"Home health care nurses have access to hard to reach and difficult to treat populations who are at the highest risk for smoking-related diseases," says lead author Belinda Borrelli, PhD, a psychologist at The Miriam Hospital and associate professor at Brown Medical School.
Ninety-eight home health care nurses from the Visiting Nurses Association of Rhode Island were randomly assigned to deliver one of two counseling techniques to 273 patients during routine medical visits motivational enhancement or standard care.
Motivational enhancement explored a patient's ambivalence to quitting and focused on building the confidence and motivation to quit. These patients also had their carbon monoxide levels measured in order to explain the disease risks associated with that level. The nurses educated patients on the dangers of carbon monoxide using everyday examples they could relate to.
"We communicated to the patients that the carbon monoxide they inhale from smoking cigarettes is the same poisonous gas that comes out of the tail pipe of their car," says Borrelli.
Standard care included the five "A's" of quitting as developed by the Agency for Health Care Policy and Research (AHCPR) - ask about smoking, assess motivation to quit, advise to quit, assist with quitting, arrange follow-up.
"We found that while both types of home-based counseling resulted in individuals quitting smoking or making positive strides towards quitting, those in the motivational enhancement
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