Family Practice, Vol 14, 227-232, Copyright © 1997 by World Organization of Family Doctors
R Robertson, LM Osman and JG Douglas
BACKGROUND: Asthma clinics have become widespread in general practice with
nurses now playing an important role in asthma review. However, little is
known about training of nurses carrying out reviews and how this affects
the nurse role in patient management. OBJECTIVES: We aimed to discover the
level of asthma training of practice nurses carrying out review of adult
asthma patients in one Health Authority and to see if this has any effect
on their perception of their role. METHOD: All 187 practice nurses in
Grampian were sent a postal questionnaire investigating how asthma review
is organized in general practice, their role in review and the asthma
training they had received. Personal interviews were carried out with 17
nurses, exploring in more depth the topics covered in the questionnaire.
RESULTS: A total of 167 nurses from 92% of the practices in Grampian
responded, of whom 61% carried out asthma reviews. Among nurses carrying
out reviews 71% did so on their own. 49% of nurses had or were training for
advanced asthma qualification. Nurses without an asthma qualification were
significantly more likely to feel that their training was not sufficient
for their asthma related tasks (54% versus 11%, P = 0.0002). Nurses without
advanced asthma qualifications were less likely to provide or review a
self-management plan (29% versus 49%, P = 0.01), to review patient PEF
recording (38% versus 65%, P < 0.01), to discuss patient worries (75%
versus 94%, P < 0.05) or to make the initial diagnosis of asthma (24%
versus 76%, P < 0.005). Nurses were unlikely to view their role as fully
responsible unless they had an asthma qualification (13% versus 49%, P <
0.001). CONCLUSION: Nurses without advanced asthma qualifications do not
feel fully confident in responsibility for patient management. Nurses
without training are more likely to only carry out routine monitoring at
reviews while nurses with asthma training are more likely to actively
develop patient self- management skills. This suggests that nurses should
be supported to obtain asthma qualifications if they are to give the best
possible care to asthma patients.
ORIGINAL CLINICAL RESEARCH
Adult asthma review in general practice: nurses' perception of their role
Respiratory Unit, Aberdeen Royal Hospitals Trust/Department of Medicine, University of Aberdeen, UK.
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