Factors and Strategies Influencing Integrated Self-Management Support for People With Chronic Diseases and Common Mental Disorders: A Qualitative Study of Canadian Primary Care Nurses' Experience

Abstract

Aim

To describe the factors influencing clinical integration of self-management support by primary care nurses for people with physical chronic diseases and common mental disorders, as well as strategies for improvement.

Design

Thorne's interpretive descriptive qualitative approach.

Methods

Semi-structured interviews lasting from 60 to 90 min were carried out virtually with nurses from Family Medicine Groups and University Family Medicine Groups across the province of Quebec (Canada) from January 2022 to January 2023. Twenty-three primary care nurses were recruited through purposive and snowball sampling from three networks. Iterative deductive and inductive thematic analysis was completed using Valentijn's Rainbow Model of Integrated Care.

Results

The study identified several factors influencing integrated self-management support from primary care nurses across integration domains: clinical (knowledge, skills, training and experience; workload; approaches and activities; attitudes and behaviours; clinical tools), professional (interprofessional and nursing roles; collaboration; team composition), normative and functional (culture and organisational mechanisms). Improvement strategies pointed to the necessity of developing training regarding common mental disorders, adapted clinical tools, clinical support and coaching through collaboration and culture change.

Conclusion

These findings suggest that a cultural shift emphasising continuous improvement through targeted training and coaching is essential to enhance integrated self-management support. Identifying factors and improvement strategies will help implement future interventions and tailor current practices.

Implications for the Profession and/or Patient Care

Identifying barriers and facilitators, along with proposing improvement strategies, will enable the implementation of more effective interventions and the adaptation of care practices to better support self-management. Additionally, it will influence stakeholders to modify the context surrounding integrated self-management support and interprofessional practise.

Reporting Method

Consolidated criteria for reporting qualitative research (COREQ).

Patient and Public Contribution

No patient or public contribution.