Using the lens of enablement to explore patients’ experiences of Nurse Practitioner care in the Primary Health Care setting

Abstract

Background: Patient enablement is a patient-centred concept reflecting a patient's ability to cope, understand and manage their own health. It can be used as a measure of the quality of care and has been linked with improved patient outcomes. While there have been studies into patient enablement following consultations with General Practitioners (GPs) and practice nurses, Nurse Practitioners’ (NPs) role in enabling patients remains unexplored. Aim: To use the lens of enablement to explore patients’ lived experience of NP care in a Primary Health Care (PHC) setting in Australia. Methods: Using a qualitative approach, 12 patients who had consulted an NP in PHC participated in unstructured interviews. An interpretative phenomenological approach was used to inform the study. A secondary analysis was conducted to explore possible synergies and resonance between the data and the constructs of the Patient Enablement Instrument (PEI). Findings: This small qualitative study found that, following consultations with NPs in PHC, patients reported personal approaches and behaviours consistent with enablement. Three key existential themes appeared to contribute to patient enablement: the way NPs used consultation time (temporality), the building of partnerships between NPs and patients (relationality) and through NPs’ holistic and hands-on consultation approach (corporality). The effective use of time in the consultation was seen as particularly important. Conclusion: The findings from this study suggest consultations with NPs do enable patients. This is a previously undocumented strength of NP care. Further research, using a variety of settings, methods and patient and health care provider populations, is recommended.