Abstract
BackgroundSelf-management support is widely accepted for the management of chronic conditions. Self-management often requires behaviour change in patients, in which primary care nurses play a pivotal role. To support patients in changing their behaviour, the structured behaviour change Activate intervention was developed. This intervention aims to enhance physical activity in patients at risk for cardiovascular disease in primary care as well as to enhance nurses’ role in supporting these patients. This study aimed to evaluate nurses’ perceptions towards the delivery and feasibility of the Activate intervention.MethodsA qualitative study nested within a cluster-randomised controlled trial using semistructured interviews was conducted and thematically analysed. Fourteen nurses who delivered the Activate intervention participated.ResultsThree key themes emerged concerning nurses’ perceptions of delivering the intervention: nurses’ engagement towards delivering the intervention; acquiring knowledge and skills; and dealing with adherence to the consultation structure. Three key themes were identified concerning the feasibility of the intervention: expectations towards the use of the intervention in routine practice; perceptions towards the feasibility of the training programme; and enabling personal development.ConclusionsDelivering a behaviour change intervention is challenged by the complexity of changing nurses’ consultation style, including acquiring corresponding knowledge and skills. The findings have increased the understanding of the effectiveness of the Activate trial and will guide the development and evaluation of future behaviour change interventions delivered by nurses in primary care.Trial registrationClinicalTrials.gov NCT02725203.
Highlights
Self-management support is widely accepted for the management of chronic conditions
Self-management support requires nurses to adapt their traditional consultation style, which is focused on giving advice, informing and educating patients about their condition, towards a more coaching-oriented consultation style aimed at supporting patients in changing their behaviour [8,9,10]
This study evaluated the perceptions of the providers towards the delivery and feasibility of a self-management intervention alongside the cluster-randomised controlled Activate trial
Summary
Self-management support is widely accepted for the management of chronic conditions. Selfmanagement often requires behaviour change in patients, in which primary care nurses play a pivotal role. Primary care nurses play a pivotal role in the management of chronic conditions, promoting self -management and offering follow-up consultations [6] They in a key position to support these patients in changing their health behaviour [6]. Self-management support requires nurses to adapt their traditional consultation style, which is focused on giving advice, informing and educating patients about their condition, towards a more coaching-oriented consultation style aimed at supporting patients in changing their behaviour [8,9,10]. Adapting their consultation style adequately implies that nurses need to change their behaviour, which is challenging to accomplish [8, 11,12,13,14]. Insight into the perceptions of providers towards the delivery and feasibility of such interventions, as part of a process evaluation, might enhance our understanding of the effectiveness of complex interventions and shed some light on how the intervention works [16,17,18,19]
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