Wilkinson Mandy, Whitehead Lisa, Crowe Marie
Centre for Postgraduate Nursing Studies, University of Otago, Christchurch, New Zealand.
School of Nursing and Midwifery, Edith Cowan University, Joondalup, Australia.
J Clin Nurs. 2016 Jan;25(1-2):240-6. doi: 10.1111/jocn.13072.
This study explored nurses' attitudes, views and beliefs about their role in long-term condition self-management.
Nurses are well-placed to assist individuals in long-term condition self-management. Yet, there is limited research exploring underlying beliefs of nurses regarding their role in long-term condition self-management and how those beliefs may impact on the practice of self-management.
A descriptive, cross-sectional qualitative design.
A purposive sample of nurses (n = 14) working in primary care and secondary care settings in New Zealand.
One focus group and two interviews were conducted. Data were analysed through thematic analysis by the three authors.
All nurses interviewed described promoting patient self-management of long-term conditions and the approaches they took to do so in practice. The nurses described a strong sense of accountability in relation to their practice. They worked to ensure patient follow-up and referrals as necessary and described themselves as lynch pins in the management of long-term conditions. Nurses also recognised that patients would engage at different levels in the self-management process. However, the sense of accountability did raise a question around the balance between professional accountability and responsibility for the management of the condition and the reality of nurses' ability to work with patients as partners in the self-management of long-term conditions.
Nurses described both understanding of the importance of promoting patient self-management but also a strong sense of professional accountability to provide quality care. Nurses recognised that they needed to work to find a balance between these two positions.
In order for nurses to work as an advocate to support optimal care it is vital that nurses recognise where patient's boundaries and capabilities lie. Nurses are at risk of blurring the boundaries and may not always support people to make choices that promote and/or maintain "self" control (or autonomy) in long-term condition management.
本研究探讨了护士对其在长期疾病自我管理中角色的态度、观点和信念。
护士在协助个体进行长期疾病自我管理方面具有良好的条件。然而，关于护士对其在长期疾病自我管理中角色的潜在信念以及这些信念如何影响自我管理实践的研究有限。
描述性横断面定性设计。
从新西兰初级保健和二级保健机构中选取的14名护士作为有目的的样本。
进行了一次焦点小组讨论和两次访谈。三位作者通过主题分析对数据进行了分析。
所有接受访谈的护士都描述了促进患者对长期疾病进行自我管理以及他们在实践中采取的方法。护士们对自己的实践表现出强烈的责任感。他们努力确保患者得到必要的随访和转诊，并将自己描述为长期疾病管理中的关键人物。护士们也认识到患者在自我管理过程中的参与程度会有所不同。然而，这种责任感确实引发了一个问题，即专业责任与疾病管理责任之间的平衡，以及护士作为长期疾病自我管理伙伴与患者合作的实际能力。
护士们既认识到促进患者自我管理的重要性，也有提供优质护理的强烈专业责任感。护士们认识到他们需要努力在这两个立场之间找到平衡。
为了使护士能够作为倡导者支持最佳护理，护士认识到患者的界限和能力所在至关重要。护士存在模糊界限的风险，并且在长期疾病管理中可能并不总是支持人们做出促进和/或维持“自我”控制（或自主性）的选择。
