9.4.1 Analysing community nursing case notes for evidence of support for patient self care (77)

Colin Macduff, Lecturer, CeNPRaD, School of Nursing, The Robert Gordon University, Aberdeen, Scotland, United Kingdom Co authors: Judith Sinclair c.macduff@rgu.ac.uk

Abstract:

During the past five years the promotion of self care as a means for improving health has gained considerable momentum in health care policy within many developed countries. This approach has been particularly advocated in the UK for patients with long term conditions (DOH 2005). Recently within Scotland, supporting self care has been identified as one of the seven core elements of a redesigned community nursing model. Nevertheless, little appears to be known about the support for self care that community nurses currently provide for patients with long term conditions in Scotland. As part of an ongoing study of current practice, 47 sets of community nursing case notes were analysed in order to clarify the nature and extent of evidence of support for patient self care. These notes were purposively drawn from three sites where different nursing models were in use (a Roper, Logan and Tierney adaptation; an Orem self care adaptation; and a Family Health Nursing adaptation) and pertained to one or more of six different long term conditions. This paper will report the process and outcomes of this analysis, with a view to providing insights into practice and into the methodological challenges involved in such research. A data collection form was developed for abstracting evidence in relation to the four stages of the nursing process, and the five stages of Glasgow et al’s self management model. The most striking and pervasive finding from the analysis was the considerable variability in regard to written evidence of support for self care. This variability was seen to occur both across and within sites where different nursing models were in use, and across different long term conditions. Nevertheless, a number of distinct sub-themes emerged which suggest directions for practice development and further research. These will be presented for discussion and debate.

Recommended reading list:

  • Department of Health (2005) Supporting people with long term conditions. London: DOH
  • Millard, L et al (2006) Nurse-patient interaction and decision-making in care: patient involvement in community nursing. Journal of Advanced Nursing 55 (2), 142-150
  • Friberg, F et al (2006) In search of details of patient teaching in nursing documentation – an analysis of patient records in a medical ward in Sweden

Source of Funding: UK - Professional Association

Amount in Funding: 10,001 - 50,000

Biography:

Colin is a Lecturer in Robert Gordon University, Aberdeen.. He has a background in nursing and health services research. His research interests are varied and include evaluation research, quality of life and outcome measures, community nursing, ethics and poetry in nursing. In recent years he has published widely on these subjects