Degree Name

Doctor of Philosophy


School of Nursing


Background: Chronic diseases such as diabetes, cardiovascular disease and some cancers are often attributed to lifestyle risks such as smoking, inadequate nutrition, harmful alcohol intake and limited exercise. Lifestyle interventions can reduce the probability of developing chronic disease, and maintain health for those with existing chronic conditions. An ageing population and increased prevalence of multimorbidity have created added demand for primary care services. While general practice nurses (GPNs) have an important role in managing chronic disease and lifestyle risk reduction, little is known about how GPNs communicate with patients about lifestyle risk.

Aim: This thesis sought to explore Australian GPNs’ approaches to, and perceptions of communicating about lifestyle risk with patients.

Methods: This concurrent mixed methods project was underpinned by pragmatism. Data collection included video observation of chronic disease management (CDM) consultations between 15 registered nurses (GPNs) and 40 patients from 14 general practices. Semi-structured interviews were also undertaken with participating GPNs.

For the quantitative analysis the Nonverbal Accommodation Analysis System (NAAS) was used to examine accommodative GPN-patient behaviours from the video observations. A qualitative content analysis of a subset of the video transcripts applied the ‘exploring, guiding and choosing model’, based on motivational interviewing (MI). The semi-structured interviews were analysed using thematic analysis.

FoR codes (2008)

111002 Clinical Nursing: Primary (Preventative), 111717 Primary Health Care, 111710 Health Counselling, 111716 Preventive Medicine



Unless otherwise indicated, the views expressed in this thesis are those of the author and do not necessarily represent the views of the University of Wollongong.