Primary health care nurse practitioners and patient enablement

Abstract

Background: Patient enablement has been recognised as a goal and therefore a measurable outcome measure of the quality of consultations in health care. While patient enablement following consultations with General Practitioners has been studied, little is known about if, and how, patients are enabled following consultations with Nurse Practitioners (NP). As NPs are increasingly playing a role in Primary Health Care (PHC), it is important to explore the part they play in enabling patients. Aim: To explore patients’ experiences of NP care in the PHC setting, from the perspective of both the patients and the NPs through the lens of enablement. Methods: A parallel multi-strand qualitative approach was used to explore NP care from both the perspective of the patient and the NP. The hermeneutic phenomenological approach was used for the patient strand and qualitative description for the NP strand. The Patient Enablement Index (PEI) was used as a theoretical framework to explore the data from both strands. Findings: Meta-inferences made from this study suggest that NPs enable patients by creating opportunities for education and knowledge transference and building on patient strengths and promoting self-efficacy. The three existential themes of temporality (time), relationality (relationships) and corporality (the body) were also key components of the experience of enablement within a consultation. Discussion: The data suggested a complex interplay between the experience of the consultation and the care provided by NP. Both NPs and patients described bespoke care that formed a basis for a relationship that assisted with knowledge transference and individual empowerment. Conclusion: Enablement is a previously underexplored quality of NP care in this setting. This study proposes a conceptual framework of how enablement is experienced within a NP consultation. This framework could be used to develop understanding and praxis of enablement within the PHC setting.

Date of Award	2017
Original language	English
Supervisor	Marian Currie (Supervisor) & Holly Louise Northam (Supervisor)