The Influence of Contextual Factors on the Process of Formulating Strategies to Improve the Adoption of Care Manager Activities by Primary Care Nurses.

Ariane Girard,Édith Ellefsen,Jean-Daniel Carrier,Pasquale Roberge,Joëlle Bernard-Hamel,Catherine Hudon

doi:10.5334/ijic.5556

Abstract

Background:Primary care nurses are well-suited to provide care management for common mental disorders, but their practices depend on context. Various strategies can be considered to improve the adoption of nursing care manager activities, but data from implementation studies rarely address strategy formulation.Aim:To analyze the influence of contextual factors on strategy formulation to improve the adoption of care manager activities by primary care nurses.Method:A qualitative multiple case study in three primary care clinics was carried out. Data were collected through individual interviews (n = 32) and observations (n = 7), working group meetings, and relevant documents. Thematic analysis was conducted.Results:Contextual factors influenced strategy formulation through organizational readiness for change, which resulted from tension for change and perceived organizational ability to implement change. Tension for change was generated through the perceived gap between patient needs and service availability, perceived compatibility with the nurses work environment, and their assessment of their capacity to perform care manager activities or acquire the necessary skills.Conclusion:Future studies should give sufficient attention to implementation strategy formulation and consider the dynamic role of organizational readiness for change when facilitating the adoption of evidence-based practices for common mental disorders in primary care.

Highlights

Primary care nurses are well-suited to provide care management for common mental disorders, but their practices depend on context
Future studies should give sufficient attention to implementation strategy formulation and consider the dynamic role of organizational readiness for change when facilitating the adoption of evidence-based practices for common mental disorders in primary care
The collaborative care model (CCM) involves a team of health care professionals minimally including a general practitioner (GP), a care manager, and a mental health specialist, working together to implement an individualized plan developed by integrating scientific evidence with patient needs and preferences [7]

Summary

Introduction

Primary care nurses are well-suited to provide care management for common mental disorders, but their practices depend on context. In Canada, anxiety and depressive disorders are among the top five most frequently diagnosed long-term conditions [1]. These common mental disorders (CMDs) are strongly associated with long-term physical conditions such as diabetes or cardiovascular diseases [2]. The CCM has shown convincing potential to cost-effectively improve the mental health status of people with long-term physical conditions [8, 9, 10]

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Conclusion