Community Nurses Are Important Providers of Continuity of Care for Patients With Chronic Diseases: A Qualitative Study

Ge, Jinjin; Zhang, Yongfang; Fan, Enfang; Yang, Xi; Chu, Liping; Zhou, Xiaoling; Liu, Weiqun

doi:10.1177/00469580231160888

Cited by 4 publications

(5 citation statements)

References 6 publications

(5 reference statements)

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“…Similarly, the findings in this thesis indicate that a consistent presence of NPs in municipal healthcare setting can help mitigate care-related injuries and reduce hospital admissions (II-III). The importance of maintaining high levels of continuity aligns with studies conducted by Ge et al (2023) and Lowe et al (2022), both of which confirmed the significance of such continuity for older adults with complex care needs. Specifically, Lowe et al (2022) found that the substantial continuity provided by NPs led to a 51% reduction in hospitalization.…”

Section: Nps' Expanded Practice Enhancing Personcentred Care and Prov...supporting

confidence: 67%

Exploring the pioneering nurse practitioner role in Sweden: insights and perspectives for potential role development into municipal healthcare

Ljungbeck

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The nurse practitioner role is undergoing a global evolution to meet the increasing demands of healthcare. The growing population of older adults with chronic illnesses and complex healthcare requirements presents a significant challenge to healthcare resources. These patients require person-centred care with consistent access to healthcare providers, a need that the nurse practitioner role might be equipped to fulfil. Nurse practitioners are seasoned professionals who have pursued additional education, typically at the master’s level. Their specialized expertise in advanced nursing and expanded medical skills enable them to autonomously manage both nursing and medical needs in clinical practice. In Sweden, the advancement of the nurse practitioner role is in its early phases, it lacks national regulation and formal recognition as a professionally protected title. Nonetheless, local initiatives to develop the role have been undertaken, and there is ongoing dialogue at the national level with interest from the Swedish Government in formalizing the role. This aligns with the evolving healthcare reform, and the transition from hospital-based care to home-based care. Consequently, this transition necessitates a heightened level of nursing expertise in municipal healthcare, a demand that could potentially be met by the nurse practitioner role. Nevertheless, the development of the nurse practitioner role is complex and necessitates further research and preparation. Therefore, the overall aim of this thesis is to explore the pioneering Nurse Practitioner role by situating it within the Swedish context, across diverse viewpoints to guide its potential role development into municipal healthcare. The thesis comprises four studies: three qualitative (I, III, IV) and one employing iterative qualitative and quantitative components (II). Study I involves a scoping review, that uses qualitative content analysis to examine 16 papers on content in nurse practitioner education. Study II, uses a Delphi survey approach incorporating three rounds of questionnaires with the aim of establishing consensus on challenges and opportunities for nurse practitioner role development. Content analysis was followed by descriptive statistics in subsequent rounds. Study III, a focus group study, uses thematic analysis to help identify the preparatory work required before introducing the nurse practitioner role into municipal healthcare. The final study (IV) is centred on Swedish nurse practitioners’ experiences working in this pioneering nursing role. The data collection for the fourth study involved 15 semi-structured individual interviews, which were examined using content analysis. The findings from these studies offer insights into the nurse practitioner role in a Swedish context across diverse viewpoints to guide potential role development in municipal healthcare. Study I presents the core content of nurse practitioner education, while Study II identifies challenges and opportunities. Study III deals with the preparatory work needed before role development and encompasses areas such as education, national and local regulation, and strategies to foster acceptance for the nurse practitioner role within the healthcare team. The findings from Study IV provide insights into the reality of working as a nurse practitioner in Sweden, providing crucial perspectives to consider in on-going role development. The thesis as a whole offers insights that can be of value in the preparatory phase for developing the nurse practitioner role. There must be a clear and compelling intention to enhance patient satisfaction when developing the NP role. For it to be accepted as a new professional nursing role, national guidelines are required to bolster local role development in healthcare teams.

