Using the lens of enablement to explore patients’ experiences of Nurse Practitioner care in the Primary Health Care setting
- Authors: Frost, Jane , Currie, Marian , Cruickshank, Mary , Northam, Holly
- Date: 2018
- Type: Text , Journal article
- Relation: Collegian Vol. 25, no. 2 (2018), p. 193-199
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- Description: Background: Patient enablement is a patient-centred concept reflecting a patient's ability to cope, understand and manage their own health. It can be used as a measure of the quality of care and has been linked with improved patient outcomes. While there have been studies into patient enablement following consultations with General Practitioners (GPs) and practice nurses, Nurse Practitioners’ (NPs) role in enabling patients remains unexplored. Aim: To use the lens of enablement to explore patients’ lived experience of NP care in a Primary Health Care (PHC) setting in Australia. Methods: Using a qualitative approach, 12 patients who had consulted an NP in PHC participated in unstructured interviews. An interpretative phenomenological approach was used to inform the study. A secondary analysis was conducted to explore possible synergies and resonance between the data and the constructs of the Patient Enablement Instrument (PEI). Findings: This small qualitative study found that, following consultations with NPs in PHC, patients reported personal approaches and behaviours consistent with enablement. Three key existential themes appeared to contribute to patient enablement: the way NPs used consultation time (temporality), the building of partnerships between NPs and patients (relationality) and through NPs’ holistic and hands-on consultation approach (corporality). The effective use of time in the consultation was seen as particularly important. Conclusion: The findings from this study suggest consultations with NPs do enable patients. This is a previously undocumented strength of NP care. Further research, using a variety of settings, methods and patient and health care provider populations, is recommended. © 2017 Australian College of Nursing Ltd
The shortage-surplus paradox : a literature review of primary health care accessibility
- Authors: Terry, Melissa , Terry, Daniel , Hoang, Ha , Hannah, Chona
- Date: 2013
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 1, no. 3 (2013), p. 40-50
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- Description: The National Primary Health Care Strategy in Australia recommends primary health care services need to be clinically and culturally appropriate and delivered in a timely and affordable manner. However simultaneously recognised, access is still inequitable in among various population groups and many areas of Australia. Geographical Information System (GIS) have been used to explore geographical health disparities, planning health care service delivery and provide data in a meaningful way to inform public health strategies. Moreover, GIS has also been used to spatially analyse, measure and provide insight into a population’s accessibility to health care services. A literature search was conducted to identify studies which examined primary health care accessibility using GIS techniques among various urban and rural populations. A limited number of studies demonstrated in addition to distance; time; and location, low socioeconomic status, Culturally and Linguistically Diverse (CALD) background among other factors influences health care access. In addition, other factors were identified to impact health care access, which is an individualised process, influenced by individual characteristics, beliefs, attitudes, and an individual’s activity space. As health care accessibility becomes more prominent within policy, among practitioners and increasingly researched, it has the potential to move beyond recognising areas of poor accessibility among individuals and communities. With a greater integration of both spatial and aspatial data, the process has the likelihood, to provide greater insight into patient behaviour, public perception, amelioration service quality and improve population health and wellbeing.
Investing in big ideas: utilisation and cost of Medicare Allied Health services in Australia under the Chronic Disease Management initiative in primary care
- Authors: Cant, Robyn , Foster, Michele
- Date: 2011
- Type: Text , Journal article
- Relation: Australian health review : a publication of the Australian Hospital Association Vol. 35, no. 4 (2011), p. 468-474
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- Description: To critically examine utilisation of the 13 allied health services provided through Medicare Chronic Disease Management program and related general practitioner (GP) care planning initiatives.
Priority setting in primary health care : A framework for local catchments
- Authors: McDonald, John , Ollerenshaw, Alison
- Date: 2011
- Type: Text , Journal article
- Relation: Rural and remote health Vol. 11, no. 2 (2011), p. 1714
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- Description: Managers and staff in primary health care partnerships in local catchments, particularly in regional areas, are periodically required to work collaboratively to set health priorities. Setting priorities involves making decisions about which health needs are most important and what programs will be funded to address them. There is no universally agreed set of decision-making rules for setting priorities. Dominant approaches prioritise health economics, and have favoured expert knowledge drawn from technical-rational methodologies rather than consumer involvement and community action. However, research reveals that setting priorities is a complex, value laden, contested process buffeted by competing objectives and political interests. As such, an interdisciplinary, collaborative approach is called for. Using reflective practice from a priority setting project for a primary care partnership in a local, regional catchment in Victoria, Australia, a conceptual framework for priority setting is presented that identifies 13 interconnected factors spanning economic, political, policy, epidemiological, moral, evidentiary and evaluative domains. This interdisciplinary framework extends current knowledge about the considerations and trade-offs in setting priorities among collaborating primary health care agencies. It offers a potentially valuable heuristic tool for healthcare decision-makers in rural areas.