A qualitative study of lifestyle counselling in general practice in Ireland

Background. There is limited information in Ireland on the attitudes of GPs and practice nurses to lifestyle counselling and the strategies or approaches they use. Furthermore, there is no national framework or resources to support the systematic and uniform provision of lifestyle counselling. Objectives. To explore the views of Irish primary health care practitioners about behavioural risk factor management in particular to the provision of lifestyle counselling. To identify barriers to behavioural risk factor management and to inform the development of a risk factor management toolkit for general practice. Methods. The research design is a qualitative study consisting of six focus groups with primary health care practitioners in urban and rural locations in the Republic of Ireland. Two focus groups were conducted with GPs, two with practice nurses, one with a mixed group of GPs and practice nurses and one with a Primary Care Team. In total, 56 participants, aged 30–64 years, attended the focus groups. Descriptive analysis was performed. Results. GPs and practice nurses experienced considerable barriers to lifestyle counselling. These include insufficient time, patient resistance, lack of funding for prevention and lack of training. Participants were aware of the value of patient-centred lifestyle counselling; however, the provision of simple lifestyle information and advice was the predominant strategy used. Conclusions. GPs and practice nurses regularly conduct lifestyle counselling despite considerable barriers. It is essential that they are supported to carry out lifestyle counselling as part of a systematic ‘whole practice approach’ to prevention in general practice.