The Influence of Contextual Factors on the Process of Formulating Strategies to Improve the Adoption of Care Manager Activities by Primary Care Nurses

Abstract

Background: Primary care nurses are well-suited to provide care management for common mental disorders, but their practices depend on context. Various strategies can be considered to improve the adoption of nursing care manager activities, but data from implementation studies rarely address strategy formulation. Aim: To analyze the influence of contextual factors on strategy formulation to improve the adoption of care manager activities by primary care nurses. Method: A qualitative multiple case study in three primary care clinics was carried out. Data were collected through individual interviews (n = 32) and observations (n = 7), working group meetings, and relevant documents. Thematic analysis was conducted. Results: Contextual factors influenced strategy formulation through organizational readiness for change, which resulted from tension for change and perceived organizational ability to implement change. Tension for change was generated through the perceived gap between patient needs and service availability, perceived compatibility with the nurses work environment, and their assessment of their capacity to perform care manager activities or acquire the necessary skills. Conclusion: Future studies should give sufficient attention to implementation strategy formulation and consider the dynamic role of organizational readiness for change when facilitating the adoption of evidence-based practices for common mental disorders in primary care.

Adoption of care management activities by primary care nurses for people with common mental disorders and physical conditions: A multiple case study

“…It included two patient partners with CMDs and LTCs, three researchers in the field of nursing and collaborative mental health care, one nurse manager, one family doctor, one primary care nurse, one psychiatrist and one psychologist. Different categories of stakeholders were involved throughout the project; a description of how they were involved is provided in other publications related to this manuscript (Girard, 2020;Girard et al, 2021).…”