Nurses' experiences with cardiovascular risk communication and lifestyle counselling during preventive dialogues in primary care: a qualitative interview study.
Sjöström A, Hörnsten &, et al. • BMC primary care • 2026
Nurses experienced cardiovascular risk communication in preventive dialogues as a process of 'Shifting between leading and following,' balancing individualised adaptation with professional guidance while navigating structural and contextual challenges.
Key Findings
Results
Nurses described their approach to cardiovascular risk communication as translating clinical risk into person-centred, relational dialogue by flexibly combining structure, responsiveness, and motivational strategies.
Analysis generated an overarching theme titled 'Shifting between leading and following'
This theme illustrated how nurses balanced individualised adaptation with professional guidance
Nurses navigated structural and contextual challenges while doing so
11 nurses delivering VIP health dialogues were interviewed across primary care centres in Västerbotten County
Results
The first main category, 'Meeting the person professionally while taking a step back,' captured how nurses explored each patient's unique situation, needs, motivations, and attitudes.
Nurses described an individualised, patient-centred approach to preventive dialogues
This category reflected nurses stepping back from a directive role to explore the patient's perspective
The approach was described as relational rather than purely clinical
Data were derived from semistructured interviews conducted between December 2024 and April 2025
Results
The second main category, 'Continuously adapting approaches in self-management support,' captured nurses' use of flexible strategies to support patients in understanding and working with lifestyle change.
Strategies described included gradual goal setting, visual tools, and practical daily habit suggestions
These strategies were used to support patients in understanding cardiovascular risk and making lifestyle changes
The approach was characterised by ongoing adaptation rather than a fixed protocol
Qualitative content analysis identified meaning units, codes, categories, and the overarching theme
Discussion
The study identified that understanding preventive dialogues as interactive, person-centred processes supported by sensitive use of visualisation tools may inform continued development of cardiovascular prevention in primary care.
Visualisation tools were noted as a sensitive and potentially valuable component of risk communication
The authors note this approach 'warrants further evaluation'
Findings were drawn from nurses working within the Västerbotten Intervention Programme (VIP), described as 'one of the world's largest prevention programmes'
The study followed COREQ reporting guidelines for qualitative research
Background
Nurses in primary care play a key role in structured preventive dialogues, yet little was previously known about how they experience and navigate risk communication in real-world primary care settings.
The study was motivated by a gap in knowledge about nurses' real-world experiences with CVD risk communication
CVD is described as 'the leading cause of morbidity and mortality globally and in Sweden'
The VIP involves structured preventive health dialogues delivered by nurses
Sample consisted of 11 nurses; interviews were audio-recorded and transcribed verbatim
What This Means
This research studied how nurses in Sweden experience talking with patients about heart disease risk and lifestyle changes during structured health check appointments. Researchers interviewed 11 nurses who conduct these preventive health dialogues as part of the Västerbotten Intervention Programme (VIP), one of the world's largest heart disease prevention programs. The interviews explored how nurses actually communicate risk and support patients in making healthier choices in everyday clinical practice.
The study found that nurses described their work as a dynamic balancing act — shifting between taking the lead professionally and stepping back to follow the patient's own perspective, needs, and readiness for change. Two main patterns emerged: first, nurses made a deliberate effort to understand each patient as an individual rather than simply delivering clinical information; second, they continuously adapted their approach using tools like visual aids, gradual goal setting, and practical everyday suggestions to help patients understand their risk and make manageable changes.
This research suggests that effective cardiovascular prevention in primary care is not just about measuring risk numbers, but about building a responsive, person-centred conversation. The findings highlight the value of flexibility, relationship, and tailored communication strategies in nurse-led prevention work, and indicate that the use of visual tools to explain risk deserves further study as a potentially important component of these conversations.
Sjöström A, Hörnsten &, Wennberg P, Lundberg T, Dahlin Almevall A. (2026). Nurses' experiences with cardiovascular risk communication and lifestyle counselling during preventive dialogues in primary care: a qualitative interview study.. BMC primary care. https://doi.org/10.1186/s12875-026-03401-7