Professionals' perspectives on existing practice and conditions for nurse-led gout care based on treatment recommendations: a qualitative study in primary healthcare
Gout affects nearly 2 % of the population and is associated with repeated painful flares of arthritis. Preventive urate-lowering therapy is widely available, but only one third of patients receive adequate treatment. Lack of knowledge among healthcare professionals and patients within primary health...
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| Veröffentlicht in: | BMC PRIMARY CARE 2022-04, Vol.23 (1), p.71, Article 71 |
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| creator | Sedelius, Helene Tistad, Malin Bergsten, Ulrika Dehlin, Mats Iggman, David Wallin, Lars Svärd, Anna |
| description | Gout affects nearly 2 % of the population and is associated with repeated painful flares of arthritis. Preventive urate-lowering therapy is widely available, but only one third of patients receive adequate treatment. Lack of knowledge among healthcare professionals and patients within primary healthcare are implicated as partial explanations for this undertreatment. Nurse-led care has proved to be an effective model when treating patients with gout, but there is a need for more knowledge about factors that can be expected to influence the future implementation of such care. The aim of this study was to describe factors influencing existing gout care in primary healthcare and the conditions for a future implementation of nurse-led gout care based on national treatment recommendations.
In this qualitative study, focus group discussions with 56 nurses and physicians and individual interviews with eight managers were conducted at nine primary healthcare units in central Sweden. A deductive qualitative content analysis based on the main constructs of the framework Integrated Promoting Action on Research Implementation in Health Services was followed by an inductive analysis within the frames of the main constructs: innovation, recipients and context.
Gout-related contacts with primary healthcare was described as being patient initiated, diagnostics was in some respects complex and nurse-led care was experienced as a favourable primary healthcare model in general (innovation). Gout was seen as a low-priority condition with acute flares and there was inadequate knowledge of gout, including preventive treatment (recipients). Primary healthcare was perceived as having a holistic but fragmented responsibility for gout care, recommendations against keeping waiting lists complicated follow-up appointments and a need for motivation and support when introducing new practices was emphasised (context).
In this study, investigating the perspective of professionals, several factors were found to influence existing gout care. It will be crucial to target these factors in the development of a future implementation strategy. |
| doi_str_mv | 10.1186/s12875-022-01677-z |
| format | Article |
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In this qualitative study, focus group discussions with 56 nurses and physicians and individual interviews with eight managers were conducted at nine primary healthcare units in central Sweden. A deductive qualitative content analysis based on the main constructs of the framework Integrated Promoting Action on Research Implementation in Health Services was followed by an inductive analysis within the frames of the main constructs: innovation, recipients and context.
Gout-related contacts with primary healthcare was described as being patient initiated, diagnostics was in some respects complex and nurse-led care was experienced as a favourable primary healthcare model in general (innovation). Gout was seen as a low-priority condition with acute flares and there was inadequate knowledge of gout, including preventive treatment (recipients). Primary healthcare was perceived as having a holistic but fragmented responsibility for gout care, recommendations against keeping waiting lists complicated follow-up appointments and a need for motivation and support when introducing new practices was emphasised (context).
