Barriers to and enablers of the promotion of patient and family participation in primary healthcare nursing in Brazil, Germany and Spain: A qualitative study.

Background: Most health systems are insufficiently prepared to promote the participation of chronically ill patients in their care. Strong primary health care (PHC) strengthens patients' resources and thus promotes their participation. The tasks of providing continuous care to people with chronic di...

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Publicado en:Health Expectations Vol. 26; no. 6; pp. 2396 - 2409
Autores principales: Heumann, Marcus, Röhnsch, Gundula, Zabaleta‐del‐Olmo, Edurne, Toso, Beatriz Rosana Gonçalves de Oliveira, Giovanella, Ligia, Hämel, Kerstin
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Dec2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2023
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        atl: Barriers to and enablers of the promotion of patient and family participation in primary healthcare nursing in Brazil, Germany and Spain: A qualitative study.
      aug:
        au:
          Heumann, Marcus
          Röhnsch, Gundula
          Zabaleta‐del‐Olmo, Edurne
          Toso, Beatriz Rosana Gonçalves de Oliveira
          Giovanella, Ligia
          Hämel, Kerstin
        affil: Department of Health Services Research and Nursing Science, School of Public Health, Bielefeld University, Bielefeld, Germany
      sug:
        subj:
          Primary Health Care Utilization
          Primary Health Care Germany
          Primary Health Care Spain
          Health Promotion
          Nursing Role
          Health Services Accessibility
          Family Education
          Consumer Participation Education
          Critically Ill Patients
          Human
          Brazil
          Germany
          Spain
          Qualitative Studies
          Interviews
          Nursing Knowledge
          Nursing Practice
          Thematic Analysis
          Patient Attitudes
          Conflict (Psychology)
          Communication
          Work Environment
          Workload
          Education, Interdisciplinary
          Patient Education
          Data Analysis Software
          Funding Source
      ab: Background: Most health systems are insufficiently prepared to promote the participation of chronically ill patients in their care. Strong primary health care (PHC) strengthens patients' resources and thus promotes their participation. The tasks of providing continuous care to people with chronic diseases and promoting self‐management are the responsibility of PHC nurses. Recent research assessing enablers of or barriers to nurses' efforts to support patients' participation has mostly not considered the special situation of patients with chronic diseases or focused on the PHC setting. Objective: To investigate enablers of and barriers to PHC nurses' efforts to promote the participation of chronically ill patients in their care. Methods: We interviewed 34 practicing PHC nurses and 23 key informants with advanced knowledge of PHC nursing practice in Brazil, Germany and Spain. The data was analyzed using thematic coding. Results: We identified four categories of barriers and enablers. (1) Establishing bonds with patients: Interviewees emphasized that understanding patients' views and behaviours is important for PHC nurses. (2) Cooperation with relatives and families: Good relationships with families are fundamental, however conflicts within families could challenge PHC nurses efforts to strengthen participation. (3) Communication and cooperation within PHC teams: PHC nurses see Cooperative team structures as a potential enabler, while the dominance of a 'biomedical' approach to patient care is seen as a barrier. (4) Work environment: Interviewees agreed that increased workload is a barrier to patient participation. Discussion and Conclusions: Supporting patient participation should be acknowledged as an important responsibility for nurses by general practitioners and PHC planners. PHC nurses should be trained in communicative competence when discussing participation with chronically ill patients. Interprofessional education could strengthen other professionals' understanding of patient participation as a nursing task. Patient or Public Contribution: This study is part of a research project associated with the research network 'forges: User‐oriented care: Promotion of health in the context of chronic diseases and care dependency'. The study's focus and provisional results were discussed continuously with partners in health and social care practice and presented to and discussed with the public at two conferences in which patient representatives, professionals and researchers participated.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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