The process of patient enablement in general practice nurse consultations: a grounded theory study.
OBJECTIVE
The aim of this study was to gain insight into the process of patient enablement in general practice nursing consultations.


BACKGROUND
Enhanced roles for general practice nurses may benefit patients through a range of mechanisms, one of which may be increasing patient enablement. In studies with general practitioners enhanced patient enablement has been associated with increases in self-efficacy and skill development.


METHODS
This study used a constructivist grounded theory design.


METHODS
In-depth interviews were conducted with 16 general practice nurses and 23 patients from 21 general practices between September 2013 - March 2014. Data generation and analysis were conducted concurrently using constant comparative analysis and theoretical sampling focussing on the process and outcomes of patient enablement. Use of the storyline technique supported theoretical coding and integration of the data into a theoretical model.


RESULTS
A clearly defined social process that fostered and optimised patient enablement was constructed. The theory of 'developing enabling healthcare partnerships between nurses and patients in general practice' incorporates three stages: triggering enabling healthcare partnerships, tailoring care and the manifestation of patient enablement. Patient enablement was evidenced through: 1. Patients' understanding of their unique healthcare requirements informing their health seeking behaviours and choices; 2. Patients taking an increased lead in their partnership with a nurse and seeking choices in their care and 3. Patients getting health care that reflected their needs, preferences and goals.


CONCLUSIONS
This theoretical model is in line with a patient-centred model of health care and is particularly suited to patients with chronic disease.
Department of Health Services Research and Policy, Research School of Population Health, Australian National University, Canberra, Australia.
Jane
http://orcid.org/0000-0003-1406-4593
J
Desborough
National Institute for Mental Health Research, Australian National University, Canberra, Australia.
Michelle
M
Banfield
Social Foundations of Medicine, Australian National University Medical School, Australian National University, Canberra, Australia.
Christine
C
Phillips
School of Health & Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia.
Jane
J
Mills
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058006:General Practice / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D009722:Nurse Practitioners / Q000592:standards*; D009723:Nurse-Patient Relations; D010358:Patient Participation; D017060:Patient Satisfaction; D057184:Practice Patterns, Nurses'
general practice nurses; grounded theory; nurse-patient interaction; patient enablement; primary care; self-efficacy