surgery : a qualitative study exploring the views of Australian clinicians. / Luxton, Nia A.; MacKenzie, Ross; Shih, Patti.

In: Heart, lung and circulation, Vol. 28, No. 8, 08.2019, p. 1246-1252.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Smoking cessation care in cardiothoracic surgery

T2 - Heart, lung and circulation

AU - Luxton, Nia A.

AU - MacKenzie, Ross

AU - Shih, Patti

PY - 2019/8

Y1 - 2019/8

N2 - Background: Smoking cessation (SC) care in the perioperative period of cardiothoracic surgery is important to reduce surgical risk and help achieve long-term smoking abstinence in patients who continue to smoke. The implementation of clinical guidelines for SC care in the perioperative period has proved challenging, yet little is known of what influences the inter-disciplinary team involved in the cardiothoracic area. This qualitative study explored the views of the clinicians involved in perioperative period of cardiothoracic surgery in Australia on their SC advice and support. Methods: Semi-structured interviews were conducted with 52 cardiothoracic surgeons, anaesthetists, nurses and physiotherapists in three public tertiary referral hospitals and three private hospitals in New South Wales (NSW). Data was thematically analysed, and categorised using the Behaviour Change Wheel “Capabilities, Opportunity, Motivation & Behaviour” (COM-B) analysis framework to understand the factors that influence clinicians’ views and perceived abilities to provide SC care. Results: Barriers and facilitators to providing SC care were identified. The most commonly identified barriers in capability were the lack of knowledge, training and institutional engagement. Opportunity was hindered by lack of time, hospital support and resources, yet facilitated by the existence of a collaborative, multidisciplinary team and the ability to follow-up patients long term. In motivation, clinicians’ attitudes and experience negatively influenced the initiation of the cessation conversation, while intrinsic attributes of empathy and positivity were drivers to provide SC care. Conclusions: Clinicians’ views, together with inadequate SC training, resources and engagement to implement clinical guidelines, contribute to inconsistent SC care. There is a need for hospitals to provide adequate SC resources and training to all clinicians to improve SC care to cardiothoracic surgery patients throughout the perioperative period.

AB - Background: Smoking cessation (SC) care in the perioperative period of cardiothoracic surgery is important to reduce surgical risk and help achieve long-term smoking abstinence in patients who continue to smoke. The implementation of clinical guidelines for SC care in the perioperative period has proved challenging, yet little is known of what influences the inter-disciplinary team involved in the cardiothoracic area. This qualitative study explored the views of the clinicians involved in perioperative period of cardiothoracic surgery in Australia on their SC advice and support. Methods: Semi-structured interviews were conducted with 52 cardiothoracic surgeons, anaesthetists, nurses and physiotherapists in three public tertiary referral hospitals and three private hospitals in New South Wales (NSW). Data was thematically analysed, and categorised using the Behaviour Change Wheel “Capabilities, Opportunity, Motivation & Behaviour” (COM-B) analysis framework to understand the factors that influence clinicians’ views and perceived abilities to provide SC care. Results: Barriers and facilitators to providing SC care were identified. The most commonly identified barriers in capability were the lack of knowledge, training and institutional engagement. Opportunity was hindered by lack of time, hospital support and resources, yet facilitated by the existence of a collaborative, multidisciplinary team and the ability to follow-up patients long term. In motivation, clinicians’ attitudes and experience negatively influenced the initiation of the cessation conversation, while intrinsic attributes of empathy and positivity were drivers to provide SC care. Conclusions: Clinicians’ views, together with inadequate SC training, resources and engagement to implement clinical guidelines, contribute to inconsistent SC care. There is a need for hospitals to provide adequate SC resources and training to all clinicians to improve SC care to cardiothoracic surgery patients throughout the perioperative period.

KW - surgeons

KW - anaesthetists

KW - physiotherapists

KW - nurses

KW - preoperative

KW - tobacco

KW - lung cancer

KW - hospital

KW - coronary artery disease

UR - http://www.scopus.com/inward/record.url?scp=85047239774&partnerID=8YFLogxK

U2 - 10.1016/j.hlc.2018.04.293

DO - 10.1016/j.hlc.2018.04.293

M3 - Article

VL - 28

SP - 1246

EP - 1252

JO - Heart, lung and circulation

JF - Heart, lung and circulation

SN - 1443-9506

IS - 8

ER -