PUB - Publikationen an der Universität Bielefeld

Background: Offering person-centred care for patients with complex chronic conditions challenges healthcare systems worldwide. Strong multiprofessional primary healthcare (PHC) can contribute by addressing the multiple social and health needs of patients with chronic conditions and multimorbidity. PHC nurses are increasingly responsible for chronic care and participation support in models of team-based care. It is therefore important to strengthen their abilities to support patient participation and self-care. Aim: To identify barriers and enablers PHC nurses face when supporting the participation of patients with complex chronic conditions. Method: We conducted interviews with 34 practicing PHC nurses and 23 key informants in Brazil, Germany, and Spain. The data were analysed from a cross-country perspective using thematic coding. Results: Four categories for barriers and enablers emerged. They refer to (1) nurses’ ability to build “bonds” with patients and foster trusting relationships; (2) their approach to strengthening the resources for self-care in patients’ families; (3) in how far nurses’ engagement towards patient participation is supported by other professions in the PHC team; and (4) to what extent nurses are facilitated to engage in participation support by their work environment, e.g., technical infrastructure and time to have conversations with patients. Conclusion: PHC nurses are challenged to address the support needs of patients with complex chronic conditions and engage in patient participation and self-care, as these patients and their families are often overwhelmed by the complexity of chronic care. PHC nurses also see chances for tailored healthcare provision through the participation of patients with complex chronic conditions.