Department of Health Services Research and Policy, Research School of Population Health, Australian National University, Canberra, ACT, Australia.
Australian National University Medical School, Australian National University, Canberra, ACT, Australia.
J Adv Nurs. 2018 Mar;74(3):564-578. doi: 10.1111/jan.13461. Epub 2017 Oct 25.
To develop a conceptual model that provides a comprehensive understanding of the structures and processes underpinning patient enablement and satisfaction in general practice nurse consultations.
Current evidence regarding patient satisfaction and enablement arising from general practice nursing care is either quantitative or qualitative. To date, no studies have integrated the results of mixed methods research to provide a deeper understanding of processes that facilitate their achievement.
A concurrent mixed methods study.
Our 2013-2014 concurrent mixed methods study comprised a quantitative study that analysed variables identified in interviews with general practice nurses, patients and practice managers with data from a cross-sectional survey of 678 patients receiving nursing care in 21 general practices; and a qualitative study that used a grounded theory approach to in-depth interviews with nurses and patients from these same practices. Using joint displays, we compared and integrated the results of the multilevel analyses and the grounded theory model derived from these studies.
We conceptualized a model-'developing a positive patient experience with nurses in general practice'-in which time, continuity of care, nursing scope of practice and autonomy, and patients' health conditions provide platforms for the processes of triggering healthcare partnerships and tailoring care in nurse consultations.
This model builds on previous evidence describing processes and characteristics that optimize the quality of care in general practice nurse consultations. It provides a practical tool to inform education and training for general practice nurses and other clinicians.
构建一个概念模型,全面理解支撑普通科护士诊症中患者赋权和满意度的结构和过程。
目前关于普通科护理照顾所产生的患者满意度和赋权的证据,不是定量的就是定性的。迄今为止,没有研究综合混合方法研究的结果,以深入了解促进这些结果实现的过程。
同时进行的混合方法研究。
我们在 2013-2014 年进行的同时进行的混合方法研究包括一项定量研究,该研究分析了与普通科护士、患者和诊所经理访谈中确定的变量,这些变量的数据来自对 21 家普通科诊所中接受护理的 678 名患者的横断面调查;以及一项定性研究,该研究使用扎根理论方法对来自这些相同诊所的护士和患者进行深入访谈。使用联合展示,我们比较和整合了多水平分析和源自这些研究的扎根理论模型的结果。
我们构建了一个模型——“在普通科中与护士建立积极的患者体验”,其中时间、护理连续性、护理实践范围和自主权以及患者的健康状况为触发医疗保健伙伴关系和调整护士诊症中护理的过程提供了平台。
该模型建立在先前描述优化普通科护士诊症中护理质量的过程和特征的证据基础上。它为普通科护士和其他临床医生的教育和培训提供了一个实用工具。