Pelletier Jérôme, Vermette Sarah, Lauzier Sophie, Bujold Mathieu, Bujold Louise, Martin Élisabeth, Guillaumie Laurence
Département des sciences infirmières, Université du Québec à Rimouski, Rimouski, Québec, Canada.
Direction de santé publique du Centre intégré de santé et de services sociaux de Chaudière-Appalaches, Sainte-Marie, Québec, Canada.
J Am Assoc Nurse Pract. 2019 May;31(5):300-308. doi: 10.1097/JXX.0000000000000141.
The increasing prevalence of chronic diseases is driving health care systems to rethink their operations. Despite numerous studies supporting the advantages of primary health care nurse practitioners (PHCNPs) in chronic disease management, implementing practices that fully use the skills of these practitioners seems impeded in the Canadian province of Québec. This study explores the views of leaders involved in primary health care regarding the contributions PHCNPs can make in chronic disease management and the challenges they face in doing so.
Through semistructured interviews, an exploratory descriptive qualitative study was conducted with 20 key informants across Québec who hold a variety of professional positions connected to PHCNPs.
Primary health care nurse practitioners were perceived to be able to improve self-management support for chronic diseases. In reality, however, PHCNPs are mainly devoting their time to clientele in acute care, and current regulations governing their practices limit their involvement in chronic disease management.
Integrating PHCNPs offers a unique opportunity for health care settings to redefine the roles of family physicians and registered nurses and to restructure practices toward a chronic disease-oriented system. A clinical manager should be designated to monitor this restructuring process and ensure its success.
慢性病患病率的不断上升促使医疗保健系统重新审视其运作方式。尽管有大量研究支持初级保健执业护士（PHCNPs）在慢性病管理方面的优势，但在加拿大魁北克省，充分利用这些执业护士技能的实践似乎受到阻碍。本研究探讨了参与初级保健的领导者对PHCNPs在慢性病管理中所能做出的贡献以及他们在这一过程中所面临挑战的看法。
通过半结构化访谈，对魁北克省20名关键信息提供者进行了一项探索性描述性定性研究，这些信息提供者担任与PHCNPs相关的各种专业职位。
人们认为初级保健执业护士能够改善对慢性病的自我管理支持。然而，实际上，PHCNPs主要将时间投入到急症护理的患者身上，并且目前关于其执业的规定限制了他们参与慢性病管理。
整合PHCNPs为医疗保健机构提供了一个独特的机会，以重新定义家庭医生和注册护士的角色，并朝着以慢性病为导向的系统重组实践。应指定一名临床经理来监督这一重组过程并确保其成功。