In this study, investigating the perspective of professionals, several factors were found to influence existing gout care. It will be crucial to target these factors in the development of a future implementation strategy.</description><identifier>ISSN: 2731-4553</identifier><identifier>EISSN: 2731-4553</identifier><identifier>EISSN: 1471-2296</identifier><identifier>DOI: 10.1186/s12875-022-01677-z</identifier><identifier>PMID: 35392809</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>barriers ; Care and treatment ; Chronic illnesses ; Data collection ; Diabetes ; Disease ; education ; Evaluation ; Experiences ; Focus groups ; General & Internal Medicine ; Gout ; Gout - diagnosis ; Gout Suppressants - therapeutic use ; Humans ; I-PARIHS ; Implementation ; Interviews ; management ; Medical care ; Medicin och hälsovetenskap ; Nurse's Role ; Nurse-led care ; Nurses ; Nursing ; of-life ; Omvårdnad ; patient ; Patient outcomes ; Personnel experiences ; Physicians ; Primary Health Care ; Primary healthcare ; Qualitative Research ; Quality management ; Quality of life ; Rheumatism</subject><ispartof>BMC PRIMARY CARE, 2022-04, Vol.23 (1), p.71, Article 71</ispartof><rights>2022. The Author(s).</rights><rights>COPYRIGHT 2022 BioMed Central Ltd.</rights><rights>2022. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c696t-84324c05e73112eeced3fabc89591bd7a632b1ee3b0e92b6f4e68e6366fc2e863</citedby><cites>FETCH-LOGICAL-c696t-84324c05e73112eeced3fabc89591bd7a632b1ee3b0e92b6f4e68e6366fc2e863</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8988383/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8988383/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,554,729,782,786,866,887,27933,27934,53800,53802</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35392809$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:du-41348$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-473774$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttps://gup.ub.gu.se/publication/316064$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:149284533$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Sedelius, Helene</creatorcontrib><creatorcontrib>Tistad, Malin</creatorcontrib><creatorcontrib>Bergsten, Ulrika</creatorcontrib><creatorcontrib>Dehlin, Mats</creatorcontrib><creatorcontrib>Iggman, David</creatorcontrib><creatorcontrib>Wallin, Lars</creatorcontrib><creatorcontrib>Svärd, Anna</creatorcontrib><title>Professionals' perspectives on existing practice and conditions for nurse-led gout care based on treatment recommendations: a qualitative study in primary healthcare</title><title>BMC PRIMARY CARE</title><addtitle>BMC Prim Care</addtitle><description>Gout affects nearly 2 % of the population and is associated with repeated painful flares of arthritis. Preventive urate-lowering therapy is widely available, but only one third of patients receive adequate treatment. Lack of knowledge among healthcare professionals and patients within primary healthcare are implicated as partial explanations for this undertreatment. Nurse-led care has proved to be an effective model when treating patients with gout, but there is a need for more knowledge about factors that can be expected to influence the future implementation of such care. The aim of this study was to describe factors influencing existing gout care in primary healthcare and the conditions for a future implementation of nurse-led gout care based on national treatment recommendations.
In this qualitative study, focus group discussions with 56 nurses and physicians and individual interviews with eight managers were conducted at nine primary healthcare units in central Sweden. A deductive qualitative content analysis based on the main constructs of the framework Integrated Promoting Action on Research Implementation in Health Services was followed by an inductive analysis within the frames of the main constructs: innovation, recipients and context.
Gout-related contacts with primary healthcare was described as being patient initiated, diagnostics was in some respects complex and nurse-led care was experienced as a favourable primary healthcare model in general (innovation). Gout was seen as a low-priority condition with acute flares and there was inadequate knowledge of gout, including preventive treatment (recipients). Primary healthcare was perceived as having a holistic but fragmented responsibility for gout care, recommendations against keeping waiting lists complicated follow-up appointments and a need for motivation and support when introducing new practices was emphasised (context).
