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Keywords:

  • discrete choice experiment;
  • extended role;
  • patient opinion;
  • patient satisfaction;
  • practice nurse;
  • primary health care

Abstract

Background  This study investigated patient opinion about the provision of nurse-led vs. doctor-led primary health care in the treatment of minor illness.

Design  A postal questionnaire survey including discrete choice experiment (DCE) of a national sample followed by telephone interviews with respondent volunteers.

Setting and participants  A large random sample of the population of Scotland from a range of general practices including traditional and extended practice nursing roles was invited to participate.

Main outcome measures  Patient satisfaction with, opinion of and preference for practice nurse (PN) vs. doctor consultation in primary care in relation to gender, age, education and income.

Results  Questionnaire response rate was 49% (1343 of 2740). Women, younger people, the less well-educated and those with higher income had a more positive attitude towards the PN. Older people had a more positive attitude to the doctor. Results from the DCE indicated that whilst most respondents would prefer a doctor consultation, many would be happy to consult with a nurse if other aspects of the consultation were improved.

Forty-eight people were interviewed. The main perceived differences between doctors and nurses were academic ability and qualifications. Most respondents thought nurses could deal with relatively minor problems and should be able to prescribe some drugs.

Conclusion  Patients would always want their choice of health professional to be available at first contact. However, this study suggests that, in primary health-care practices, if nurses take on more roles previously the preserve of doctors, patients would accept them, particularly if patients receive information on nurses’ capabilities.