046. Integrating Care for Joint Pain and Anxiety and Depression into Reviews for Long-Term Conditions: The Enhance Study (original) (raw)

The Partnering with Patients Model of Nursing Interventions: A First Step to a Practice Theory

The development of a body of knowledge, gained through research and theory building, is one hallmark of a profession. This paper presents the " Partnering with Patients Model of Nursing Interventions " , providing direction towards how complex nursing interventions can be developed, tested and subsequently adopted into practice. Coalescence of understanding of patient-centred care, the capabilities approach and the concept of complex healthcare interventions led to the development of the model assumptions and concepts. Application of the model to clinical practice is described, including presentation of a case study, and areas for future research including understanding both patients' and nurses' perceptions and experiences when the model is in use, and testing the effect of nursing interventions based on the model are recommended.

Feasibility of training practice nurses to deliver a psychosocial intervention within a collaborative care framework for people with depression and long-term conditions

BMC nursing, 2016

Practice nurses (PNs) deliver much of the chronic disease management in primary care and have been highlighted as appropriately placed within the service to manage patients with long-term physical conditions (LTCs) and co-morbid depression. This nested qualitative evaluation within a service development pilot provided the opportunity to examine the acceptability of a Brief Behavioural Activation (BBA) intervention within a collaborative care framework. Barriers and facilitators to engaging with the intervention from the patient and clinician perspective will be used to guide future service development and research. The study was conducted across 8 practices in one Primary Care Trust (1) in England. Through purposive sampling professionals (n = 10) taking part in the intervention (nurses, GPs and a mental health gateway worker) and patients (n = 4) receiving the intervention participated in semi-structured qualitative interviews. Analysis utilised the four Normalisation Process Theor...

Contributes for the development of a psychotherapeutic intervention model in nursing: A focus group study in Portugal and Spain

Perspectives in Psychiatric Care, 2017

Purpose: To explore the aspects set forth as the minimum set of features that should integrate a psychotherapeutic intervention model in nursing. Design and Methods: Two focus groups were conducted, with the participation of 15 nursing professionals. Data were analysed thematically. Findings: Five topics previously identified were analysed: theoretical conceptualization, structure, patients' inclusion and exclusion criteria, operationalization, and evaluation of the intervention(s) effectiveness. Theoretical conceptualization has been mainly grounded on Peplau's theory. Moreover, participants believe that standardized nursing language and nursing process should be the presumptions of the model. Practice Implications: This study allowed the identification of a minimum set of features that should integrate a psychotherapeutic intervention model in nursing, about which consensus must be reached with a view to its further development.

Developing a U.K. protocol for collaborative care: a qualitative study

General Hospital Psychiatry, 2006

Objective: This study aimed to explore the views of stakeholders including patients, general practitioners (GPs) and mental health workers on the feasibility, acceptability and barriers to a collaborative care model for treatment of depression within the context of U.K. primary health care. Method: We used semistructured interviews and focus groups with a purposive sample of 11 patients and 38 professionals from a wide selection of primary and secondary care mental health services, as well as framework analysis using a bconstant comparativeQ approach to identify key concepts and themes. Results: Regular contact for patients with depression is acceptable and valued by both patients and professionals. However, patients value support, whereas professionals focus on information. To be acceptable to patients, contacts about medication or psychosocial support must minimize the potential for patient disempowerment. The use of the telephone is convenient and lends anonymity, but established mental health workers think it will impair their judgments. While patients merely identified the need for skilled case managers, GPs preferred established professionals; however, these workers did not see themselves in this role. All involved were cautious about deploying new workers. Additional barriers included practical and organizational issues. Conclusions: Although a telephone-delivered mix of medication support and low-intensity psychological intervention is generally acceptable, significant issues to be addressed include the values of the current mental health workforce, fears about new workers' experience and competence, the balance of face-to-face and telephone contacts and case manager education in nonspecific skills necessary to develop a therapeutic alliance, as well as the knowledge and skills required for education, medication support and behavioral activation. Qualitative research can add value to careful modeling of collaborative care prior to international implementation. D

Collaborative care. The role of practice nurses

Australian family physician

In patients with either type 2 diabetes mellitus or coronary heart disease the presence of depression leads to increased morbidity and mortality. 1,2 This comorbid depression is often missed in routine general practice. 3 To address these problems we describe the implementation of collaborative care based on new roles for practice nurses (PNs), information technology solutions, and a shift of focus toward self care. a similar model of collaborative care has been shown overseas to be an effective way to improve the management of depression in primary care. 4 Method A feasibility study focusing on additional roles for PNs. Six practices in southeast Australia were selected by invitation on the basis of having PNs available to participate in the study. Patients were selected by the general practitioner from a disease registry or opportunistically invited to attend the PN before review by the usual doctor. Regular follow up checks by the PN/doctor team were organised at 3-6 month intervals according to clinical need. The GP Management Plan template allowed de-identified collection and feedback of data, as well as prompting review appointments. Structured interviews were conducted with all PNs and GPs in the study to evaluate the usefulness of the collaborative model. Ethics approval was obtained from the Flinders University Social and Behavioural Research Ethics Committee.

Qualitative Evidence Syntheses Within Cochrane Effective Practice and Organisation of Care: Developing a Template and Guidance

International Journal of Qualitative Methods

A growing number of researchers are preparing systematic reviews of qualitative evidence, often referred to as ‘qualitative evidence syntheses’. Cochrane published its first qualitative evidence synthesis in 2013 and published 27 such syntheses and protocols by August 2020. Most of these syntheses have explored how people experience or value different health conditions, treatments and outcomes. Several have been used by guideline producers and others to identify the topics that matter to people, consider the acceptability and feasibility of different healthcare options and identify implementation considerations, thereby complementing systematic reviews of intervention effectiveness.Guidance on how to conduct and report qualitative evidence syntheses exists. However, methods are evolving, and we still have more to learn about how to translate and integrate existing methodological guidance into practice. Cochrane’s Effective Practice and Organisation of Care (EPOC) ( www.epoc.org ) ha...