Complementary and Integrative Medicine, Aging and Chronic Illness: Towards an Interprofessional Approach in Primary Health Care

Managing chronic illness is highly complex and the pathways to access health care for the patient are unpredictable and often unknown. While multidisciplinary care (MDC) arrangements are promoted in the Australian primary health care system, there is a paucity of research on multidisciplinary collaboration from patients’ perspectives. This exploratory study is the first to gain an understanding of the experiences, perceptions, attitudes and potential role of people with chronic illness (asthma) on the delivery of MDC in the Australian primary health care setting. In-depth semi-structured interviews were conducted with asthma patients from Sydney, Australia. Qualitative analysis of data indicates that patients are significant players in MDC and their perceptions of their chronic condition, perceived roles of health care professionals, and expectations of health care delivery, influence their participation and attitudes towards multidisciplinary services. Our research shows the challenges presented by patients in the delivery and establishment of multidisciplinary health care teams, and highlights the need to consider patients’ perspectives in the development of MDC models in primary care.

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Modifying the PACIC to assess provision of chronic illness care: An exploratory study with primary health care nurses

Journal of Primary Health Care ◽

10.1071/hc10118 ◽

2010 ◽

Vol 2 (2) ◽

pp. 118 ◽

Cited By ~ 7

Author(s):

Jenny Carryer ◽

Claire Budge ◽

Chiquita Hansen ◽

Katherine Gibbs

Keyword(s):

Health Care ◽

Primary Health Care ◽

Chronic Illness ◽

Care Delivery ◽

Self Management ◽

Chronic Illness Care ◽

Management Support ◽

Primary Health ◽

Health Practitioners ◽

Primary Health Care Nurses

INTRODUCTION: In line with Wagners Chronic Care Model, the Patient Assessment of Chronic Illness Care (PACIC) has been developed to evaluate chronic illness care delivery from the patient's perspective. Modification of the instrument to assess the same aspects of care delivery from the health practitioners perspective would enable individual practitioners to evaluate their own provision of self-management support, and would also enable a more direct comparison between care provided and care received within the chronic illness context. AIM: To explore the potential of a modified PACIC instrument to assess individual health practitioners delivery of care to chronic illness patients with a sample of primary health care nurses. METHODS: Seventy-seven primary care nurses completed the modified PACIC, reworded to ask about care provision rather than receipt of care. An additional seven cultural sensitivity items were included, as were questions about the suitability of the types of chronic illness care and who should be providing the care. RESULTS: The modified PACIC items appear to be appropriate for use with health practitioners. Agreement that the types of care described in the PACIC should be provided was almost unanimous, and the predominant view was that self-management support should be provided by both nurses and doctors. Mean scale scores were higher than those generally reported from studies using the PACIC. DISCUSSION: The results of this first evaluation of a modified PACIC suggest that the original items plus the cultural sensitivity items can be used to assess self-management support by individual health practitioners. KEYWORDS: Chronic illness; self-management; primary health care, nurses

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Using Foucault: Genealogy, Governmentality and the Problem of Chronic Illness

Genealogy ◽

10.3390/genealogy2020013 ◽

2018 ◽

Vol 2 (2) ◽

pp. 13 ◽

Cited By ~ 3

Author(s):

Ann Reich ◽

Margo Turnbull

Keyword(s):

Health Care ◽

Primary Health Care ◽

Chronic Illness ◽

Integrated Care ◽

Chronic Diseases ◽

Unique Contribution ◽

Australian Study ◽

Primary Health ◽

Health And Disease ◽

Critical Consideration

This article explores the unique contribution that Foucault’s work on genealogy and governmentality can make to the analysis of contemporary programs of government. The article uses an Australian study of the ‘problem’ of chronic illness to argue that this perspective offers valuable insights into how ‘problems’ such as chronic illness have become linked to advanced liberal discourses and practices of self-governing and self-responsibility. These insights are particularly valuable in fields such as primary health care that have a noted shortage of critical and reflective studies that explore the links between people and changing ideas of health and disease. This article details how taking up an analytics of governmentality and political genealogy informed by Foucault, facilitated the tracing of the dominant discourses and practices, and the connections to the day-to -day lives of the clients with chronic diseases. Importantly, this approach opened up a more critical consideration of the ways in which dispersed approaches to governing through programs, such as integrated care, shape and influence the lives of individuals. These dispersed ways of governing are not linear but rather unfold through ongoing relays, connections and the (re)production of discourses.

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