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

Abstract

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.

Self-care experiences of Indonesian adults with chronic disease living in Montreal

“…Nevertheless, the results suggest that access to nurses needs to be improved and the role of nursing needs to be strengthened in self-care support for those (immigrants) living with chronic illness. Nurse practitioners may be one approach to improving access and to addressing the person-centred care gap as they are well-positioned to provide comprehensive supportive care to a broad array of patients living with chronic illness either through direct care or by working collaboratively with family physicians (Guillaumie et al, 2019). Future work could explore from the nurses', and family-physicians' perspectives on how nurses' role in self-care support in the context of private medical practice and family medicine groups, may be optimally achieved.…”