title: [Being cared for and caring: living with multiple chronic diseases (Leila)-a qualitative study about APN contributions to integrated care].
abstract: BACKGROUND
  Living with multiple chronic diseases is complex and leads to enhanced care needs. To foster integrated care a project called "Living with chronic disease" (Leila) was initiated.
  
  
  OBJECTIVE
  The aim was to develop an Advanced Practice Nursing (APN) service in collaboration with medical centers for persons who are living with multiple chronic diseases. The following research questions were addressed: 1. What are patients' experiences, referring physicians and APNs with the Leila-Service? 2. How are referral processes performed? 3. How do the involved groups experience collaboration and APN role development?
  
  
  METHODS
  A qualitative approach according grounded theory of Corbin and Strauss was used to explore the experiences with the Leila project and the interaction of the persons involved. 38 interviews were conducted with patients who are living with multiple chronic diseases, their APN's and the referring physicians.
  
  
  RESULTS
  The findings revealed "Being cared for and caring" as main category. The data demonstrated how patients responded to their involvement into care and that they were taken as serious partners in the care process. The category "organizing everyday life" describes how patients learned to cope with the consequences of living with multiple chronic diseases. "Using all resources" as another category demonstrates how capabilities and strengths were adopted.
  
  
  CONCLUSIONS
  The results of the cooperation- and allocation processes showed that the APN recognition and APN role performance have to be negotiated. Prospective APN-services for this patient population should be integrated along with physician networks and other service providers including community health nursing.
authors: Zürcher Hochschule für Angewandte Wissenschaften ZHAW, Institut für Pflege, Departement Gesundheit, Winterthur, Schweiz.
authors: Maria
authors: M
authors: Müller-Staub
authors: Zürcher Hochschule für Angewandte Wissenschaften ZHAW, Institut für Pflege, Departement Gesundheit, Winterthur, Schweiz.
authors: Nicole
authors: N
authors: Zigan
authors: Zürcher Hochschule für Angewandte Wissenschaften ZHAW, Institut für Pflege, Departement Gesundheit, Winterthur, Schweiz.
authors: Daniela
authors: D
authors: Händler-Schuster
authors: Zürcher Hochschule für Angewandte Wissenschaften ZHAW, Institut für Pflege, Departement Gesundheit, Winterthur, Schweiz.
authors: Sebastian
authors: S
authors: Probst
authors: Städtische Gesundheitsdienste Zürich, Schweiz.
authors: Renate
authors: R
authors: Monego
authors: Zürcher Hochschule für Angewandte Wissenschaften ZHAW, Institut für Pflege, Departement Gesundheit, Winterthur, Schweiz.
authors: Lorenz
authors: L
authors: Imhof
mesh_terms: D057179:Advanced Practice Nursing; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000451:nursing* / Q000523:psychology*; D003299:Cooperative Behavior; D019033:Delivery of Health Care, Integrated; D005260:Female; D066296:Grounded Theory; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D009742:Nursing Theory; D036301:Qualitative Research; D013557:Switzerland
keywords: Advanced Practice Nursing (APN); Grounded Theory; Leben mit chronischen Krankheiten; integrated care; integrierte Versorgung; living with chronic disease; multiple chronic disease; multiple chronische Krankheiten