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Understanding the role of an advanced practice nurse through the perspectives of patients with cardiovascular disease: A qualitative study

机译:了解先进实践护士的角色通过心血管疾病患者的角度:定性研究

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Abstract Aims and objectives To explore patients’ understanding of the role of an advanced practice nurse (APN). Background The increasing prevalence of multimorbidities among people living with cardiovascular disease (CVD) has increased the complexity of their clinical care. Implementing the role of APNs in new models of care has been shown to improve outcomes in the CVD population. However, the CVD population's understanding of and experiences with the APN role have not been examined in Singapore. Methods An exploratory descriptive qualitative design using semi‐structured face‐to‐face individual interviews was undertaken (November 2017–March 2018). Fourteen participants were purposively sampled from an outpatient clinic in one of Singapore's national heart centres. Thematic analysis was undertaken. The COREQ guidelines were adhered to. Findings The multi‐ethnic sample included ten males and four females. Two main themes were identified: (1) APNs play a complementary role to doctors and (2) the acceptance of the APN role takes time. Each theme was supported by three subthemes to further elucidate the role and acceptance of APNs. Conclusion A lack of understanding of the role of APNs is present, thereby causing the less than optimal patient acceptance of APNs. As patients with CVD experience improvements to their health through APN‐led services, they may gain confidence in APNs’ skills and knowledge. Relevance to clinical practice When introducing new roles, fully explaining these roles to the target population is pertinent as it will be facilitative to patient engagement and optimisations of care. The findings support the call for APNs to explain the value and essence of advanced practice nursing more effectively. There should be a greater emphasis on teaching APNs to introduce and explain the role of APNs through APN preparatory education and incorporating this practice in APN practice standards, especially in contexts where APN development is premature.
机译:摘要旨在探讨患者对先进实践护士(APN)作用的理解。背景技术患有心血管疾病(CVD)的人们在患有心血管疾病(CVD)的人们中增加的患病率增加了他们的临床护理的复杂性。在新的护理模型中实施APN的角色已被证明在CVD人群中改善了结果。然而,CVD人口对新加坡尚未检查对APN角色的认识和经验。方法采用半结构面对面各个访谈的探索性描述性定性设计(2017年11月至2018年3月)。十四名参与者在新加坡的全国心脏中心之一的门诊诊所自动抽出。主题分析进行了。核心准则遵守。调查结果包括十种男性和四个女性。确定了两个主要主题:(1)APN对医生和(2)接受APN角色的互补作用。每个主题都支持三个子项,以进一步阐明APN的作用和接受。结论存在缺乏对APN的作用的理解,从而导致少于最佳的患者接受APN。由于CVD通过APN-LED服务对其健康进行改善的患者,他们可能会对APNS的技能和知识提供信心。与临床实践引入新角色时的相关性,充分解释目标人群的这些角色是相关的,因为它将有助于患者参与和护理优化。调查结果支持APNS更有效地解释高级练习护理的价值和本质。应该更加强调教学APNS来推出和解释APN通过APN预备教育的作用,并将这种做法纳入APN实践标准,特别是在APN开发过早的环境中。

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