Health promotion practices delivered by primary health care nurses: Elements for success in Finland

Maijala, Virpi; Tossavainen, Kerttu; Turunen, Hannele

doi:10.1016/j.apnr.2015.11.002

Cited by 22 publications

(23 citation statements)

References 17 publications

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“…However, this body of research stresses the importance of adapting strategies to country-specific and local needs of primary healthcare professionals. Third, response rates were suboptimal, although they are comparable to response rates in other Delphi studies (Elfeddali et al 2010 ; Maijala et al 2016 ).…”

Section: Discussionsupporting

confidence: 68%

“…The Delphi methodology is a technique for systematic structuring of informed opinions from a large group of experts on complex issues by means of iteration with controlled feedback (Linstone and Turoff 1975 ). The Delphi method has been used before in implementation research informing the use of implementation strategies on a range of topics (Heather et al 2004 ; Huijg et al 2013 ; Maijala et al 2016 ).…”

Section: Methodsmentioning

confidence: 99%

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Strategies to Overcome Barriers to Implementation of Alcohol Screening and Brief Intervention in General Practice: a Delphi Study Among Healthcare Professionals and Addiction Prevention Experts

et al. 2016

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Despite the evidence base, alcohol screening and brief intervention (ASBI) have rarely been integrated into routine clinical practice. The aim of this study is to identify strategies that could tackle barriers to ASBI implementation in general practice by involving primary healthcare professionals and addiction prevention experts. A three-round online Delphi study was carried out in the Netherlands. The first-round questionnaire consisted of open-ended questions to generate ideas about strategies to overcome barriers. In the second round, participants were asked to indicate how applicable they found each strategy. Items without consensus were systematically fed back with group median ratings and interquartile range (IQR) scores in the third-round questionnaire. In total, 39 out of 69 (57 %) invited participants enrolled in the first round, 214 participants completed the second round, and 144 of these (67 %) completed the third-round questionnaire. Results show that participants reached consensus on 59 of 81 strategies, such as the following: (1) use of E-learning technology, (2) symptom-specific screening by general practitioners (GPs) and/or universal screening by practice nurses, (3) reimbursement incentives, (4) supportive materials, (5) clear guidelines, (6) service provision of addiction care centers, and (7) more publicity in the media. This exploratory study identified a broad set of strategies that could potentially be used for overcoming barriers to ASBI implementation in general practice and paves the way for future research to experimentally test the identified implementation strategies using multifaceted approaches.Electronic supplementary materialThe online version of this article (doi:10.1007/s11121-016-0653-4) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 68%

Section: Methodsmentioning

confidence: 99%

Strategies to Overcome Barriers to Implementation of Alcohol Screening and Brief Intervention in General Practice: a Delphi Study Among Healthcare Professionals and Addiction Prevention Experts

et al. 2016

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“…Several studies have determined that, among health professionals, nurses are best placed to promote health and to deliver preventive programs within the primary care context [85, 86]. Their employment as providers of self-management support programs in primary care can further improve the health status of chronic patients, even if the task shifting from physicians to nurses in this particular area requires specific education and training.…”

Section: Discussionmentioning

confidence: 99%

Are community-based nurse-led self-management support interventions effective in chronic patients? Results of a systematic review and meta-analysis

et al. 2017

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The expansion of primary care and community-based service delivery systems is intended to meet emerging needs, reduce the costs of hospital-based ambulatory care and prevent avoidable hospital use by the provision of more appropriate care. Great emphasis has been placed on the role of self-management in the complex process of care of patient with long-term conditions. Several studies have determined that nurses, among the health professionals, are more recommended to promote health and deliver preventive programs within the primary care context. The aim of this systematic review and meta-analysis is to assess the efficacy of the nurse-led self-management support versus usual care evaluating patient outcomes in chronic care community programs. Systematic review was carried out in MEDLINE, CINAHL, Scopus and Web of Science including RCTs of nurse-led self-management support interventions performed to improve observer reported outcomes (OROs) and patients reported outcomes (PROs), with any method of communication exchange or education in a community setting on patients >18 years of age with a diagnosis of chronic diseases or multi-morbidity. Of the 7,279 papers initially retrieved, 29 met the inclusion criteria. Meta-analyses on systolic (SBP) and diastolic (DBP) blood pressure reduction (10 studies—3,881 patients) and HbA1c reduction (7 studies—2,669 patients) were carried-out. The pooled MD were: SBP -3.04 (95% CI -5.01—-1.06), DBP -1.42 (95% CI -1.42—-0.49) and HbA1c -0.15 (95% CI -0.32–0.01) in favor of the experimental groups. Meta-analyses of subgroups showed, among others, a statistically significant effect if the interventions were delivered to patients with diabetes (SBP) or CVD (DBP), if the nurses were specifically trained, if the studies had a sample size higher than 200 patients and if the allocation concealment was not clearly defined. Effects on other OROs and PROs as well as quality of life remain inconclusive.

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“…This reality emphasizes the need to valorize health education actions and to understand the importance of each professional category in these practices (19) , which must assume the responsibility of an activity based on the clinical component (35) . In addition, there is a need for an organizational culture that promotes such activities, sufficient financial resources and, above all, appreciation of managers (36) , through a reordering of the work process of the Family Health Teams (37) . Thus, the limitation on the part of the nurses with respect to the accomplishment of these activities is not a responsibility only of the professional, but of all involved in the process.…”

Section: Discussionmentioning

confidence: 99%

Perception of the Primary Care multiprofessional team on health education

et al. 2019

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Objective: To understand the perception of the Primary Health Care multiprofessional team on the practices of health education and on the role of nurses in the performance of educational activities. Method: Exploratory and descriptive study with a qualitative approach. Data were collected through a semi-structured interview with the participation of 12 professionals from the Family Health Strategy. To analyze the data, we used the technique of content analysis, with thematic approach, proposed by Bardin. Results: Three categories emerged: Perception of the multiprofessional team on health education; Educational practices in Primary Health Care: everyone's task?; and The role of nurses in health education. Final considerations: It was verified that the multiprofessional team perceives health education as being the responsibility of all the professionals. Some professionals consider the nurse as an important educator, others as executor of management and care actions and, to a lesser extent, of educational actions.

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Health promotion practices delivered by primary health care nurses: Elements for success in Finland

Cited by 22 publications

References 17 publications

Strategies to Overcome Barriers to Implementation of Alcohol Screening and Brief Intervention in General Practice: a Delphi Study Among Healthcare Professionals and Addiction Prevention Experts

Strategies to Overcome Barriers to Implementation of Alcohol Screening and Brief Intervention in General Practice: a Delphi Study Among Healthcare Professionals and Addiction Prevention Experts

Are community-based nurse-led self-management support interventions effective in chronic patients? Results of a systematic review and meta-analysis

Perception of the Primary Care multiprofessional team on health education

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