Chronic Disease Nurses' Experiences with Patients as Partners in a Self-management Model

Chronic Disease Nurses' Experiences with Patients as Partners in a Self-management Model

Author: 
Carole Josephine Gillam
Program of study: 
D.H.A.
Abstract: 
The prevalence of chronic disease in the baby boomer generation will challenge healthcare sustainability globally as the cohort ages. Successful outcomes for patients with chronic diseases require patients to support themselves. Within the integrated approach to care in British Columbia the patient is viewed as a key partner in the development of plans for care and, to the extent that the patient is capable, accepts responsibility and accountability for managing day-to-day care in the community setting by adopting self-management behaviors. Nursing has been identified as having a key role to play in chronic disease management, including the role of supporting the patient as a partner in self-management. The purpose of the qualitative, phenomenological study was to explore the themes that evolved from the perceptions of 20 chronic disease management (CDM) nurses who work across the Province of British Columbia and to determine the professional lived experiences of the CDM nurses who work with patients as partners in a self-management role. The five emergent themes arising from the study are: (a) job satisfaction, (b) lack of patient understanding of the patient-as-partner approach, (c) lack of CDM nurse commitment to patient-as-partner approach, (d) job frustration, and (e) ethical dilemmas. The study findings are significant to the developing body of knowledge of the role of CDM nurses supporting patients as partners in self- management. The implications arising from the current study are significant to leadership individuals who are spearheading the provincial commitment to a patient-aspartner approach as a foundation to CDM.
Dedication: 
Firstly, I dedicate this journey in memory of my Mum, Annie Davies; from my very early years she instilled in me the value of an education and encouraged me to never give up. My Mum died before this work was complete, but I know she would be proud. I would also like to dedicate this two special people, my husband Andrew and my daughter Nicky. I would never have completed this work without their unwavering support.
Acknowledgements: 
There are many people who have helped and supported me through my doctoral journey over the years: work colleagues, friends, and members of the University of Phoenix faculty, and it would be impossible to individually thank all of these wonderful people. I do, though, want to express heartfelt appreciation to all who by a word, conversation, or gesture helped me achieve one of my life’s dreams. Dr. Alexander, thank you from the bottom of my heart. In addition to your professionalism, the kindness and interest you displayed unwaveringly towards me led me to believe I was journeying with a very special human being. A debt of gratitude is owed also to my two committee members, Dr. Lehrman and Dr. Rose, for the patience, advice, and guidance offered throughout this process. Cindy, Penny, and Wendy B, my good friends, thank you for being around and always supporting me. My sisters Susan, Kitty, and Jackie maintained an active interest encouraging me from overseas in England. Another person I must acknowledge is someone whom I really couldn’t have achieved this milestone without: Shanaya Nelson, my editor, you are a star, and a very, very patient star at that!