Involvement of the practice nurse in supporting older people with heart failure: GP perspectives

摘要

Aim: To explore the views of general practitioners (GPs) regarding the involvement of the practice nurse (PN)nin supporting older people with heart failure (HF) throughout the disease trajectory and identify specificnimplications for initiating advance care planning and improving end-of-life care.nMethods: Thirty GPs in a large urban area of New Zealand (NZ) participated in in-depth qualitative interviews.nThe interviews were recorded and transcribed verbatim. Data were entered into Nvivo software and werenanalysed thematically.nResults: While the GPs’ experiences of working with the PN as contributor to the management of oldernpatients with HF were positive overall, very minimal involvement of the PN in palliative and end-of-life carenmanagement was identified. However, significant potential for expansion was identified, particularly in thenareas PNs are currently involved in, namely communication, education, and coordinating services, all ofnwhich are considered essential to effective palliative and end-of-life care.nConclusion: The views of GPs are important as they employ PNs in NZ and are central to the ways in which thenPN role can be developed in the future to improve services for older people with HF throughout the diseasentrajectory. Our study indicates that there is significant potential to expand the role of the PN throughout the HFndisease trajectory, a development which could address some of the current gaps in palliative and end-of-lifencare management for these patients. Further research is required to develop and evaluate a model whichnoptimizes the PN role throughout the disease trajectory of people with HF.