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Self‐management support in routine primary care by nurses
Author(s) -
Westland Heleen,
Schröder Carin D.,
Wit Jessica,
Frings Judith,
Trappenburg Jaap C. A.,
Schuurmans Marieke J.
Publication year - 2018
Publication title -
british journal of health psychology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.05
H-Index - 88
eISSN - 2044-8287
pISSN - 1359-107X
DOI - 10.1111/bjhp.12276
Subject(s) - behaviour change , primary care , observational study , self management , nursing , behavior change methods , medicine , psychology , content analysis , set (abstract data type) , family medicine , psychological intervention , computer science , programming language , social science , pathology , machine learning , sociology
Objectives To examine how and to what extent self‐management support, including behaviour change support, is provided by primary care nurses in routine consultations with chronically ill patients. Design Observational study design. Methods Routine consultations of primary care nurses in the Netherlands with chronically ill patients were audio‐taped and analysed. The analysis identified health topics addressed according to health care standards, self‐management topics addressed using a validated set of topics, and behaviour change techniques (BCTs) using the Behaviour Change Techniques Taxonomy v1. Results Seventy‐eight routine consultations of 17 primary care nurses with chronically ill patients were included in the analysis. Nurses addressed both health topics and self‐management topics in brief, fragmented, and often inconsistent manners. Dietary intake and physical activity were the most frequently addressed topics. Nurses applied 21 BCTs to target behaviour change, but the use of these techniques was mainly inconsistent and implicit. The most consistently used BCTs were review behaviour goal(s) (56.4%) and feedback on behaviour (51.3%). Conclusions Nurses addressed both health topics and self‐management topics in their routine consultations. The duration, frequency, and number of addressed topics differed throughout the consultations. Nurses tended to prioritize the monitoring and optimization of patients’ medical treatment and provided limited self‐management support. Nurses seldom deepened their focus on behaviour change and infrequently used effective techniques to support this change. Adoption of self‐management in primary care, including behaviour change, might be enhanced if nurses consistently and explicitly use effective BCT s in their consultations.Statement of contribution What is already known on this subject?Primary care nurses play a pivotal role in self‐management support for patients with a chronic condition. Adequate self‐management support requires nurses to activate patients and enhance behaviour change. Little is known regarding to what extent nurses provide self‐management support in routine primary care.What does this study add?Self‐management support is brief, fragmented, and inconsistently provided by nurses. Nurses tend to prioritize medical treatment optimization and seldom focus on behavioural change. Nurses’ use of effective behaviour change techniques is low and should be enhanced.