The Flinders Program™ of chronic condition self-management in New Zealand: Survey findings

Abstract

Introduction: The Flinders Program™ of Chronic Condition self-Management in New Zealand (NZ) has been given focus as a useful and appropriate approach for self-management support and improvement of long-term condition management. Aim: To determine the use of the Flinders Program™ in NZ and identify barriers and enablers to its use. Method: A web-based survey was undertaken in June 2009 with 355 eligible participants of the 500 who had completed 'Flinders' training in since 2005. Results: 152 (43%) respondents completed the survey over a one-month time frame. Of those who responded, the majority were primary care nurses (80%; 118). Fifty-five percent (82) of survey respondents reported using some or all of the Flinders tools. Of these, 11% (16) reported using all of the tools or processes with 77% (104) of respondents having completed six or fewer client assessments utilising the Flinders tools. This indicates that respondents were relatively inexperienced with use of the Flinders Program™. Barriers to implementation were identified as the time needed for structured appointments (up to one hour), funding, resistance from colleagues, lack of space and insufficient ongoing support. Discussion: Despite the extent of training in the use of the Flinders Program™, there is limited use in clinical practice of the tools and processes associated with the model. Without structured support for quality improvement initiatives and self-management programmes, the ability to implement learned skills and complex interventions is limited.