The Experience of Care at Nurse‐Led Rheumatology Clinics

Abstract

The experiences emphasized the need for a holistic approach to care. In this process, the organization of care and the role and skills of the nurse should be focused on the individual's needs and perspectives. The social environment, professional approach and value-adding measures are particularly relevant for optimal care at nurse-led rheumatology outpatient clinics.

Patient Satisfaction with Pharmacist‐Led Collaborative Follow‐Up Care in an Ambulatory Rheumatology Clinic

“…In the literature, improved patient satisfaction is often related back to improved access, empathy and effective patient education (Hill, 1997;Arthur and Clifford, 2004;Koksvik et al, 2013). Indeed, the additional time generally spent with a nurse or other allied healthcare practitioner has been shown to be of importance in measuring patient satisfaction, as sufficient time is allocated for more holistic care (Arthur and Clifford, 2004;Bala et al, 2012). Although the extra time spent with the patient could be driving the difference in satisfaction scores in our and other studies, it is more likely to be the practitioners' ability to conduct a broader assessment during that time.…”

Patient preferences for psychological support in inflammatory arthritis: a multicentre survey

“…There is increasing recognition that the rheumatology team, with their understanding of the disease and its treatment, can play a vital therapeutic role in helping patients with IA to increase their sense of control and improve their psychological well-being,33 and these survey findings suggest that patients would find this acceptable and useful. Other research has highlighted the value of nurse-led, patient-centred care for improving patients’ coping and emotional states,34 35 and European guidelines recommend that nurses provide psychosocial and self-management support 36. In light of evidence that access to psychological services is limited for patients with RA, the finding has significant implications for service delivery and policy development 37.…”

A randomized study comparing regular care with a nurse‐led clinic based on tight disease activity control and person‐centred care in patients with rheumatoid arthritis with moderate/high disease activity: A 6‐month evaluation

“…Several publications on nurse‐led clinics in rheumatology have been published over the last decade(s), mostly performed in patients with low disease activity or in remission (Arvidsson et al, ; Bala et al, ; Hill, Thorpe, & Bird, ; Larsson, Fridlund, Arvidsson, Teleman, & Bergman, ; Ndosi et al, ; Ndosi, Vinall, Hale, Bird, & Hill, ; Tijhuis, Zwinderman, Hazes, Breedveld, & Vlieland, ). Although there is a relative lack of randomized clinical trials investigating the effect of nurse‐led clinics in patients with moderate or high disease activity, there is support for the notion that the nurse‐led clinics can: improve the patient's function; increase the patient's knowledge about the disease (Hill et al, ; Tijhuis et al, ); improve self‐efficacy (Primdahl, Wagner, Holst, & Hørslev‐Petersen, ); and add value for the patient, in terms of increased security, continuity and a positive feeling of being seen as a person (Arvidsson et al, ; Bala et al, ; Larsson, Bergman, Fridlund, & Arvidsson, ). This led us to hypothesize that a nurse‐led clinic built on principles of person centred care and stringent follow‐up, with tight control and treat‐to‐target strategy, would be more effective than care as usual in patients with RA with moderate to high disease activity.…”

“…Several publications on nurse-led clinics in rheumatology have been published over the last decade(s), mostly performed in patients with low disease activity or in remission (Arvidsson et al, 2006;Bala et al, 2012;Hill, Thorpe, & Bird, 2003;Larsson, Fridlund, Arvidsson, Teleman, & Bergman, 2014;Ndosi et al, 2014;Ndosi, Vinall, Hale, Bird, & Hill, 2011;Tijhuis, Zwinderman, Hazes, Breedveld, & Vlieland, 2003).…”

“…Although there is a relative lack of randomized clinical trials investigating the effect of nurse-led clinics in patients with moderate or high disease activity, there is support for the notion that the nurse-led clinics can: improve the patient's function; increase the patient's knowledge about the disease (Hill et al, 2003;Tijhuis et al, 2003); improve selfefficacy (Primdahl, Wagner, Holst, & Hørslev-Petersen, 2012); and add value for the patient, in terms of increased security, continuity and a positive feeling of being seen as a person (Arvidsson et al, 2006;Bala et al, 2012;Larsson, Bergman, Fridlund, & Arvidsson, 2012). This led us to hypothesize that a nurse-led clinic built on principles of person centred care and stringent follow-up, with tight control and treat-to-target strategy, would be more effective than care as usual in patients with RA with moderate to high disease activity.…”