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Section: Nps' Expanded Practice Enhancing Personcentred Care and Prov...supporting

confidence: 67%

Exploring the pioneering nurse practitioner role in Sweden: insights and perspectives for potential role development into municipal healthcare

Ljungbeck

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“…According to previous reports, 11 home-based patients with chronic diseases, such as disabled individuals, dementia patients, and disabled elderly individuals, and their caregivers hope that their treatment plans formulated by higher-level hospitals can be continued in the community or at home. Community nurses should provide home-based patients with convenient, standardized and safe care so that they can enjoy the same care as patients in higher-level hospitals.…”

Section: Discussionmentioning

confidence: 99%

“…On the basis of the findings of a previous qualitative study, 11 the Beredi comparative study method was used. The role model indices and corresponding dimension settings of 3 representative community nurses were described, explained and compared, and representative indicators were selected to form a framework.…”

Section: Methodsmentioning

confidence: 99%

“…To better provide residents with differentiated, individualized, diversified, full-process, and comprehensive transitional care services, it is particularly important to clarify the responsibilities of community nurses and realize the institutionalization of continuous community care. In a preliminary study, 11 we found that the scope of service of community nurses regarding continuous care for patients chronic diseases should cover the following 4 aspects: ① individualized projects that allow patients to continue treatment, care, and recovery; ② “peer education” conditions for patients; ③ supportive care for caregivers; and ④ full health management for the family doctor team.…”

Section: Introductionmentioning

confidence: 99%

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A Delphi Study to Construct an Index of Practice for Community Nurses Providing Transitional Home Care for Patients with Chronic Diseases

Ge,

Zhao,

et al. 2024

INQUIRY

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Community nurses play a key role in providing continuous home care for patients with chronic diseases. However, a perfect system of responsibilities and requirements has not yet been formed, and nurses cannot provide high-quality nursing services for home-based patients. We attempted to construct an index of the scope of practice for community nurses providing home-based transitional care for patients with chronic diseases and to guide nurses in playing an active role in transitional care work. From March to May 2023, 14 representative community nurses from the Shanghai Community Health Service Center were selected for group interviews and 2 rounds of Delphi consultation. A total of 14 valid questionnaires were collected. The authority coefficients were 0.94 and 0.93, and the Kendall coefficients were 0.56 and 0.59 for the 2 rounds of expert consultation ( P < .05). Finally, an index system, including 6 primary indices (transitional caring provider, patient self-management facilitator, community group intervention organizer, home caregiver supporter, family physician team collaborator and supervisor of home medical equipment use, and medical waste disposal) was constructed for community nurses involved in providing home-based transitional care for patients with chronic diseases. The weight values of the 6 indices were 0.19, 0.17, 0.21, 0.13, 0.14 and 0.16, respectively (CR = 0.035, and the consistency test was passed), and 16 secondary indicators and 42 tertiary indicators were identified. In this Delphi study, an index system that can be used to determine community nurses’ roles in providing home-based transitional and continuous care for patients with chronic diseases was successfully established. The index system is considered reliable and easy to use and will provide a meaningful reference for community nurses and policy-makers.

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“…The role of community nursing interventions has become increasingly important, in tackling this problem. 1,2 These interventions provide strategies to enhance the well-being and quality of life for individuals who are dealing with conditions. This review explores aspects of community nursing interventions in managing diseases, focusing on their effectiveness, challenges, and areas that can be improved upon.…”

mentioning

confidence: 99%

Community nursing interventions for chronic disease management

Albarnawi,

Alroqabi,

Ogdi

et al. 2023

Int J Community Med Public Health

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Chronic illnesses present a hurdle in the field of healthcare in community settings. This review of existing literature delves into the role of community nursing interventions when it comes to managing diseases. It sheds light on their effectiveness challenges and potential areas for improvement. Chronic diseases like diabetes, cardiovascular conditions, and respiratory ailments contribute substantially to both mortality rates and morbidity levels. They also place a burden on healthcare systems. Community nursing interventions play a role in addressing these diseases in underserved and rural communities. These strategies include programs, self-management initiatives, home visits, telehealth services, and coordinated care. Research indicates that these approaches have been successful in improving outcomes and reducing the burden, on healthcare systems. To fully maximize the benefits of these interventions we need to overcome obstacles that come our way. Issues such as staffing shortages, the need for training among nurses involved in community care, and the seamless integration of technology must be addressed to optimize their effectiveness. To further advance the field of community nursing interventions for disease management, future research should focus on developing strategies to overcome these challenges effectively. In addition to evaluate the long-term impact of community nursing interventions to understand how effective they are.

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Community Nurses Are Important Providers of Continuity of Care for Patients With Chronic Diseases: A Qualitative Study

Cited by 4 publications

References 6 publications

Exploring the pioneering nurse practitioner role in Sweden: insights and perspectives for potential role development into municipal healthcare

Exploring the pioneering nurse practitioner role in Sweden: insights and perspectives for potential role development into municipal healthcare

A Delphi Study to Construct an Index of Practice for Community Nurses Providing Transitional Home Care for Patients with Chronic Diseases

Community nursing interventions for chronic disease management

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