Exploring the attitudes, beliefs and behaviours of community nurses towards patient self-care
evidence and practice    

Exploring the attitudes, beliefs and behaviours of community nurses towards patient self-care

Donna Jones Locality Clinical Manager, Shropshire Community Health NHS Trust, Shrewsbury, England

Why you should read this article:
  • To enhance your understanding of community nurses’ attitudes, beliefs and behaviours regarding patient self-care

  • To gain knowledge of the perceived barriers to supporting patient self-care

  • To recognise the importance of adopting a biopsychosocial model of care to meet patients’ holistic needs

Background Self-care is a strategy for providing out-of-hospital care and promoting patients’ independence. However, evidence suggests that some healthcare professionals practise with paternalistic attitudes that are fundamentally opposed to self-care.

Aim To explore the attitudes, beliefs and behaviours of community nurses towards patient self-care and identify the barriers to self-care.

Method This study used Q methodology combined with naturally occurring focus groups. A concourse of 25 Q-statements was developed based on the literature and a ‘Q-table’ was created on which participants rank the Q-statements, known as a Q-sort. A total of 29 community nurses participated in four focus groups. Each focus group created a Q-sort, and these were combined into one Q-sort table for analysis.

Findings From the Q-sort data and the focus group discussions, it was identified that patient safety concerns often mean that community nurses restrict self-care to those they believe will comply with a prescribed care regimen. It was also found that some nurses adopt a biomedical model of care that does not address patients’ psychological and social needs, and which inhibits their self-care. Another finding was that older people often view the role of the nurse as a ‘caregiver’, which is reinforced by the lack of focus on self-care in the aim and function of the community nursing service.

Conclusion For self-care to be successful, the author suggests that paternalistic safety concerns should be relaxed in favour of patient autonomy. Community nurses should also ensure that they adopt a biopsychosocial model of care to meet patients’ holistic needs. A focus on self-care must be integral to the function and purpose of community nursing services to drive forward a change in culture.

Primary Health Care. doi: 10.7748/phc.2020.e1640

Peer review

This article has been subject to external double-blind peer review and has been checked for plagiarism using automated software

Correspondence

donnajones8@nhs.net

Conflict of interest

None declared

Jones D (2020) Exploring the attitudes, beliefs and behaviours of community nurses towards patient self-care. Primary Health Care. doi: 10.7748/phc.2020.e1640

Acknowledgements The author would like to thank the participants of this study for taking part in this research. The author would also like to thank her employer for supporting her to conduct this research

Published online: 10 June 2020

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