Background: Practice nurses (PNs) deliver much of the chronic disease management in primary care and have\nbeen highlighted as appropriately placed within the service to manage patients with long-term physical conditions\n(LTCs) and co-morbid depression.\nThis nested qualitative evaluation within a service development pilot provided the opportunity to examine the\nacceptability of a Brief Behavioural Activation (BBA) intervention within a collaborative care framework. Barriers and\nfacilitators to engaging with the intervention from the patient and clinician perspective will be used to guide future\nservice development and research.\nMethods: The study was conducted across 8 practices in one Primary Care Trust 1 in England. Through purposive\nsampling professionals (n = 10) taking part in the intervention (nurses, GPs and a mental health gateway worker)\nand patients (n = 4) receiving the intervention participated in semi-structured qualitative interviews. Analysis utilised\nthe four Normalisation Process Theory (NPT) concepts of coherence, cognitive participation, collective action and\nreflexive monitoring to explore the how this intervention could be implemented in practice.\nResults: Awareness of depression and the stigma associated with the label of depression meant that, from a\npatient perspective a PN being available to ââ?¬Ë?listenââ?¬â?¢ was perceived as valuable. Competing practice priorities,\nperceived lack of time and resources, and lack of engagement by the whole practice team were considered the\ngreatest barriers to the implementation of this intervention in routine primary care.\nConclusion: Lack of understanding of, participation in, and support from the whole practice team in the\ncollaborative care model exacerbated the pressures perceived by PNs. The need for formal supervision of PNs to\nenable them to undertake the role of case manager for patients with depression and long-term conditions is\nemphasised.
Loading....