Nursing activities for patients with chronic disease in family medicine groups: A multiple‐case study

Poitras, Marie-Ève; Chouinard, Maud‐Christine; Fortin, Martin; Girard, Ariane; Crossman, Sue; Gallagher, Frances

doi:10.1111/nin.12250

Cited by 15 publications

(23 citation statements)

References 42 publications

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“…Other important aspects include the drive to help the patient, leadership, and clinical experience, which have also been identified as context‐specific factors influencing the activities of nurses in primary care settings (Poitras et al . ). For all these reasons, recruiting a competent CM can be challenging, as is the case in other types of interventions oriented towards the care management of a complex clientele (Hudon et al .…”

Section: Discussionmentioning

confidence: 97%

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Challenges of adopting the role of care manager when implementing the collaborative care model for people with common mental illnesses: A scoping review

Girard

Ellefsen

Roberge

et al. 2019

Int J Mental Health Nurs

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This review aimed to identify the main factors influencing the adoption of the role of care manager (CM) by nurses when implementing the collaborative care model (CCM) for common mental illnesses in primary care settings. A total of 19 studies met the inclusion criteria, reporting on 14 distinct interventions implemented between 2000 and 2017 in five countries. Two categories of factors were identified and described as follows: (i) strategies for the CCM implementation (e.g. initial care management training and supervision by a mental health specialist) and (ii) context‐specific factors (e.g. organizational factors, collaboration with team members, nurses’ care management competency). Identified implementation strategies were mainly aimed towards improving the nurse's care management competency, but their efficacy in developing the set of competencies needed to fulfil a CM role was not well demonstrated. There is a need to better understand the relationship between the nurses’ competencies, the care management activities, the strategies used to implement the CCM and the context‐specific factors. Strategies to optimize the adoption of the CM role should not be solely oriented towards the individual's competency in care management, but also consider other context‐specific factors. The CM also needs a favourable context in order to perform his or her activities with competency.

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Section: Discussionmentioning

confidence: 97%

“…; Poitras et al . ). A meta‐analysis has also demonstrated the positive impact on mental health conditions for patients with both depression and physical long‐term diseases when nurses play the CM role (Ekers et al .…”

Section: Introductionmentioning

confidence: 97%

Challenges of adopting the role of care manager when implementing the collaborative care model for people with common mental illnesses: A scoping review

Girard

Ellefsen

Roberge

et al. 2019

Int J Mental Health Nurs

Self Cite

View full text Add to dashboard Cite

show abstract

“…In primary care, it has been suggested that a holistic perspective may provide more meaning for care providers. Poitras et al highlights the importance of context-specific factors influencing the activities of nurses in primary care settings such as the drive to help the patient, leadership, and clinical experience [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

The care manager meeting the patients’ unique needs using the care manager model—A qualitative study of experienced care managers

et al. 2021

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Background Implementation of a care manager in a collaborative care team in Swedish primary care via a randomized controlled trial showed successful outcome. As four years have elapsed since the implementation of care managers, it is important to gain knowledge about the care managers’ long-term skills and experiences. The purpose was to examine how long-term experienced care managers perceived and experienced their role and how they related to and applied the care manager model. Method Qualitative study with a focus group and interviews with nine nurses who had worked for more than two years as care managers for common mental disorders. The analysis used Systematic Text Condensation. Results Four codes arose from the analysis: Person-centred; Acting outside the comfort zone; Successful, albeit some difficulties; Pride and satisfaction. The care manager model served as a handrail for the care manager, providing a trustful and safe environment. Difficulties sometimes arose in the collaboration with other professionals. Conclusion This study shows that long-term experience of working as a care manager contributed to an in-depth insight and understanding of the care manager model and enabled care managers to be flexible and act outside the comfort zone when providing care and support to the patient. A new concept emerged during the analytical process, i.e. the Anchored Care Manager, which described the special competencies gained through experience. Trial registration NCT02378272 Care Manager—Coordinating Care for Person Centered Management of Depression in Primary Care (PRIM—CARE).

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“…This may be especially relevant, as the practices of primary care nurses may be impacted by the arrival of PHCNPs, potentially giving rise to tensions (Anderson, 2017; MacLellan et al., 2015). However, PHCNPs did not highlight a need to receive support from primary care nurses in providing case management or self-management programs, which usually include health education, self-management support, and directing the patient toward health and community resources (Poitras, Chouinard, Gallagher, et al., 2018; Poitras, Chouinard, Fortin, et al., 2018). Yet, these activities are time-consuming and realistically cannot be solely provided by PHCNPs (Hudon et al., 2018).…”

Section: Discussionmentioning

confidence: 99%

“…Activities provided by primary care nurses to patients with chronic illness conditions may overlap with those provided by physicians and PHCNPs, and this may lead to some confusion regarding how these activities should be distributed between these professionals. In fact, nursing care for patients with chronic health conditions vary widely between primary care settings and depend on the previous experiences of the health professionals involved, leadership, and organizational support for innovation (Poitras, Chouinard, Fortin, et al., 2018).…”

Section: Background and Purposementioning

confidence: 99%

Perspectives of Quebec Primary Health Care Nurse Practitioners on Their Role and Challenges in Chronic Disease Management: A Qualitative Study

et al. 2019

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Background Primary health care nurse practitioners (PHCNPs) can play a key role in chronic disease management. However, little is known about the challenges they face. Purpose The study aimed to describe PHCNPs’ perspectives on their role for patients with chronic health conditions, the barriers they face, and facilitating factors. Methods A qualitative descriptive exploratory study was conducted with 24 PHCNPs in the Canadian province of Quebec. Results PHCNPs believe that they are in an optimal position to address the needs of patients with chronic health conditions, especially in providing self-management support. However, PHCNPs reported feeling pressured to practice according to a biomedical model and to constantly defend their role in chronic disease management. They feel that they are frequently being diverted from their role to compensate for the lack of family doctors. PHCNPs made concrete recommendations to optimize their autonomous practice and quality of care: promoting strong interprofessional communication skills, genuine mentoring relationships between PHCNPs and partner physicians, managers upholding the full scope of PHCNPs’ practice, and a more flexible legislative framework. Conclusions The original conception of PHCNPs as health professionals with unique characteristics is at stake. The factors that should be targeted to support the autonomy of PHCNPs were identified.

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Nursing activities for patients with chronic disease in family medicine groups: A multiple‐case study

Cited by 15 publications

References 42 publications

Challenges of adopting the role of care manager when implementing the collaborative care model for people with common mental illnesses: A scoping review

Challenges of adopting the role of care manager when implementing the collaborative care model for people with common mental illnesses: A scoping review

The care manager meeting the patients’ unique needs using the care manager model—A qualitative study of experienced care managers

Perspectives of Quebec Primary Health Care Nurse Practitioners on Their Role and Challenges in Chronic Disease Management: A Qualitative Study

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