Patients' experiences of a nurse‐led rheumatology clinic in Sweden: A qualitative study

Abstract

In this study, patients' experiences of a nurse-led rheumatology clinic for those undergoing biological therapy are discussed. The study had an explorative design, based on a qualitative content analysis with an inductive approach. Strategic sampling was used in order to achieve variations in experiences of a nurse-led clinic. Interviews were conducted with 20 participants, and the analysis resulted in the theme "the nurse-led rheumatology clinic provided added value to patient care". The participants' experiences of the encounter with the nurse led to a sense of security (due to competence and accessibility), familiarity (due to confirmation and sensitivity), and participation (due to exchange of information and involvement). Replacing every second visit to a rheumatologist with one to a nurse added value to the rheumatology care, making it more complete. Nurses and rheumatologists complemented each other, as they approached patients from different perspectives. This study suggests that a nurse-led rheumatology clinic adds value to the quality of care for patients in rheumatology units.

Randomized controlled trial of a nurse‐led rheumatology clinic for monitoring biological therapy

“…A nurse and a rheumatologist complement each other, as they encounter the patients from different perspectives (Larsson et al . ). This is consistent with experiences of patients from nurse‐led clinics in diabetes care (Edwall et al .…”

Health promotion interventions to prevent early childhood human influenza at the household level: a realist review to identify implications for programmes inHongKong

“…, Larsson et al . ). The home setting is an optimal place for health promotion and education, especially for children and their families as learning takes place within an everyday context.…”

A randomized study comparing regular care with a nurse‐led clinic based on tight disease activity control and person‐centred care in patients with rheumatoid arthritis with moderate/high disease activity: A 6‐month evaluation

“…Several publications on nurse‐led clinics in rheumatology have been published over the last decade(s), mostly performed in patients with low disease activity or in remission (Arvidsson et al, ; Bala et al, ; Hill, Thorpe, & Bird, ; Larsson, Fridlund, Arvidsson, Teleman, & Bergman, ; Ndosi et al, ; Ndosi, Vinall, Hale, Bird, & Hill, ; Tijhuis, Zwinderman, Hazes, Breedveld, & Vlieland, ). Although there is a relative lack of randomized clinical trials investigating the effect of nurse‐led clinics in patients with moderate or high disease activity, there is support for the notion that the nurse‐led clinics can: improve the patient's function; increase the patient's knowledge about the disease (Hill et al, ; Tijhuis et al, ); improve self‐efficacy (Primdahl, Wagner, Holst, & Hørslev‐Petersen, ); and add value for the patient, in terms of increased security, continuity and a positive feeling of being seen as a person (Arvidsson et al, ; Bala et al, ; Larsson, Bergman, Fridlund, & Arvidsson, ). This led us to hypothesize that a nurse‐led clinic built on principles of person centred care and stringent follow‐up, with tight control and treat‐to‐target strategy, would be more effective than care as usual in patients with RA with moderate to high disease activity.…”