Philippa Miskelly, Ngaire Kerse and Janine Wiles
Managing patients in advanced age is complex, especially when it comes to multi-morbidities and polypharmacy. The purpose of this qualitative study is to investigate challenges…
Abstract
Purpose
Managing patients in advanced age is complex, especially when it comes to multi-morbidities and polypharmacy. The purpose of this qualitative study is to investigate challenges, opportunities and potential solutions from a primary healthcare provider perspective.
Design/methodology/approach
Fifty-seven participants joined in group discussions on challenges and opportunities of working with advanced age. Participants included general practitioners (GPs), practice nurses, students and administration staff working in ten general practices. A thematic analysis was developed, supported by NVivo software.
Findings
Poor lines of communication and fragmentation of services between differing levels of health care services available for older people were highlighted. This has implications for quality of care and equity of services. Participants also reported challenges in treatment and funding regimes.
Research limitations/implications
The small sample size and regional nature of the study, along with the semi-structured nature of the group discussions and rigorous thematic analysis, indicate that this qualitative data is transferable, dependable, confirmable and credible. Comparing the views of tertiary and community services would be useful.
Practical implications
A range of potential strategies and solutions to the current fragmented services was offered by GPs. For example, adequately funded and staffed community-based health hubs; IT platforms enabling timely flow of patient information between primary and tertiary health providers and creation of medical, nursing and allied health roles aimed at improving synergy between GP and tertiary services.
Originality/value
Obtaining the perspectives of general practice highlights the challenges and complexities of caring for those in advanced age brings. These insights have not been previously been explored in-depth within this setting in New Zealand.
Details
Keywords
Philippa Rasmussen, Tiffany Conroy and Mette Grønkjær
Nurses with specialised knowledge, experience and education are needed to provide specific care in nursing subspecialties such as child and adolescent mental health (CAMH…
Abstract
Purpose
Nurses with specialised knowledge, experience and education are needed to provide specific care in nursing subspecialties such as child and adolescent mental health (CAMH) nursing. However, some of these attributes are implicit and not clear to the wider nursing community. The purpose of this paper is to explore the applicability of a conceptual framework for CAMH inpatient nursing practice to other areas of CAMH nursing practice. This paper presents an exploratory study regarding the applicability of the framework to two small cohorts of CAMH nurses. This study was conducted in Tasmania, Australia and Northern Denmark. These settings were chosen due to the self-perceived knowledge gap surrounding the role and professional identity of these Australian and Danish CAMH nurses.
Design/methodology/approach
An exploratory qualitative study within the social constructivist paradigm was undertaken. The method of data collection was two focus groups of CAMH nurses in Tasmania, Australia and Northern Denmark. The data were analysed using an adaptation of a six-phase thematic analysis process.
Findings
The analysis of the data resulted in three themes: individual preparation and experience of CAMH nurses, knowledge transfer and nurses’ perceptions of their individual and team roles. The findings have contributed new knowledge of CAMH nursing.
Originality/value
The findings of this study may support the applicability of the conceptual framework with participants’ endorsing that it reflects their role.