Goal setting and lifestyle changes in a nurse‐led counselling programme for leg ulcer patients: an explorative analysis of nursing records

Irene van de Glind · Maud M. Heinen · Andrea W.M. Evers · Theo van Achterberg

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Behavioral Health and Interventions Nursing Diagnosis and Documentation Diagnosis and Treatment of Venous Diseases

Abstract

AIMS AND OBJECTIVES: To describe goals set in individual nurse-led lifestyle counselling sessions in leg ulcer patients, and to explore patient and goal characteristics in relation to health behaviour change. BACKGROUND: Goal setting is increasingly used in nurse-led counselling programmes, but the delivery is often unknown, especially in patient groups for which only recently programmes have been developed, such as patients with venous leg ulcers. DESIGN: A secondary analysis of data collected in the intervention arm of a randomised clinical trial of counselling sessions in venous leg ulcer patients. METHODS: Nursing records (n = 71) were explored for the number of goals set, topic, quality and course of goals during the trajectory. Furthermore, goals and patient characteristics were compared in relation to health behaviour change. RESULTS: Forty-one patients (58%) succeeded in changing their behaviour after setting a goal. Setting goals for conducting leg exercises was chosen by most patients in this study, goals for adherence with compression therapy were chosen the least. Sixty-eight per cent of the goals met criteria for being Specific, Measurable and Time-bound. Patients who achieved behaviour change were significantly younger compared to the patients who did not. Except for age, there were no differences in characteristics between the group that did and did not achieve behaviour change. CONCLUSIONS: Goal setting could be improved by setting goals more Specific, Measurable and Time-bound, and by setting goals on an essential topic for behaviour change. This explorative study did not show that goal characteristics, including the quality of goals, were related to patients' behaviour change. RELEVANCE TO CLINICAL PRACTICE: The delivery of goal setting in this programme, and most likely in similar programmes, could be improved. Regular quality checks in daily goal setting practice should be considered. More research is needed into how to best provide health promotion to frail and elderly people.

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1992Health Behavior and Health Education: Theory, Research, and Practice 2017Planning Health Promotion Programs: An Intervention Mapping Approach 1995Goal Setting as a Strategy for Health Behavior Change 2009Goal-setting for behavior change in primary care: An exploration and status report 2011Goal setting as a health behavior change strategy in overweight and obese adults: A systematic literature review examining intervention components 2013The components of action planning and their associations with behavior and health outcomes 2005Supporting adherence and healthy lifestyles in leg ulcer patients: Systematic development of the Lively Legs program for dermatology outpatient clinics 2006Action Planning: A Call To Action

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