TY - JOUR
T1 - Nurses' perspectives on challenges and facilitators when implementing a self-management support intervention as an everyday healthcare practice
T2 - A qualitative study
AU - Fredens, Mia
AU - Palmhøj Nielsen, Camilla
AU - Grønkjaer, Mette
AU - Kjaerside Nielsen, Berit
AU - Konstantin Nissen, Nina
AU - Benthien, Kirstine Skov
AU - Toft, Ulla
AU - Rasmussen, Knud
AU - Kidholm, Kristian
AU - Deleuran Terkildsen, Morten
N1 - © 2023 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.
PY - 2024/6
Y1 - 2024/6
N2 - AIM: To explore registered nurses' perspectives on challenges and facilitators to implementing a telephone-based self-management support (SMS) intervention (Proactive Health Support) as an everyday healthcare practice, during the early stages of implementation.DESIGN: Data were collected using a qualitative research design involving focus-group interviews and participant observations.METHODS: We conducted participant observation following nine nurses and four focus group interviews with 14 nurses. Data were analysed using thematic analyses.RESULTS: Proactive Health Support was implemented in units organized independently of the existing organizational units within healthcare services. This independent organization, along with the intervention's generic (non-disease specific) design, empowered nurses to become autonomous practitioners capable of prioritizing the operationalization of SMS as an everyday healthcare practice. However, unlearning already embedded medical practices and establishing new nursing roles necessary to accommodate the intervention in practice was experienced a challenge. Education and supervision were identified as valuable tools for successful implementation.CONCLUSION: Our study highlights the significance of organizational context and autonomy in successful SMS implementation. Balancing external factors like organizational context, priority and time is vital, but navigating the internal shift in professional practice is equally crucial. Role transition processes can constitute challenges demanding accommodation.IMPLICATIONS FOR THE PROFESSION: From a nursing perspective, this study highlights that practising SMS requires substantial training and education. Generic SMS interventions can introduce higher levels of contingency due to their versatile nature. Thus, equipping nurses with competencies that enable them to navigate this unpredictability flexibly is crucial.IMPACT: Policymakers and administrators should allocate resources and support implementation processes in ways that accommodate both internal and external conditions to facilitate nurses in delivering effective SMS.REPORTING METHOD: This study adheres to the SRQR guideline.PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
AB - AIM: To explore registered nurses' perspectives on challenges and facilitators to implementing a telephone-based self-management support (SMS) intervention (Proactive Health Support) as an everyday healthcare practice, during the early stages of implementation.DESIGN: Data were collected using a qualitative research design involving focus-group interviews and participant observations.METHODS: We conducted participant observation following nine nurses and four focus group interviews with 14 nurses. Data were analysed using thematic analyses.RESULTS: Proactive Health Support was implemented in units organized independently of the existing organizational units within healthcare services. This independent organization, along with the intervention's generic (non-disease specific) design, empowered nurses to become autonomous practitioners capable of prioritizing the operationalization of SMS as an everyday healthcare practice. However, unlearning already embedded medical practices and establishing new nursing roles necessary to accommodate the intervention in practice was experienced a challenge. Education and supervision were identified as valuable tools for successful implementation.CONCLUSION: Our study highlights the significance of organizational context and autonomy in successful SMS implementation. Balancing external factors like organizational context, priority and time is vital, but navigating the internal shift in professional practice is equally crucial. Role transition processes can constitute challenges demanding accommodation.IMPLICATIONS FOR THE PROFESSION: From a nursing perspective, this study highlights that practising SMS requires substantial training and education. Generic SMS interventions can introduce higher levels of contingency due to their versatile nature. Thus, equipping nurses with competencies that enable them to navigate this unpredictability flexibly is crucial.IMPACT: Policymakers and administrators should allocate resources and support implementation processes in ways that accommodate both internal and external conditions to facilitate nurses in delivering effective SMS.REPORTING METHOD: This study adheres to the SRQR guideline.PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
KW - Adult
KW - Attitude of Health Personnel
KW - Female
KW - Focus Groups
KW - Humans
KW - Male
KW - Middle Aged
KW - Nurse's Role/psychology
KW - Nursing Staff, Hospital/psychology
KW - Qualitative Research
KW - Self-Management
KW - complex intervention
KW - registered nurses
KW - implementation
KW - self-management support
KW - Denmark
UR - http://www.scopus.com/inward/record.url?scp=85177798714&partnerID=8YFLogxK
U2 - 10.1111/jan.15988
DO - 10.1111/jan.15988
M3 - Journal article
C2 - 38012863
SN - 0309-2402
VL - 80
SP - 2475
EP - 2486
JO - Journal of Advanced Nursing
JF - Journal of Advanced Nursing
IS - 6
ER -