Patient Reported Experiences of Receiving Person-Centred, Nurse-Led Follow-Up After Revascularisation for Intermittent Claudication: Secondary Analysis of a Randomised Controlled Trial.

AIM

To evaluate the quality of care from the patients' perspective after receiving either person-centred, nurse-led follow-up or standard care after surgical treatment of intermittent claudication.

DESIGN

Secondary analysis of a randomised controlled trial.

METHODS

Patients at two centres for vascular surgery in Stockholm, Sweden were randomised to either a person-centred, nurse-led follow-up programme (intervention group) or a standard follow-up programme with surgeons. During their visits at 4 to 8 weeks and 1 year after surgery, they received the questionnaire Quality from patients' perspective with 28 items. The patients responded to each item from two aspects: (1) how they perceived the quality of received care and (2) subjective importance (how important the care was for them).

RESULTS

A total of 104 of 138 patients at 4-8 weeks and 159 of 193 patients at 1 year after surgery completed the questionnaire. At 4-8 weeks, the intervention group scored significantly higher perceived quality of care regarding five items: receiving useful information about "How I should take care of myself" and "Which nurse were responsible for my care", "Nurses were respectful towards me", "Nurses showed commitment/cared about me" and "Easy to get in contact with the clinic through telephone". At 1 year, the intervention group scored higher regarding two items: "Which nurses were responsible for my care" and "Next of kin treated well".

CONCLUSION

Person-centred, nurse-led follow-up as implemented in this study has been shown to lead to a higher perception of quality of care regarding information about self-care, the experience of being respected, and knowing the care provider responsible for their care. Thus, it could contribute towards improved patient satisfaction without compromising the perception of quality of care regarding other factors such as receiving the best medical care or timeliness.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This study addresses how patients with intermittent claudication, who underwent revascularisation, perceive a follow-up care that is person-centred and nurse-led compared to standard care delivered by surgeons. The results indicate that patients find the person-centred and nurse-led follow-up programme satisfactory, with equal or higher quality of care and that follow-up can be delivered by nurses with retained patient safety. Thus, vascular units may consider transitioning follow-up care from surgeons to nurses while maintaining positive patient's perception of quality of care, patient satisfaction and safety.

REPORTING METHOD

Reporting of the work was made using the Consolidated Standards of Reporting Trials (CONSORT) statement.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

TRIAL REGISTRATION

Study Details | Person-centred Follow-up and Health Promotion Programme After Revascularization for Intermittent Claudication | ClinicalTrials.gov: NCT03283358.