General practice nurses report minimal support as one obstacle to implementing self-management strategies for long-term conditions

2015 ◽  
Vol 18 (3) ◽  
pp. 86-86
Author(s):  
Susan Procter ◽  
Lauren Griffiths
Keyword(s):  
General Practice ◽  
Management Strategies ◽  
Self Management ◽  
Long Term Conditions ◽  
Minimal Support ◽  
Practice Nurses

scholarly journals The feasibility of assessing the Flinders Programme of Patient Self-Management in New Zealand primary care settings

2010 ◽  
Vol 2 (4) ◽  
pp. 294 ◽  
Author(s):  
Margaret Horsburgh ◽  
Janine Bycroft ◽  
Faith Mahony ◽  
Dianne Roy ◽  
Denise Miller ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
New Zealand ◽  
Self Management ◽  
Participant Recruitment ◽  
Practice Nurses ◽  
Management Capacity ◽  
Term Trial

INTRODUCTION: The Flinders ProgramTM has been adopted in New Zealand as a useful and appropriate approach for self-management with primary care clients who have chronic conditions. The Flinders ProgramTM has not been evaluated in New Zealand settings. AIM: To assess the feasibility of undertaking a substantive long-term trial to gauge the effectiveness of primary care nurses using the Flinders ProgramTM to improve health outcomes for New Zealand populations. METHODS: A pilot study was undertaken considering four components of feasibility of conducting a long-term trial: practice recruitment, participant recruitment, delivery of the intervention and outcome measures. This included comparing 27 intervention and 30 control patients with long-term health conditions with respect to change in self-management capacity—Partners in Health (PIH) scale—quality of care using the Patient Assessment of Chronic Illness Care (PACIC) scale and self-efficacy across six months. Intervention participants received care planning with practice nurses using the Flinders ProgramTM in general practices, while control participants received usual care in comparable practices. RESULTS: General practice and participant recruitment was challenging, together with a lack of organisational capacity and resources in general practice for the Flinders ProgramTM. The measures of self-management capacity (PIH), quality of care (PACIC) and self-efficacy were useful and valuable primary outcome measures. DISCUSSION: The overall findings do not support a substantive trial of the Flinders ProgramTM in primary care. Difficulties associated with participant recruitment and ability of practice nurses to undertake the Flinders ProgramTM within general practice need to be resolved. KEYWORDS: Self-management; long-term conditions; chronic conditions; chronic illness; primary care; nurses

scholarly journals Chronic pain: good management of practical pain control strategies is associated with being older, more health activated and having better mental health

2020 ◽  
Vol 12 (3) ◽  
pp. 225
Author(s):  
Claire Budge ◽  
Melanie Taylor ◽  
Materoa Mar ◽  
Chiquita Hansen ◽  
Folole Fai
Keyword(s):  
Mental Health ◽  
Chronic Pain ◽  
General Practice ◽  
Pain Management ◽  
Pain Control ◽  
Control Strategies ◽  
Patient Activation ◽  
Self Management ◽  
Long Term Conditions

ABSTRACT INTRODUCTIONChronic pain affects a large proportion of the adult population and people in pain need to learn how to manage it in order to maintain quality of life. AIMThis study aimed to examine how well people with long-term conditions make use of self-management strategies to control their pain, and to identify personal attributes associated with a higher degree of success. METHODSPeople with chronic pain who participated in the first phase of a longitudinal long-term conditions study in the MidCentral region made up the study sample (N=326, response rate 21%). They completed a questionnaire by mail or online, which included items on pain management, general health, patient activation, experiences with general practice and demographics. RESULTSPain control strategies were managed fairly well overall. Taking pain medication and avoiding caffeine, alcohol, heavy meals and exercise before bed were managed best, whereas sleep, relaxation breathing and remaining socially active were managed least well. A multiple regression analysis found higher scores on patient activation, self-rated overall pain management at home, mental health and older age (≥75 years) to be associated with better management. DISCUSSIONThis study identified pain control strategies that are managed well, and less well, outside of a specific intervention. Results highlight topics for discussion in consultations and identify areas where general practice could provide better self-management support, such as sleep and exercise. Better overall pain control strategy management was most strongly associated with patient activation; that is, a combination of knowledge, skills and confidence to manage health and health care that is amenable to intervention. Improving the level of activation in people with long-term conditions may enhance their use of pain control strategies.

scholarly journals Experiences of self-management support in patients with diabetes and multimorbidity: a qualitative study in Norwegian general practice

2020 ◽  
Vol 21 ◽  
Author(s):  
Monica Sørensen ◽  
Karen Synne Groven ◽  
Bjørn Gjelsvik ◽  
Kari Almendingen ◽  
Lisa Garnweidner-Holme
Keyword(s):  
Diabetes Mellitus ◽  
General Practice ◽  
Well Being ◽  
Self Management ◽  
Management Support ◽  
Structured Interviews ◽  
Long Term Conditions ◽  
Patients With Diabetes ◽  
Emotional Aspects

