Poitras Marie-Eve, Chouinard Maud-Christine, Fortin Martin, Girard Ariane, Crossman Sue, Gallagher Frances
Département des Sciences de la Santé, Université du Québec à Chicoutimi, Chicoutimi, Québec, Canada.
Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean, Saguenay, Québec, Canada.
Nurs Inq. 2018 Oct;25(4):e12250. doi: 10.1111/nin.12250. Epub 2018 Jul 8.
Family Medicine Groups (FMGs) are the most recently developed primary care organizations in Quebec (Canada). Nurses within FMGs play a central role for patients with chronic diseases (CD). However, this complex role and the nursing activities related to this role vary across FMGs. Inadequate knowledge of nursing activities limits the implementation of exemplary nursing practices. This study aimed to describe FMG nursing activities with patients with CD and to describe the facilitators and barriers to these activities. A multiple-case study was performed with ten nurses practicing among patients with CD in FMGs. Five data sources were used to provide an in-depth description of nursing activities and the facilitators and barriers to the development of these activities. After qualitative data analysis, findings show that nursing activities are clustered into five domains: Global assessment of the patient, Care management, Health promotion, Nurse-physician collaboration, and Planning services for patients with CD. Activities vary depending on contextual factors identified in each case. This multiple-case study provides a clear description of nursing activities with patients with CD. There is a need for improved nursing activities and expertise in domains of activities that are less present in FMGs, such as case management and interprofessional collaboration.
家庭医学团体（FMGs）是加拿大魁北克省最近发展起来的初级保健组织。FMGs中的护士在慢性病（CD）患者护理中发挥着核心作用。然而，这一复杂角色以及与该角色相关的护理活动在不同的FMGs中存在差异。对护理活动的了解不足限制了模范护理实践的实施。本研究旨在描述FMGs中护士对CD患者的护理活动，并描述这些活动的促进因素和障碍。对在FMGs中为CD患者提供护理的10名护士进行了多案例研究。使用了五个数据源来深入描述护理活动以及这些活动发展的促进因素和障碍。经过定性数据分析，结果表明护理活动可分为五个领域：患者综合评估、护理管理、健康促进、护士与医生协作以及为CD患者规划服务。活动因每个案例中确定的背景因素而异。这项多案例研究清晰地描述了FMGs中护士对CD患者的护理活动。在FMGs中较少出现的活动领域，如病例管理和跨专业协作，需要改进护理活动并提升专业技能。
