Nurses' perspectives on challenges and facilitators when implementing a self‐management support intervention as an everyday healthcare practice: A qualitative study

Author:

Fredens Mia1ORCID,Palmhøj Nielsen Camilla12,Grønkjær Mette34,Kjærside Nielsen Berit1,Konstantin Nissen Nina1,Benthien Kirstine Skov56,Toft Ulla6,Rasmussen Knud7,Kidholm Kristian8,Deleuran Terkildsen Morten1910

Affiliation:

1. DEFACTUM – Public Health Research, Central Denmark Region Aarhus Denmark

2. Department of Public Health Aarhus University Aarhus Denmark

3. Clinical Nursing Research Unit Aalborg University Hospital Aalborg Denmark

4. Department of Clinical Medicine Aalborg University Aalborg Denmark

5. Palliative Care Unit Copenhagen University Hospital Hvidovre Denmark

6. Center for Clinical Research and Prevention Bispebjerg and Frederiksberg Hospital Copenhagen Denmark

7. Department of Data and Development Research, Zealand Region Sorø Denmark

8. Centre for Innovative Medical Technology Odense University Hospital Odense Denmark

9. Department of Forensic Psychiatry Aarhus University Hospital Psychiatry Aarhus Denmark

10. Department of Clinical Medicine Aarhus University Aarhus Denmark

Abstract

AbstractAimTo explore registered nurses' perspectives on challenges and facilitators to implementing a telephone‐based self‐management support (SMS) intervention (Proactive Health Support) as an everyday healthcare practice, during the early stages of implementation.DesignData were collected using a qualitative research design involving focus‐group interviews and participant observations.MethodsWe conducted participant observation following nine nurses and four focus group interviews with 14 nurses. Data were analysed using thematic analyses.ResultsProactive Health Support was implemented in units organized independently of the existing organizational units within healthcare services. This independent organization, along with the intervention's generic (non‐disease specific) design, empowered nurses to become autonomous practitioners capable of prioritizing the operationalization of SMS as an everyday healthcare practice. However, unlearning already embedded medical practices and establishing new nursing roles necessary to accommodate the intervention in practice was experienced a challenge. Education and supervision were identified as valuable tools for successful implementation.ConclusionOur study highlights the significance of organizational context and autonomy in successful SMS implementation. Balancing external factors like organizational context, priority and time is vital, but navigating the internal shift in professional practice is equally crucial. Role transition processes can constitute challenges demanding accommodation.Implications for the ProfessionFrom a nursing perspective, this study highlights that practising SMS requires substantial training and education. Generic SMS interventions can introduce higher levels of contingency due to their versatile nature. Thus, equipping nurses with competencies that enable them to navigate this unpredictability flexibly is crucial.ImpactPolicymakers and administrators should allocate resources and support implementation processes in ways that accommodate both internal and external conditions to facilitate nurses in delivering effective SMS.Reporting MethodThis study adheres to the SRQR guideline.Patient or Public ContributionNo patient or public contribution.

Funder

Ministeriet Sundhed Forebyggelse

Publisher

Wiley

Subject

General Nursing

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