Abstract Aim: The purpose of this study was to explore how patients with diabetes and multimorbidity experience self-management support by general practitioners (GPs), nurses and medical secretaries in Norwegian general practice. Background: Self-management support is recognised as an important strategy to improve the autonomy and well-being of patients with long-term conditions. Collaborating healthcare professionals (cHCPs), such as nurses and medical secretaries, may have an important role in the provision of self-management support. No previous study has explored how patients with diabetes and multimorbidity experience self-management support provided by cHCPs in general practice in Norway. Methods: Semi-structured interviews with 11 patients with type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) with one or more additional long-term condition were performed during February–May 2017. Findings: Patients experienced cHCPs as particularly attentive towards the psychological and emotional aspects of living with diabetes. Compared to GPs, whose appointments were experienced as stressful, patients found cHCPs more approachable and more likely to address patients’ questions and worries. In this sense, cHCPs complemented GP-led diabetes care. However, neither cHCPs nor GPs were perceived to involve patients’ in clinical decisions or goal setting during consultations.

scholarly journals Measuring care alignment in general practice consultations for people with long-term conditions: an exploratory study

2016 ◽  
Vol 8 (3) ◽  
pp. 256
Author(s):  
Jenny Carryer ◽  
R Claire Budge ◽  
Helen Francis
Keyword(s):  
General Practice ◽  
General Practitioner ◽  
Chronic Care ◽  
Practice Nurse ◽  
Self Report ◽  
Self Management ◽  
Care Provision ◽  
Management Support ◽  
Long Term Conditions

ABSTRACT INTRODUCTION Chronic care Model (CCM) aims to make the care of people with long term conditions (LTC) planned, proactive and patient-centred. The patient assessment of chronic care (PACIC) and our recently developed modified PACIC (MPACIC) allow patient and provider views to be compared. AIM To explore the use of measures of care provision and receipt in primary care long-term conditions management and to assess congruity between patient and provider views of support. METHODS For this observational self-report study, 13 pairs of matched patient and provider dyads (patient/general practitioner and patient/practice nurse) were recruited from general practice. Patients with long-term conditions were asked to rate the support provided by their general practitioner and practice nurse, separately, using the PACIC instrument, a measure of care processes. The modified version for providers (MPACIC) was similarly administered, with GPs and PNs (herein referred to as practitioners) rating the care specifically provided to the 13 patients. Aggregated scores were compared and a case study example was used. RESULTS For 67% of ratings, patients and practitioners agreed (0 or 1 category difference) on the frequency of self-management support provision. Some disagreement was found for 19% of ratings, and considerable disagreement was found for 15%. The strongest agreement was found with Delivery System Design and the least with Goal Setting. Generally, there was little difference between patient/doctor and patient/nurse agreement. DISCUSSION Agreement between patients and practitioners regarding the level of self-management support received and provided was relatively high. This study demonstrates ways the PACIC and MPACIC can be used together to measure patient/practitioner agreement about long-term condition care provision.

scholarly journals Are the needs of people with multiple long-term conditions being met? Evidence from the 2018 General Practice Patient Survey

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e041569
Author(s):  
Lucina Rolewicz ◽  
Eilís Keeble ◽  
Charlotte Paddison ◽  
Sarah Scobie
Keyword(s):  
General Practice ◽  
Unmet Need ◽  
Patient Survey ◽  
Secondary Outcome ◽  
Community Based ◽  
Long Term Conditions ◽  
Local Services ◽  
Community Based Services ◽  
Practice Patient

ObjectivesTo investigate individual, practice and area level variation in patient-reported unmet need among those with long-term conditions, in the context of general practice (GP) appointments and support from community-based services in England.DesignCross-sectional study using data from 199 150 survey responses.SettingPrimary care and community-based services.ParticipantsRespondents to the 2018 English General Practice Patient Survey with at least one long-term condition.Primary and secondary outcome measuresThe primary outcomes were the levels of unmet need in GP and local services among patients with multiple long-term conditions. Secondary outcomes were the proportion of variation explained by practice and area-level factors.ResultsThere was no relationship between needs being fully met in patients’ last practice appointment and number of long-term conditions once sociodemographic characteristics and health status were taken into account (5+conditions−OR=1.04, 95% CI 0.99 to 1.09), but there was a relationship for having enough support from local services to manage conditions (5+conditions−OR=0.84, 95% CI 0.80 to 0.88). Patients with multimorbidity that were younger, non-white or frail were less likely to have their needs fully met, both in GP and from local services. Differences between practices and local authorities explained minimal variation in unmet need.ConclusionsLevels of unmet need are high, particularly for support from community services to manage multiple conditions. Patients who could be targeted for support include people who feel socially isolated, and those who have difficulties with their day-to-day living. Younger patients and certain ethnic groups with multimorbidity are also more likely to have unmet needs. Increased personalisation and coordination of care among these groups may help in addressing their needs.

Benzodiazepines: Dependence and addiction in general practice

2019 ◽  
Vol 12 (11) ◽  
pp. 656-663
Author(s):  
Denise Gleeson
Keyword(s):  
General Practice ◽  
Diagnostic Criteria ◽  
Management Strategies ◽  
Optimal Management ◽  
Benzodiazepine Dependence ◽  
The Uk

Benzodiazepines are only recommended for short periods (2–4 weeks), yet there is evidence of substantial long-term use across the UK. Poor availability of services is one major challenge in supporting withdrawal. Confusion about terminology can lead to inaccurate or inadequate diagnosis of benzodiazepine dependence and addiction, and sub-optimal management of these patients. This article provides an overview of benzodiazepines, diagnostic criteria and available management strategies.

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