Principles of confrontational counselling in smokers with chronic obstructive pulmonary disease (COPD)

Kotz, Daniel; Huibers, Marcus J.H.; Vos, Reinder; Schayck, C.P. van; Wesseling, Geertjan

doi:10.1016/j.mehy.2007.05.012

Cited by 12 publications

(11 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A potential limitation of this approach is that the intensity and the standardisation of the counselling and the use of smoking cessation medication in the two groups may have diluted the specific effect of the information about lung damage. However, it may be that the cognitive change the intervention aimed at (challenging selfexempting beliefs about smoking and increasing risk perceptions in order to increase the desire to stop smoking) can only be achieved through intensive counselling and not through brief advice, which was initially hypothesised [17].…”

Section: Discussionmentioning

confidence: 99%

“…The present authors hypothesised that early detection of COPD and confrontation with spirometry for smoking cessation may be effective if ''confrontational counselling'' is applied [17]. Confrontational counselling is a patient-centred approach that involves confronting smokers with the consequences of their addiction (previously undiagnosed COPD) and which uses specific communication skills to identify and challenge irrational beliefs about smoking.…”

Section: Statement Of Interestmentioning

confidence: 99%

“…Participants' attendance of counselling was assessed by counting the number of counselling sessions attended and dividing this number by four. Specific elements of confrontational counselling [17] were added to the L-MIS in the experimental group, which discriminated the treatment from that in control group 1 (table 1). This involved discussing the results from spirometry and the prognosis of COPD, and challenging irrational beliefs about smoking.…”

Section: Interventionsmentioning

confidence: 99%

See 2 more Smart Citations

Efficacy of confronting smokers with airflow limitation for smoking cessation

Kotz¹,

Wesseling²,

Huibers³

et al. 2009

European Respiratory Journal

Self Cite

View full text Add to dashboard Cite

The objective of the present study was to test whether confronting smokers with previously undetected chronic obstructive pulmonary disease (COPD) increases the rate of smoking cessation.In total, 296 smokers with no prior diagnosis of COPD were detected with mild-to-moderate airflow limitation by means of spirometry and randomly allocated to: confrontational counselling by a nurse with nortriptyline for smoking cessation (experimental group); regular counselling by a nurse with nortriptyline (control group 1); or ''care as usual'' for smoking cessation by the general practitioner (control group 2). Only the experimental group was confronted with their abnormal spirometry (mean forced expiratory volume in one second (FEV1) post-bronchodilator 80.5% predicted, mean FEV1/forced vital capacity post-bronchodilator 62.5%).There was no difference in cotinine-validated prolonged abstinence rate between the experimental group (11.2%) and control group 1 (11.6%) from week 5-52 (odds ratio (OR) 0.96, 95% confidence interval (CI) 0.43-2.18). The abstinence rate was approximately twice as high in the experimental group compared with control group 2 (5.9%), but this difference was not statistically significant (OR 2.02,).The present study did not provide evidence that the confrontational approach increases the rate of long-term abstinence from smoking compared with an equally intensive treatment in which smokers were not confronted with spirometry. The high failure rates (o88%) highlight the need for treating tobacco addiction as a chronic relapsing disorder.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Statement Of Interestmentioning

confidence: 99%

Section: Interventionsmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy of confronting smokers with airflow limitation for smoking cessation

Kotz¹,

Wesseling²,

Huibers³

et al. 2009

European Respiratory Journal

Self Cite

View full text Add to dashboard Cite

show abstract

“…The common basis for the counselling in both groups was the so-called ''L-MIS'' protocol for the treatment of nicotine and tobacco addiction which had been implemented among all respiratory nurses in the Netherlands in previous years (Table 1, top) [16]. Specific elements of ''confrontational counselling'' [12] were added to the L-MIS in the experimental group which discriminated the treatment from that in the control group (Table 1, bottom). Confrontational counselling is a supportive, nonjudgmental and non-directive approach which involves communication skills and elements of cognitive therapy [12,13].…”

Section: Interventionsmentioning

confidence: 99%

“…We conducted a randomized controlled trial on the efficacy of what we have termed ''confrontational counselling'' [12]. This is a patient-centred approach which involves confronting smokers with the consequences of their addiction (previously undiagnosed COPD) and which uses specific communication skills to identify and challenge irrational beliefs about smoking.…”

mentioning

confidence: 99%