Yong Loo Lin School of Medicine, Alice Lee Centre for Nursing Studies, Clinical Research Centre, National University of Singapore, Singapore, Singapore.
National University Heart Centre, Singapore, Singapore.
J Clin Nurs. 2020 May;29(9-10):1623-1634. doi: 10.1111/jocn.15224. Epub 2020 Mar 3.
To explore patients' understanding of the role of an advanced practice nurse (APN).
The increasing prevalence of multimorbidities among people living with cardiovascular disease (CVD) has increased the complexity of their clinical care. Implementing the role of APNs in new models of care has been shown to improve outcomes in the CVD population. However, the CVD population's understanding of and experiences with the APN role have not been examined in Singapore.
An exploratory descriptive qualitative design using semi-structured face-to-face individual interviews was undertaken (November 2017-March 2018). Fourteen participants were purposively sampled from an outpatient clinic in one of Singapore's national heart centres. Thematic analysis was undertaken. The COREQ guidelines were adhered to.
The multi-ethnic sample included ten males and four females. Two main themes were identified: (1) APNs play a complementary role to doctors and (2) the acceptance of the APN role takes time. Each theme was supported by three subthemes to further elucidate the role and acceptance of APNs.
A lack of understanding of the role of APNs is present, thereby causing the less than optimal patient acceptance of APNs. As patients with CVD experience improvements to their health through APN-led services, they may gain confidence in APNs' skills and knowledge.
When introducing new roles, fully explaining these roles to the target population is pertinent as it will be facilitative to patient engagement and optimisations of care. The findings support the call for APNs to explain the value and essence of advanced practice nursing more effectively. There should be a greater emphasis on teaching APNs to introduce and explain the role of APNs through APN preparatory education and incorporating this practice in APN practice standards, especially in contexts where APN development is premature.
探索患者对高级实践护士（APN）角色的理解。
患有心血管疾病（CVD）的人群中多种疾病的患病率不断增加，增加了他们临床护理的复杂性。在新的护理模式中实施 APN 角色已被证明可以改善 CVD 人群的结局。然而，新加坡尚未研究 CVD 人群对 APN 角色的理解和体验。
采用探索性描述性定性设计，使用半结构式面对面个人访谈（2017 年 11 月至 2018 年 3 月）。从新加坡一家国家心脏中心的门诊诊所中，有针对性地抽取了 14 名参与者。进行了主题分析。遵循 COREQ 指南。
多民族样本包括 10 名男性和 4 名女性。确定了两个主要主题：（1）APN 与医生互补；（2）接受 APN 角色需要时间。每个主题都有三个子主题支持，以进一步阐明 APN 的角色和接受度。
对 APN 角色的理解不足，导致患者对 APN 的接受程度不理想。随着 CVD 患者通过 APN 主导的服务改善健康状况，他们可能会对 APN 的技能和知识充满信心。
在引入新角色时，向目标人群充分解释这些角色非常重要，因为这将有助于患者的参与和优化护理。研究结果支持呼吁 APN 更有效地解释高级实践护理的价值和本质。应该更加重视教导 APN 通过 APN 预备教育介绍和解释 APN 角色，并将其纳入 APN 实践标准，特别是在 APN 发展不成熟的情况下。
