The Medical Research Council recommends strong theoretical underpinning in the design and evaluation of lifestyle intervention programmes (LIPs). This qualitative study aimed to use Basic Needs Theory (BNT) as a framework to explore participants’ perspectives on a workplace dietitian‐led LIP. Specifically, experiences with LIP engagement and initiation and maintenance of behaviour change were evaluated. Fifteen semi‐structured face‐to‐face interviews were conducted with participants who had previously completed a workplace cardiovascular disease and type 2 diabetes prevention programme, which involved advice and motivational support with making dietary and lifestyle changes. Interviews were audio recorded and transcribed verbatim. To evaluate the narrative, interpretative phenomenological analyses were used with BNT as the theoretical framework. A total of 12 themes were identified in relation to the three concepts of BNT – autonomy, competence and relatedness – and organised into three domains: intervention engagement, behaviour change initiation and behaviour change maintenance. Line manager and colleague support to attend was reported to have a strong influence on intervention engagement, and the importance of dietitian and peer guidance in initiating behaviour changes was highlighted. Differences between participants who maintained behavioural changes compared to those who relapsed included autonomously seeking support (relatedness) through family, friends, healthcare professionals and commercial slimming organisations. BNT provided an insightful theoretical framework to evaluate factors that underpinned the effectiveness of a dietitian‐led cardiovascular and type 2 diabetes prevention LIP. Attendance and retention in workplace LIPs can depend on participants’ managerial and colleague support, so recruitment processes should consider targeting managers in marketing and promotional activities. Workplace LIPs may increase the likelihood of behaviour change maintenance by including methods that foster longer term participant relatedness and emotional support.

OBJECTIVE: To investigate the process of consenting to do-not-resuscitate status from the perspective of critical care nurses who have been involved with patients and/or family members during their decision. METHOD: A network sample of 22 critical care nurses, with at least 1 year's experience in a critical care unit and self-reported multiple experiences with the do-not-resuscitate consent process, participated in the study. Semistructured, formal interviews were used to collect data. All interviews were tape recorded and transcribed verbatim. The grounded theory method was used to collect and analyze data. RESULTS: The analysis revealed a core category: consenting to do-not-resuscitate status. Integrated into the process were intervening conditions that further explained the process: the meaning of "do not resuscitate," the importance of time/timing in the process, the nurse's role and conflict issues that arose during the process of consenting to do-not-resuscitate status. CONCLUSIONS: The theoretical model developed in this study provides a framework to describe the role of critical care nurses in the do-not-resuscitate process. In addition, a description of the categories provides information for nurses, especially novice nurses, to consider when caring for patients and families who are in the process of making decisions concerning resuscitation.

Background: Across England in the United Kingdom, population screening for cardiovascular disease primarily takes place within general practice in the form of the National Health Service Health Check. Additional screening sites such as occupational health are advocated to improve the population impact.Aims: To investigate participant experiences with cardiovascular and type 2 diabetes risk assessment (RA) at occupational health and subsequent support-seeking at general practice.Methods: Face-to-face interviews were conducted for this qualitative study.Participants were recruited at three workplaces; a steel works and 2 hospital sites.Using interpretive phenomenological analyses, themes were drawn from salient narratives and categorically organised.Results: There were 29 participants. Themes (n = 16) were organised into two domains; factors that facilitated (n = 9) or thwarted (n = 7) participant engagement with the RA and general practice. All participants described the RA as worthwhile and strongly valued RA at occupational health. Those with obesity and high cardiovascular disease risk highlighted their difficulties in making lifestyle changes. Participants reported confusion and anxiety when GP advice about medication appeared to contradict what participants had interpreted during RA at occupational health. Conclusions:This study highlights factors that facilitate or thwart engagement in cardiovascular risk assessment at occupational health services and general practice follow-up. Stakeholders can integrate these factors into standard operating procedures to enhance participant engagement and enable safe guards that minimise potential harm to participants.