Attending to power differentials: How NP-led group medical visits can influence the management of chronic conditions
| Autor: | Martin Dawes, Laura Housden, Annette J. Browne, Sabrina T. Wong |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male group medical visits Canada Health Knowledge Attitudes Practice Nurse practitioners Primary care power 03 medical and health sciences 0302 clinical medicine Nursing Patient Education as Topic quality of care Agency (sociology) Medicine Humans diffusion of innovation Nurse Practitioners 030212 general & internal medicine Quality of care 030504 nursing Primary Health Care business.industry Self-Management Public Health Environmental and Occupational Health Direct observation Middle Aged Self Efficacy Group Processes Original Research Paper Leadership Chronic disease Socioeconomic Factors nurse practitioner Chronic Disease Female 0305 other medical science business Original Research Papers |
| Zdroj: | Health Expectations : An International Journal of Public Participation in Health Care and Health Policy |
| ISSN: | 1369-7625 |
| Popis: | Objective In Canada, primary care reform has encouraged innovations, including nurse practitioners (NPs) and group medical visits (GMVs). NP-led GMVs provide an opportunity to examine barriers and enablers to implementing this innovation in primary care. Design An instrumental case study design (n=3): two cases where NPs were using GMVs and one case where NPs were not using GMVs, was completed. In-depth interviews with patients and providers (N=24) and 10 hours of direct observation were completed. Interpretive descriptive methods were used to analyse data. Results/Findings Two main themes were identified: (i) acquisition of knowledge and (ii) GMVs help shift relationships between patients and health-care providers. Participants discussed how patients and providers learn from one another to facilitate self-management of chronic conditions. They also discussed how the GMV shifts inherent power differentials between providers and between patients and providers. Discussion NP-led GMVs are a method of care delivery that harness NPs’ professional agency through increased leadership and interprofessional collaboration. GMVs also facilitate an environment that is patient-centred and interprofessional, providing patients with increased confidence to manage their chronic conditions. The GMV provides the opportunity to meet both team-based and patient-centred health-care objectives and may disrupt inherent power differentials that exist in primary care. |
| Databáze: | OpenAIRE |
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