Modifying the PACIC to assess provision of chronic illness care: An exploratory study with primary health care nurses

Abstract

INTRODUCTION: In line with Wagner’s Chronic Care Model, the Patient Assessment of Chronic Illness Care (PACIC) has been developed to evaluate chronic illness care delivery from the patient's perspective. Modification of the instrument to assess the same aspects of care delivery from the health practitioner’s perspective would enable individual practitioners to evaluate their own provision of self-management support, and would also enable a more direct comparison between care provided and care received within the chronic illness context. AIM: To explore the potential of a modified PACIC instrument to assess individual health practitioners’ delivery of care to chronic illness patients with a sample of primary health care nurses. METHODS: Seventy-seven primary care nurses completed the modified PACIC, reworded to ask about care provision rather than receipt of care. An additional seven cultural sensitivity items were included, as were questions about the suitability of the types of chronic illness care and who should be providing the care. RESULTS: The modified PACIC items appear to be appropriate for use with health practitioners. Agreement that the types of care described in the PACIC should be provided was almost unanimous, and the predominant view was that self-management support should be provided by both nurses and doctors. Mean scale scores were higher than those generally reported from studies using the PACIC. DISCUSSION: The results of this first evaluation of a modified PACIC suggest that the original items plus the cultural sensitivity items can be used to assess self-management support by individual health practitioners. KEYWORDS: Chronic illness; self-management; primary health care, nurses