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

Journal article


Luxton, Nia A., MacKenzie, Ross and Shih, Patti. (2019) Smoking cessation care in cardiothoracic surgery : A qualitative study exploring the views of Australian clinicians. Heart Lung and Circulation. 28(8), pp. 1246-1252. https://doi.org/10.1016/j.hlc.2018.04.293
AuthorsLuxton, Nia A., MacKenzie, Ross and Shih, Patti
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.

Keywordstobacco; coronary artery disease; lung cancer; preoperative; hospital
Year2019
JournalHeart Lung and Circulation
Journal citation28 (8), pp. 1246-1252
PublisherElsevier Australia
ISSN1444-2892
Digital Object Identifier (DOI)https://doi.org/10.1016/j.hlc.2018.04.293
Scopus EID2-s2.0-85047239774
Research or scholarlyResearch
Page range1246-1252
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online08 May 2018
Publication process dates
Accepted18 Apr 2018
Deposited04 Jun 2021
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