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.
To use the lens of enablement to explore patients’ lived experience of NP care in a Primary Health Care (PHC) setting in Australia.
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).
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.
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.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Collegian
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Interview mode effects in surveys of drug and alcohol use: A field experiment.Public Opinion Quarterly. 1994; 58: 210-240
- Phenomenology and rehabilitation research.Research Methods in Health: Foundations for Evidence-based Practice. 2010; : 123-139
- Meeting Australia’s emerging primary care needs by nurse practitioners.The Journal for Nurse Practitioners. 2015; 11: 647-652
- The impact of general practice nursing care on patient satisfaction and enablement in Australia: A mixed methods study.International Journal of Nursing Studies. 2016; 64: 108-119
- The process of patient enablement in general practice nurse consultations: A grounded theory study.Journal of Advanced Nursing, Journal of Advanced Nursing. 2016; https://doi.org/10.1111/jan.13199
- Investigating the relationship between consultation length and patient experience: A cross sectional study in primary care.British Journal of General Practice. 2016; 66: e896-e903
- An integrative review of enablement in primary health care.Journal of Primary Care & Community Health. 2015; 6: 264-278
- The use of a modification of the Patient Enablement Instrument in asthma.Primary Care Respiratory Journal: Journal of the General Practice Airways Group. 2007; 16: 89-92
- Being and time: a translation of Sein und Zeit.SUNY Press, 1996 (State University of New York Press, Albany)
- Measuring quality in general practice. Pilot study of a needs, process and outcome measure.Occas Pap R Coll Gen Pract. 1997; 75: 1-32
- A comparison of a Patient Enablement Instrument (PEI) against two established satisfaction scales as an outcome measure of primary care consultations.Family Practice. 1998; 15: 165-171
- Enablement in health care context: a concept analysis.Journal of Evaluation in Clinical Practice. 2011; 17: 143-149https://doi.org/10.1111/j. 1365-2753.2010.01413.x
- Family physician enabling attitudes: a qualitative study of patient perceptions.BMC Family Practice. 2013; 14: 8https://doi.org/10.1186/1471-2296-14-8
- Randomised controlled trial of nurse practitioner versus general practitioner care for patients requesting same day consultations in primary care.British Medical Journal. 2000; 320: 1043-1048
- Two principal components, coping and independence, comprise patient enablement in Japan: Cross sectional study in Tohoku area.Tohoku Journal Experimental Medicine. 2012; 227: 97-104
- Substitution of doctors by nurses in primary care.Cochrane Database Systematic Reviews. 2005; 2
- Behind the screens: Nursing, somology, and the problem of the body.Sydney University Press, 2006
- Qualitative research methods.4th ed. Oxford University Press, South Melbourne, Vic2013: c2013
- Nurse practitioners in NSW'Gaining Momentum': rapid review of the nurse practitioner literature.Australian Health Services Research Institute, Wollongong, Australia2014
- The impact of general practitioners' patient-centredness on patients' post-consultation satisfaction and enablement.Social Science and Medicine. 2002; 55: 283-299
- Factors associated with enablement in general practice: Cross-sectional study using routinely-collected data.British Journal of General Practice. 2008; 58: 346-352https://doi.org/10.3399/bjgp08x280218
- The general practice assessment questionnaire (GPAQ) − Development and psychometric characteristics.BMC Family Practice. 2008; 9: 13https://doi.org/10.1186/1471-2296-9-13
- The inverse care law: Clinical primary care encounters in deprived and affluent areas of Scotland.The Annals of Family Medicine. 2007; 5: 503-510https://doi.org/10.1370/afm.778
- More time for complex consultations in a high-deprivation practice is associated with increased patient enablement.British Journal of General Practice. 2007; 57: 960-966https://doi.org/10.3399/096016407782604910
- General practitioner empathy, patient enablement, and patient-reported outcomes in primary care in an area of high socio-economic deprivation in Scotland-a pilot prospective study using structural equation modeling.Patient Education and Counselling. 2008; 73: 240-245https://doi.org/10.1016/j.pec.2008.07.022
- Nursing research.Jones & Bartlett Learning, London, UK2012
- Is there a bias against telephone interviews in qualitative research?.Research in Nursing & Health. 2008; 31: 391-398
- Assessing the quality of patient centred consultations.Journal of Nursing Care. 2015; S1https://doi.org/10.4172/2167-1168.s1-006
- Essentials of nursing research.Ethics. 2012; 23
- Achieving value in primary care: The primary care value model.The Annals of Family Medicine. 2016; 14: 159-165
- Nurse practitioner-sensitive outcomes: A summary report.College of Registered Nurses of Nova Scotia, Halifax, NS2016
- Comparison of GP and nurse practitioner consultations: An observational study.British Journal of General Practice. 2005; 55: 938-943
- Toward a framework for patient education an analysis of enablement.Journal of Holistic Nursing. 1996; 14: 332-347
- Empowering patients with diabetes: A qualitative primary care study focusing on South Asians in Leicester, UK.Family Practice. 2005; 22: 647-652https://doi.org/10.1093/fampra/cmi069
- Researching lived experience.State University of New York Press, New York1990
- Phenomenology of practice: Meaning-giving methods in phenomenological research and writing. Vol. 13. Left Coast Press, Walnut Creek, California2014
- Randomised controlled trial comparing cost effectiveness of general practitioners and nurse practitioners in primary care.British Medical Journal. 2000; 320: 1048-1053
Published online: June 23, 2017
Accepted: June 13, 2017
Received in revised form: April 6, 2017
Received: December 16, 2016
© 2017 Australian College of Nursing Ltd. Published by Elsevier Ltd.