Occupational health nurses’ self-efficacy in implementing smoking cessation interventions for workers: a manufacturing company quality improvement project
Thornberry, Amy Janell
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The purpose of this study was to improve the delivery and quality of care to smokers at work who are poorly motivated to quit and to explore the concepts of self-efficacy for enhancing this care process within a manufacturing company. This quality improvement (QI) project aimed to educate occupational health nurses (OHN’s) by providing them with theory-based training and incentives to recruit poorly motivated smokers. Nurses practiced their skills in worker health promotion recruitment and motivational interviewing (MI) with smokers who had previously declined smoking cessation counseling. As the project evolved, theory-based applications brought OHN’s and smokers together in a new paradigm resulting in positive changes for both the OHN’s self-efficacy and smokers’ stages of change toward quitting. Paired t-tests detected statistically significant difference in OHN’s pre-and post-intervention self-efficacy scores (t(4) = -4.46, p < .001); d = 2.92) and smokers’ pre-and post-intervention stage of change toward quitting scores (t(10) = -9.07, p < .001); d = 2.09) suggesting the education intervention and motivational interviewing intervention were extremely effective in increasing OHN self-efficacy and smokers’ stage of motivation to change. Results from this pilot project indicate smokers who are poorly motivated toward quitting can be successfully recruited and counseled using motivational interviewing techniques, while simultaneously improving OHN self-efficacy toward helping these patients. Secondary findings revealed success in an innovative recruitment method of flipping the nurse-patient relationship from nurses helping patients to patients helping nurses.