title: Patients' and practice nurses' perceptions of secondary preventive care for established ischaemic heart disease: a qualitative study.
abstract: A significant proportion of patients with established ischaemic heart disease remain unrecognized in general practice and those who are receiving treatment are experiencing sub-optimal care. The provision of coronary prevention by practice nurses may be an important strategy to improve the quality of this care, and this is feasible and effective. This study explored what occurred during patients' initial assessment for secondary prevention of ischaemic heart disease with a practice nurse and investigated patients' and practice nurses' views ofnurse-led clinics in primary care. Nurses were effective in history taking and offering reassurance and dietary advice, yet were less confident in discussing patients' understandings of heart disease and related medication. Practice nurse-led coronary preventive care is acceptable to both nurses and patients. Further practice nurse education is required in heart disease, cardiac medications and skills necessary for exploring and challenging patients' understandings of these issues.
authors.affiliation: Department of Primary Health Care, University of Oxford, Institute of Health Sciences, Headington, UK. lucy.wright@dphpc.ox.ac.uk
authors.forename: F L
authors.initials: FL
authors.lastname: Wright
authors.forename: R A
authors.initials: RA
authors.lastname: Wiles
authors.forename: M
authors.initials: M
authors.lastname: Moher
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002983:Clinical Competence / Q000592:standards; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008487:Medical History Taking / Q000592:standards; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000517:prevention & control* / Q000523:psychology*; D020380:Needs Assessment; D009722:Nurse Practitioners / Q000193:education / Q000523:psychology*; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D017063:Outcome Assessment, Health Care; D010344:Patient Advocacy; D010353:Patient Education as Topic / Q000379:methods / Q000592:standards; D011320:Primary Health Care / Q000379:methods / Q000592:standards; D011787:Quality of Health Care