Examining nursing processes in primary care settings using the Chronic Care Model: an umbrella review

BMC Primary Care

Research

Denis Roy¹  Isabelle Dufour²  Andrée-Anne Poirier³  Arnaud Duhoux⁴  Emilie Dufour⁴  Martin Charette⁵  Jérôme Leclerc-Loiselle⁵  Jolianne Bolduc⁶ 

[1] Commissaire à la santé et au bien-être, Gouvernement du Québec, Montréal, Canada;Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Canada;Faculty of Medicine, Université Laval, Québec, Canada;Faculty of Nursing, Université de Montréal, Montréal, Canada;School of Nursing, Université de Sherbrooke, Sherbrooke, Canada;École de santé publique, Université de Montréal, Montréal, Canada;

关键词: Chronic care model;    Systematic review;    Community Care;    Nurse-led care;    Chronic disease;   

DOI  :  10.1186/s12875-023-02089-3

 received in 2022-07-31, accepted in 2023-06-22,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundWhile there is clear evidence that nurses can play a significant role in responding to the needs of populations with chronic conditions, there is a lack of consistency between and within primary care settings in the implementation of nursing processes for chronic disease management. Previous reviews have focused either on a specific model of care, populations with a single health condition, or a specific type of nurses. Since primary care nurses are involved in a wide range of services, a comprehensive perspective of effective nursing processes across primary care settings and chronic health conditions could allow for a better understanding of how to support them in a broader way across the primary care continuum. This systematic overview aims to provide a picture of the nursing processes and their characteristics in chronic disease management as reported in empirical studies, using the Chronic Care Model (CCM) conceptual approach.MethodsWe conducted an umbrella review of systematic reviews published between 2005 and 2021 based on the recommendations of the Joanna Briggs Institute. The methodological quality was assessed independently by two reviewers using the AMSTAR 2 tool.ResultsTwenty-six systematic reviews and meta-analyses were included, covering 394 primary studies. The methodological quality of most reviews was moderate. Self-care support processes show the most consistent positive outcomes across different conditions and primary care settings. Case management and nurse-led care show inconsistent outcomes. Most reviews report on the clinical components of the Chronic Care Model, with little mention of the decision support and clinical information systems components.ConclusionsPlacing greater emphasis on decision support and clinical information systems could improve the implementation of nursing processes. While the need for an interdisciplinary approach to primary care is widely promoted, it is important that this approach not be viewed solely from a clinical perspective. The organization of care and resources need to be designed to support contributions from all providers to optimize the full range of services available to patients with chronic conditions.PROSPERO registrationCRD42021220004.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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