The feasibility of assessing the Flinders Program™ of patient self-management in New Zealand primary care settings.
BACKGROUND
The Flinders Program™ has been adopted in New Zealand as a useful and appropriate approach for self-management with primary care clients who have chronic conditions. The Flinders Program™ has not been evaluated in New Zealand settings.


OBJECTIVE
To assess the feasibility of undertaking a substantive long-term trial to gauge the effectiveness of primary care nurses using the Flinders Program™ to improve health outcomes for New Zealand populations.


METHODS
A pilot study was undertaken considering four components of feasibility of conducting a long-term trial: practice recruitment, participant recruitment, delivery of the intervention and outcome measures. This included comparing 27 intervention and 30 control patients with long-term health conditions with respect to change in self-management capacity-Partners in Health (PIH) scale-quality of care using the Patient Assessment of Chronic Illness Care (PACIC) scale and self-efficacy across six months. Intervention participants received care planning with practice nurses using the Flinders Program™ in general practices, while control participants received usual care in comparable practices.


RESULTS
General practice and participant recruitment was challenging, together with a lack of organisational capacity and resources in general practice for the Flinders Program™. The measures of self-management capacity (PIH), quality of care (PACIC) and self-efficacy were useful and valuable primary outcome measures.


CONCLUSIONS
The overall findings do not support a substantive trial of the Flinders Program™ in primary care. Difficulties associated with participant recruitment and ability of practice nurses to undertake the Flinders Program™ within general practice need to be resolved.
School of Nursing, The University of Auckland, Auckland, New Zealand. m.horsburgh@auckland.ac.nz
Margaret P
MP
Horsburgh
Janine J
JJ
Bycroft
Faith M
FM
Mahony
Dianne E
DE
Roy
Denise J
DJ
Miller
Felicity A
FA
Goodyear-Smith
Erin Cj
EC
Donnell
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005240:Feasibility Studies; D005260:Female; D058006:General Practice / Q000458:organization & administration*; D006295:Health Resources; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D010043:Outcome and Process Assessment, Health Care; D010353:Patient Education as Topic; D018579:Patient Selection; D010865:Pilot Projects; D057184:Practice Patterns, Nurses'; D059017:Primary Care Nursing; D015397:Program Evaluation; D011787:Quality of Health Care; D012648:Self Care / Q000379:methods*; D020377:Self Efficacy