An Acceptability and Feasibility Study of a Nurse-Led Model of Contraception and Abortion Care in Rural General Practice.

AIM

To assess the acceptability and perceived feasibility of integrating a co-designed nurse-led model of contraception and medication abortion care within rural and regional general practices.

DESIGN

Qualitative exploratory design utilising Sidani and Braden's indicators of acceptability and feasibility.

METHODS

We conducted semi-structured interviews with 12 practice nurses, 8 general practitioners and 3 practice managers who currently or previously worked in rural, regional or remote general practice. Participants were recruited purposively through social media, partner organisation newsletters and snowballing. During the interview, participants were presented with an overview of the co-designed model of care and asked specific questions to gain feedback on its acceptability and perceived feasibility. Data were analysed in NVivo using template analysis and iterative categorisation. Findings were mapped according to Sidani and Braden's indicators of acceptability and feasibility.

RESULTS

Three overarching themes were identified: nurses are acceptable providers, factors influencing the feasibility of the model and factors supporting greater feasibility of the model. Participants found the nurse-led model acceptable, describing nurses as suitable and sometimes preferred providers of long-acting reversible contraception and abortion care in rural and regional settings. They also perceived the model as feasible, citing similarities to existing care processes such as infant immunisations and chronic disease management, contributing to its feasibility. However, contextual factors such as the need to adapt the model to each clinic and patient's unique needs, foster strong general practitioner-practice nurse professional relationships and ensure that staff have shared values and adequate training for contraception and abortion provision were described as critical for feasibility.

CONCLUSION

Overall, participants found the nurse-led model of care to be acceptable and feasible for implementation in rural and regional general practices. This perception carries important implications for policy and practice, highlighting the need for supportive policies to enhance the effectiveness of such models across Australian general practice.

IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE

Our findings emphasise the need for initiatives aimed at addressing inadequate funding for nurse-led care, improving documentation of this care, enhancing understanding among general practitioners and nurses regarding the scope of practice for practice nurses, and overcoming training barriers specific to rural areas. These measures are essential for enabling nurse-led models of contraception and medication abortion to function effectively in practice.

REPORTING METHOD

This paper is reported according to the consolidated criteria for reporting qualitative research (COREQ) guidelines.

PATIENT OR PUBLIC CONTRIBUTION

Two consumer representatives contributed to the development of the co-design methodology as members of the ORIENT Intervention Advisory Group Governance Committee.