Abstract:

This study investigates the impact of a health education programme on the beliefs and behaviour of a group of patients who smoke and suffer from peripheral vascular disease. The aim of this experimental study was to evaluate whether a nurse-led health education programme had any impact on intentions to smoke, attitudes, behaviour, nicotine dependence and withdrawal. The influence of recent stressful life events and health locus of control on smoking behaviour was also assessed. A three group pre-test-post-test control group design was used. Forty one subjects were randomised to three groups: Group 1 -health education with nicotine gum ; Group 2 - health education; Group 3 - usual care (control). Data collection was informed by a number of theoretical sources. Intentions, attitudes and beliefs were measured according to The Theory of Planned Behaviour. Smoking behaviour was measured by self report, end expired carbon monoxide and urinary cotinine. Nicotine dependence and withdrawal were measured using nicotine dependence scale and a nicotine withdrawal scale. Stressful life events was measured by a life events inventory and health locus of control was measured using multidimensional health locus of control scales. At the pre-test (Interview 1) baseline data were collected using structured interviews and physiological markers for smoking. The experimental intervention (a four week health education programme) was introduced to Groups 1 and 2. During the program m e data were collected from all three groups, related to smoking behaviour, nicotine dependence and withdrawal and stressful events both at week two and week three. At the post-test (Interview 2) the baseline measures were repeated. All subjects were followed up three months later. Data analysis used a range of non parametric and multiple regression procedures. The Theory of Planned Behaviour provides a valuable conceptual framework for examining the impact of health education. Some evidence is provided to support the assumption that perceived control over stopping smoking is an important factor in smoking cessation. Although the hypotheses concerning the effects of the health education program m e cannot be fully accepted the findings demonstrate that the program m e did have some impact on intentions, attitudes and behaviour. It is not possible to draw any conclusions about the role of nicotine gum in this programme. The study highlights the importance of the nurses' role in helping people form intentions to stop smoking and raises issues about the nature of health education evaluation.