Factors and Strategies Influencing Integrated Self-Management Support for People With Chronic Diseases and Common Mental Disorders: A Qualitative Study of Canadian Primary Care Nurses' Experience.
Jérémie Beaudin, Maud-Christine Chouinard, Émilie Hudon and 1 others
PMID 40062467WHAT IT FOUND
Nurses managing both physical and mental health conditions in primary care reported feeling unprepared, with training focused on chronic disease and no clear protocols for mental health.
They described referring patients away rather than supporting them, citing workload and unclear roles as barriers.
Key findings
01All participating nurses reported a lack of knowledge, skills and training in common mental disorders, with initial orientation in family medicine groups covering only physical chronic diseases.
02Nurses described disengaging from mental health support and referring patients to other professionals when those roles were available, partly because mental health care was not prioritised by their clinic's culture.
03The most frequently proposed improvement was targeted training in integrated self-management support, with nurses also asking for more time per appointment and clearer interprofessional roles.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Only nurses were interviewed. Patients' own experiences of integrated self-management support were not captured. Most participants were experienced nurses (median 17 years of practice), so the findings may not reflect the experience of newly qualified nurses. Transcripts were not returned to participants for checking, and participants were not involved in the analysis. Interviews were the only data source, with no observation or document review. Cultural safety in self-management support was not explicitly explored, despite nurses raising challenges with people facing cultural, linguistic or literacy barriers. All nurses worked in Quebec family medicine groups, where the nursing role and team structure differ from primary care in other countries.
Declared interests
The authors declared no conflicts of interest. Funding came from the Quebec Order of Nurses, the Quebec Ministry of Education and the Quebec nursing research network.
The easy way to misread this
Do not read the nurses' proposed strategies as evidence that any of them work. This study reports what nurses said would help; no intervention was delivered and no patient outcome was measured, so none of these strategies has been shown to improve self-management support or health.