DEFACTUM - Public Health Research, Central Denmark Region, Aarhus, Denmark.
Department of Public Health, Aarhus University, Aarhus, Denmark.
J Adv Nurs. 2024 Jun;80(6):2475-2486. doi: 10.1111/jan.15988. Epub 2023 Nov 27.
To explore registered nurses' perspectives on challenges and facilitators to implementing a telephone-based self-management support (SMS) intervention (Proactive Health Support) as an everyday healthcare practice, during the early stages of implementation.
Data were collected using a qualitative research design involving focus-group interviews and participant observations.
We conducted participant observation following nine nurses and four focus group interviews with 14 nurses. Data were analysed using thematic analyses.
Proactive Health Support was implemented in units organized independently of the existing organizational units within healthcare services. This independent organization, along with the intervention's generic (non-disease specific) design, empowered nurses to become autonomous practitioners capable of prioritizing the operationalization of SMS as an everyday healthcare practice. However, unlearning already embedded medical practices and establishing new nursing roles necessary to accommodate the intervention in practice was experienced a challenge. Education and supervision were identified as valuable tools for successful implementation.
Our study highlights the significance of organizational context and autonomy in successful SMS implementation. Balancing external factors like organizational context, priority and time is vital, but navigating the internal shift in professional practice is equally crucial. Role transition processes can constitute challenges demanding accommodation.
From a nursing perspective, this study highlights that practising SMS requires substantial training and education. Generic SMS interventions can introduce higher levels of contingency due to their versatile nature. Thus, equipping nurses with competencies that enable them to navigate this unpredictability flexibly is crucial.
Policymakers and administrators should allocate resources and support implementation processes in ways that accommodate both internal and external conditions to facilitate nurses in delivering effective SMS.
This study adheres to the SRQR guideline.
No patient or public contribution.
探讨注册护士在实施基于电话的自我管理支持（SMS）干预措施（Proactive Health Support）作为日常医疗保健实践时所面临的挑战和促进因素的观点，这一阶段处于实施的早期。
本研究采用定性研究设计，包括焦点小组访谈和参与式观察。
我们在 9 名护士和 4 次焦点小组访谈中对 14 名护士进行了参与式观察。使用主题分析对数据进行分析。
Proactive Health Support 在独立于医疗保健服务中现有组织单位的单元中实施。这种独立的组织以及干预措施的通用（非特定疾病）设计，使护士能够成为自主实践者，能够将 SMS 的实施作为日常医疗保健实践的重点。然而，摒弃已经嵌入的医疗实践并建立必要的新护理角色以适应实践中的干预措施是一项挑战。教育和监督被认为是成功实施的有价值的工具。
我们的研究强调了组织背景和自主权在成功实施 SMS 中的重要性。平衡组织背景、优先级和时间等外部因素至关重要，但驾驭专业实践中的内部转变同样重要。角色转换过程可能构成需要适应的挑战。
从护理角度来看，这项研究强调实施 SMS 需要大量的培训和教育。由于通用 SMS 干预措施具有多种用途，因此可能会引入更高水平的不确定性。因此，为护士提供使他们能够灵活应对这种不可预测性的能力至关重要。
政策制定者和管理人员应分配资源并以支持实施过程的方式支持内部和外部条件，以帮助护士有效地提供 SMS。
本研究遵循 SRQR 指南。
无患者或公众贡献。
