title: Do Australian general practitioners believe practice nurses can take a role in chlamydia testing? A qualitative study of attitudes and opinions.
abstract: BACKGROUND
  Chlamydia notifications continue to rise in young people in many countries and regular chlamydia testing is an important prevention strategy. Although there have been initiatives to increase testing in primary care, none have specifically investigated the role of practice nurses (PNs) in maximising testing rates. PNs have previously expressed a willingness to be involved, but noted lack of support from general practitioners (GPs) as a barrier. We sought GPs' attitudes and opinions on PNs taking an expanded role in chlamydia testing and partner notification.
  
  
  METHODS
  In the context of a cluster randomised trial in mostly rural towns in 4 Australian states, semi structured interviews were conducted with 44 GPs between March 2011 and July 2012. Data relating to PN involvement in chlamydia testing were thematically analysed using a conventional content analysis approach.
  
  
  RESULTS
  The majority of GPs interviewed felt that a role for PNs in chlamydia testing was appropriate. GPs felt that PNs had more time for patient education and advice, that patients would find PNs easier to talk to and less intimidating than GPs, and that GPs themselves could benefit through a reduction in their workload. Although GPs felt that PNs could be utilised more effectively for preventative health activities such as chlamydia testing, many raised concerns about how these activities would be renumerated whilst some felt that existing workload pressures for PNs could make it difficult for them to expand their role. Whilst some rural GPs recognised that PNs might be well placed to conduct partner notification, they also recognised that issues of patient privacy and confidentiality related to living in a "small town" was also a concern.
  
  
  CONCLUSIONS
  This is the first qualitative study to explore GPs' views around an increased role for PNs in chlamydia testing. Despite the concerns raised by PNs, these findings suggest that GPs support the concept and recognise that PNs are suited to the role. However issues raised, such as funding and remuneration may act as barriers that will need to be addressed before PNs are supported to make a contribution to increasing chlamydia testing rates in general practice.
authors.affiliation: The Kirby Institute for Infection and Immunity in Society, UNSW Australia, Sydney, NSW, Australia. rlorch@kirby.unsw.edu.au.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Lorch
authors.affiliation: Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia. j.hocking@unimelb.edu.au.
authors.forename: Jane
authors.initials: J
authors.lastname: Hocking
authors.affiliation: The Kirby Institute for Infection and Immunity in Society, UNSW Australia, Sydney, NSW, Australia. rguy@kirby.unsw.edua.au.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Guy
authors.affiliation: Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia. amvaisey@unimelb.edu.au.
authors.forename: Alaina
authors.initials: A
authors.lastname: Vaisey
authors.affiliation: Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia. annwood@unimelb.edu.au.
authors.forename: Anna
authors.initials: A
authors.lastname: Wood
authors.affiliation: The Kirby Institute for Infection and Immunity in Society, UNSW Australia, Sydney, NSW, Australia. Bdonovan@kirby.unsw.edu.au.|Sydney Sexual Health Centre, Sydney Hospital, Sydney, NSW, Australia. Bdonovan@kirby.unsw.edu.au.
authors.forename: Basil
authors.initials: B
authors.lastname: Donovan
authors.affiliation: Central Clinical School, Monash University and Melbourne Sexual Health Centre, Carlton, Victoria, Australia. cfairley@mshc.org.au.
authors.forename: Christopher
authors.initials: C
authors.lastname: Fairley
authors.affiliation: Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia. j.gunn@unimelb.edu.au.
authors.forename: Jane
authors.initials: J
authors.lastname: Gunn
authors.affiliation: The Kirby Institute for Infection and Immunity in Society, UNSW Australia, Sydney, NSW, Australia. Jkaldor@kirby.unsw.edu.au.
authors.forename: John
authors.initials: J
authors.lastname: Kaldor
authors.affiliation: Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia. m.temple-smith@unimelb.edu.au.
authors.forename: Meredith
authors.initials: M
authors.lastname: Temple-Smith
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001315:Australia; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000635:transmission; D016358:Contact Tracing; D005260:Female; D058006:General Practice; D058005:General Practitioners / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners; D024802:Nurse's Role; D011320:Primary Health Care; D036301:Qualitative Research; D012423:Rural Health