This study will explore Practice Nurses’ (PNs) perceptions of caring for adults (>65years of age) with multimorbidity, in the Irish Primary Care-General Practice setting with a view to informing practical methods for managing this patient group.
Individuals with multimorbidity account for 80% of GP consultations, 78% of all healthcare spend, 60% of all deaths worldwide, 84% of all deaths in Ireland and 77% of Europe’s disease burden.
These individuals are more likely to have longer hospital stays, frequent emergency hospital admissions, repeated costly investigations, higher use of specialists even for conditions usually managed in primary care, polypharmacy, poorer quality of life and die prematurely.
Multimorbidity occurs disproportionately within populations that are socio-economically disadvantaged and in the elderly, and particularly in populations with both.
As the prevalence increases with age this study will focus on the care of patients over the age of 65years, it is estimated that by 2026, 25% of the Irish population will be over 65years.
Each chronic condition impacts on the management of the others making caring for these individuals a challenge. Literature shows little evidence of research specifically addressing multimorbidity, as these patients are excluded from studies to minimise bias.
Most of the existing literature focuses on prevalence rather than interventions directed at improving outcomes, a Cochrane review is ongoing.
PNs provide much of the care for patients with chronic conditions. A key finding of one Irish study highlighted the vital role of PN’s, showing that Practices with a PN were more likely to see chronic disease management improvements and have advanced/ optimum practice targets.
PNs are ideally placed to identify the problems and care needs for these patients, their experience and insight is invaluable in informing and developing future initiatives.
A number of chronic diseases occur in similar patterns across Ireland and Europe. This study will concentrate on the three most common chronic diseases in which PN’s are involved in the management of:
• Cardiovascular Disease,
• Respiratory Disease,
• Diabetes.
Aim
To explore Practice Nurses’ (PNs) perceptions in caring for patients (>65 years of age) with multimorbidity, (in the Irish Primary Care-General Practice setting (IPC-GP), with a view to informing practical methods of managing this group of patients.
Research Objectives
1. To identify existing services (if any) the study participants provide, within their own practice, specifically for patients (>65years of age) with multimorbidity in the IPC-GP setting where a PN is employed.
2. To elicit PN perceptions of caring for the patient with multimorbidity.
3. To identify potential methods for caring for this group of patients at a practice level.
4. To inform any future research or initiatives for the management of multimorbidity in the IPC-GP setting.
Methodology
Because of the dearth of literature on the experiences of PNs specifically addressing multimorbidity the research design will be qualitative using the principles of a grounded theory approach.
Using a preliminary questionnaire to gather demographic information, the researcher will purposefully sample suitable participants for interview to achieve maximum variation.
Semi-structured interviews will allow an in-depth insight on which to develop theories for patient care and service delivery.
The sampling frame is Practice Nurses in the Dublin & Wicklow Branches of the Irish Practice Nurses Association.
The sample size will be determined by data saturation.
| Status | Current |
|---|---|
| Publisher | National University of Ireland, Galway |
| Description | This study will explore Practice Nurses’ (PNs) perceptions of caring for adults (>65years of age) with multimorbidity, in the Irish Primary Care-General Practice setting with a view to informing practical methods for managing this patient group. Individuals with multimorbidity account for 80% of GP consultations, 78% of all healthcare spend, 60% of all deaths worldwide, 84% of all deaths in Ireland and 77% of Europe’s disease burden. These individuals are more likely to have longer hospital stays, frequent emergency hospital admissions, repeated costly investigations, higher use of specialists even for conditions usually managed in primary care, polypharmacy, poorer quality of life and die prematurely. Multimorbidity occurs disproportionately within populations that are socio-economically disadvantaged and in the elderly, and particularly in populations with both. As the prevalence increases with age this study will focus on the care of patients over the age of 65years, it is estimated that by 2026, 25% of the Irish population will be over 65years. Each chronic condition impacts on the management of the others making caring for these individuals a challenge. Literature shows little evidence of research specifically addressing multimorbidity, as these patients are excluded from studies to minimise bias. Most of the existing literature focuses on prevalence rather than interventions directed at improving outcomes, a Cochrane review is ongoing. PNs provide much of the care for patients with chronic conditions. A key finding of one Irish study highlighted the vital role of PN’s, showing that Practices with a PN were more likely to see chronic disease management improvements and have advanced/ optimum practice targets. PNs are ideally placed to identify the problems and care needs for these patients, their experience and insight is invaluable in informing and developing future initiatives. A number of chronic diseases occur in similar patterns across Ireland and Europe. This study will concentrate on the three most common chronic diseases in which PN’s are involved in the management of: • Cardiovascular Disease, • Respiratory Disease, • Diabetes. |
| Other Contributors(s) | Dr Mary Byrne |
| Publication Year | 2009 |
| Data Available to other researchers? | No |
| Completion Date | 04/09/2009 |
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