ACCESSIBILITY, SECURITY AND COMPETENCE – THE PATIENTS' PERSPECTIVES ON NURSING CONSULTATIONS IN THREE RHEUMATOLOGY OUTPATIENT CLINICS

Background: Traditionally nurses working in rheumatology outpatient clinics in Norway have had an assistant role in relation to the rheumatologists, carrying out clinical procedures and drug trials. In some clinics the role has gradually evolved to include monitoring patients on DMARDs, patient education and individual councelling on how to manage life with chronic disabling disease. The patients are referred to clinical specialist nurses for individual consultations.Objectives: The aim of this study was to describe how patients with rheumatic diseases experience nursing consultations, whether they feel that their needs are met, and which themes they talk about with the nurses.Methods: Focus group interviews were performed at three rheumatology outpatient clinics. Twelve adult patients with the diagnoses RA and JIA were included, 9 women and 4 men. Age ranged from 26 to 69 and disease duration from 1 to 28 years. Topics relating to consultation content, the significance of meeting a nurse, confidence in the nurses compentence and satisfaction/dissatisfaction were discussed. The interviews were analysed using an established method for qualitative content analyses.Results: The identified themes were Accessibility, Security and Competence. An open phone line made access easy. Time, Continuity, Relationship, and Holistic care were identified as important prerequisites for the experience of security and competence. The participants felt confident that the nurses had the necessary knowledge and experience about their disease and drugs used, and that they would contact the physician if they were insecure. High quality care was associated with good teamwork.Conclusions: This qualitative study suggests that patients experience the nursing consultation as complementary to the medical care at rheumatology outpatient clinics. The nurses contribute to a holistic approach in rheumatology care and ensure that the patients perspectives of what is important by living with a rheumatic disease is met. Further research is needed to document the benefits of nursing consultations compared with only visits to rheumatologists.Citation: Ann Rheum Dis, volume 65, supplement II, year 2006, page 668Session: Nursing