The feasibility, acceptability and sustainability of nurse-led chronic disease management in Australian general practice: The perspectives of key stakeholders

Authors

  • Desley G Hegney RN BA (Hons) PhD,

    Professor of Nursing, Corresponding author
    • School of Nursing and Midwifery, Curtin University, Perth and Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
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  • Elizabeth Patterson BSc MHSc (Nursing) PhD,

    Head
    1. Department of Nursing, Melbourne School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
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  • Diann S Eley MSc PhD,

    Associate Professor, MBBS Research Coordinator
    1. School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
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  • Rosemary Mahomed MComHlthPrac (Hons) PhD,

    Practice Nurse
    1. School of Nursing and Midwifery, Gold Coast Campus, Griffith University, Southport, Queensland, Australia
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  • Jacqui Young RN BN MN (Edu)

    PhD candidate, Lecturer
    1. School of Nursing and Midwifery, Herston Campus, The University of Queensland, Brisbane, Queensland, Australia
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Correspondence: Desley G Hegney, Curtin University, GPO Box U1987, Perth, Western Australia 8645. Email: desley.hegney@curtin.edu.au

Abstract

This was the first Australian study investigating the acceptability, feasibility and sustainability of a nurse-led model of chronic disease management in general practice. A concurrent mixed-methods design was used within a 12-month intervention of nurse-led care in three general practices. Adult patients with type 2 diabetes, hypertension and/or stable ischaemic heart disease were randomized into nurse-led or standard care. Semi-structured interviews explored perceptions of key stakeholders towards this model including patients in the nurse-led arm, and all practice staff pre- and posttrial. The data were thematically analysed and the emergent themes were: importance of time; collaborative relationships; nurse job satisfaction, confidence and competence; patient self-management and choice. Our findings showed that nurses provided chronic disease management that was acceptable, feasible and sustainable. The collaborative involvement of doctors was intrinsic to patient acceptability of nurse-led care that facilitated job satisfaction, and therefore retention and growth within this nursing speciality.

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