Hegney Desley G, Patterson Elizabeth, Eley Diann S, Mahomed Rosemary, Young Jacqui
School of Nursing and Midwifery, Curtin University, Perth and Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
Int J Nurs Pract. 2013 Feb;19(1):54-9. doi: 10.1111/ijn.12027.
This was the first Australian study investigating the acceptability, feasibility and sustainability of a nurse-led model of chronic disease management in general practice. A concurrent mixed-methods design was used within a 12-month intervention of nurse-led care in three general practices. Adult patients with type 2 diabetes, hypertension and/or stable ischaemic heart disease were randomized into nurse-led or standard care. Semi-structured interviews explored perceptions of key stakeholders towards this model including patients in the nurse-led arm, and all practice staff pre- and posttrial. The data were thematically analysed and the emergent themes were: importance of time; collaborative relationships; nurse job satisfaction, confidence and competence; patient self-management and choice. Our findings showed that nurses provided chronic disease management that was acceptable, feasible and sustainable. The collaborative involvement of doctors was intrinsic to patient acceptability of nurse-led care that facilitated job satisfaction, and therefore retention and growth within this nursing speciality.
这是澳大利亚第一项研究全科医疗中由护士主导的慢性病管理模式的可接受性、可行性和可持续性的研究。在为期12个月的三项全科医疗护士主导护理干预中，采用了同步混合方法设计。患有2型糖尿病、高血压和/或稳定型缺血性心脏病的成年患者被随机分为护士主导护理组或标准护理组。半结构化访谈探讨了关键利益相关者对该模式的看法，包括护士主导护理组的患者以及所有参与试验前后的全科医疗工作人员。对数据进行了主题分析，出现的主题有：时间的重要性；合作关系；护士工作满意度、信心和能力；患者自我管理和选择。我们的研究结果表明，护士提供的慢性病管理是可接受的、可行的和可持续的。医生的协作参与对于护士主导护理的患者可接受性至关重要，这有助于提高工作满意度，从而促进该护理专业的人员留存和发展。