In this study, investigating the perspective of professionals, several factors were found to influence existing gout care. It will be crucial to target these factors in the development of a future implementation strategy.</description><subject>barriers</subject><subject>Care and treatment</subject><subject>Chronic illnesses</subject><subject>Data collection</subject><subject>Diabetes</subject><subject>Disease</subject><subject>education</subject><subject>Evaluation</subject><subject>Experiences</subject><subject>Focus groups</subject><subject>General & Internal Medicine</subject><subject>Gout</subject><subject>Gout - diagnosis</subject><subject>Gout Suppressants - therapeutic use</subject><subject>Humans</subject><subject>I-PARIHS</subject><subject>Implementation</subject><subject>Interviews</subject><subject>management</subject><subject>Medical care</subject><subject>Medicin och hälsovetenskap</subject><subject>Nurse's Role</subject><subject>Nurse-led care</subject><subject>Nurses</subject><subject>Nursing</subject><subject>of-life</subject><subject>Omvårdnad</subject><subject>patient</subject><subject>Patient outcomes</subject><subject>Personnel experiences</subject><subject>Physicians</subject><subject>Primary Health Care</subject><subject>Primary healthcare</subject><subject>Qualitative Research</subject><subject>Quality management</subject><subject>Quality of life</subject><subject>Rheumatism</subject><issn>2731-4553</issn><issn>2731-4553</issn><issn>1471-2296</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>D8T</sourceid><recordid>eNqFk8tu1TAQhiMEolXpC7BAlliABCm-xXG6QDoqV6kSLICt5TiT1CUnPrWTQvs-vCeTntMboqAsMpl8_4zH9p9ljxndY0yrV4lxXRY55TynTJVlfn4v2-alYLksCnH_RryV7aZ0TCnlpSq5EA-zLVGIimtabWe_PsfQQko-DLZPz8gKYlqBG_0pJBIGAj99Gv3QkVW0mHVA7NAQF4bGj6hJpA2RDFNMkPfQkC5MI3E2Aqltwm-sMEaw4xKGkURwYYlRYy-k-8SSk8n2frRzO5LGqTkjfsBWfmnjGTkC249Hc7VH2YMWlwe7m_dO9vXd2y8HH_LDT-8_HiwOc6cqNeZaCi4dLQBHZxzAQSNaWztdFRWrm9IqwWsGIGoKFa9VK0FpUEKp1nHQSuxk-bpu-gGrqTablZhgvdmkvmMERhaS8wr56k5-FUNzLboUMokbLwsh_tmrm1YGU900SwRTVEnkX97Jv_HfFibEzkyTkaUoyxl_8X-8QZwJqZF-vaYRXULj8Lii7W_Pc-vP4I9MF06NrrQWep7m-aZADCcTpNEsfXLQ93aAMCXDldS6Krmc0ad_oMdhivP1Q6rglApW0Wuqsz0YP7QB-7q5qFnghEKxSs4HsPcXCp8Glh5vKbQe87cEfC1wMaQUob2akVEzG8usjWXQWObCWOYcRU9u7s6V5NJG4jfWNCT0</recordid><startdate>20220407</startdate><enddate>20220407</enddate><creator>Sedelius, Helene</creator><creator>Tistad, Malin</creator><creator>Bergsten, Ulrika</creator><creator>Dehlin, Mats</creator><creator>Iggman, David</creator><creator>Wallin, Lars</creator><creator>Svärd, Anna</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>ZZAVC</scope><scope>ACNBI</scope><scope>DF2</scope><scope>F1U</scope></search><sort><creationdate>20220407</creationdate><title>Professionals' perspectives on existing practice and conditions for nurse-led gout care based on treatment recommendations: a qualitative study in primary healthcare</title><author>Sedelius, Helene ; 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Preventive urate-lowering therapy is widely available, but only one third of patients receive adequate treatment. Lack of knowledge among healthcare professionals and patients within primary healthcare are implicated as partial explanations for this undertreatment. Nurse-led care has proved to be an effective model when treating patients with gout, but there is a need for more knowledge about factors that can be expected to influence the future implementation of such care. The aim of this study was to describe factors influencing existing gout care in primary healthcare and the conditions for a future implementation of nurse-led gout care based on national treatment recommendations.
In this qualitative study, focus group discussions with 56 nurses and physicians and individual interviews with eight managers were conducted at nine primary healthcare units in central Sweden. A deductive qualitative content analysis based on the main constructs of the framework Integrated Promoting Action on Research Implementation in Health Services was followed by an inductive analysis within the frames of the main constructs: innovation, recipients and context.
Gout-related contacts with primary healthcare was described as being patient initiated, diagnostics was in some respects complex and nurse-led care was experienced as a favourable primary healthcare model in general (innovation). Gout was seen as a low-priority condition with acute flares and there was inadequate knowledge of gout, including preventive treatment (recipients). Primary healthcare was perceived as having a holistic but fragmented responsibility for gout care, recommendations against keeping waiting lists complicated follow-up appointments and a need for motivation and support when introducing new practices was emphasised (context).
In this study, investigating the perspective of professionals, several factors were found to influence existing gout care. It will be crucial to target these factors in the development of a future implementation strategy.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>35392809</pmid><doi>10.1186/s12875-022-01677-z</doi><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; SpringerNature Journals; SWEPUB Freely available online; PubMed Central Open Access; Springer Nature OA Free Journals; Access via BioMed Central; PubMed Central |
| subjects | barriers Care and treatment Chronic illnesses Data collection Diabetes Disease education Evaluation Experiences Focus groups General & Internal Medicine Gout Gout - diagnosis Gout Suppressants - therapeutic use Humans I-PARIHS Implementation Interviews management Medical care Medicin och hälsovetenskap Nurse's Role Nurse-led care Nurses Nursing of-life Omvårdnad patient Patient outcomes Personnel experiences Physicians Primary Health Care Primary healthcare Qualitative Research Quality management Quality of life Rheumatism |
| title | Professionals' perspectives on existing practice and conditions for nurse-led gout care based on treatment recommendations: a qualitative study in primary healthcare |
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