AB1456-HPR Shared decision making in practice and needs of rheumatic patients on nursing support

• Published in: Annals of the rheumatic diseases Vol. 77; no. Suppl 2; p. 1860
• Main Author: Voorneveld-Nieuwenhuis, J.H.E
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Limited 01.06.2018
• Subjects: Clinical decision making; Decision making; Disease management; Education; Emotions; Morbidity; Nurses; Nursing; Nursing care; Patients; Rheumatic diseases; Rheumatoid arthritis; Rheumatology
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/annrheumdis-2018-eular.3711

BackgroundValue Based Health Care entails creating value for the patient by providing meaningful care. Meaningful care can be given with focus at the perspective of the patient. Nurses play a role in measuring and monitoring care outcomes, but also have an important role in providing information about, treatment options and counselling of patients with their illness and treatment. Nurse consultation is part of the clinical pathway for rheumatoid arthritis patients.ObjectivesWhat are the needs and expectations of a patient at a consultation with the rheumatology nurse?What do rheumatology nurses discuss with patients and their relatives during the nursing consultation and does this fit with the nursing competences from the generic self-management model?MethodsBeside literature research two focus groups with patients about nursing care in the out-patient clinic where held. Also 10 nurse consultations where analysed from 3 different nurses. Qualitative data from both focus groups and observations where analysed and encoded with Atlas.ti.ResultsPatients where positive about the time spending for education and information. They expect the nurse to be a guide and give reliable information. They wanted emotional support especially when medication change and in the begin period when diagnose is set. Suggestions for subjects for follow up consultation like medication check, co-morbidity screening where positively received. Talking about self management is also a well received subject. A specific tool for self management like the self management web could support both patients and nurses.Observation in practice showed that nurses give education and advice, but coaching is a less used skill.ConclusionsPatients want emotional support, education about illness and self management support. Nurses are well equipped in give information and advice but must be educated in using there coaching skills and support patients to talk about their experienced problems in daily live.References[1] Eijk-Hustings, Y. van, Ammerlaan, J., Voorneveld-Nieuwenhuis, H., Maat, B., Veldhuizen, C., & Repping-Wuts, H. (2013). Patients’ needs and expectations with regard to rheumatology nursing care: results of multicentre focus group interviews. Annals of the Rheumatic Diseases, 72(6), 831–835.[2] Porter, M. E. (2010). What is value in health care?. New England Journal of Medicine, 363(26), 2477–2481.[3] Staa, A. L. van, Beck, D., Been-Dahmen, J.M.J., & Massey, E.K. (2017). Ondersteuning bij zelfmanagement: Een nieuwe verpleegkundige interventie. Dé Verpleegkundig Specialist, 12(1), 8–14.Disclosure of InterestNone declared