Patients’ experience of a novel interdisciplinary nurse-led self-management intervention (INSELMA)—a qualitative evaluation
(2024) In BMC Rheumatology 8(1).- Abstract
Background: Despite continuous improvements in anti-rheumatic pharmacological treatment, people with chronic inflammatory arthritis still report substantial disease impact. Based on the framework for complex interventions, we thus developed INSELMA, a novel nurse-coordinated multidisciplinary self-management intervention for patients with rheumatoid arthritis, psoriatic arthritis or axial spondyloarthritis. Based on individual biopsychosocial assessments, a rheumatology nurse facilitated goal setting and coordinated interdisciplinary support. The aim of this study was to explore the patients’ experience of participating in the six-months INSELMA intervention. Methods: Individual semi-structured interviews were conducted with 15 of the... (More)
Background: Despite continuous improvements in anti-rheumatic pharmacological treatment, people with chronic inflammatory arthritis still report substantial disease impact. Based on the framework for complex interventions, we thus developed INSELMA, a novel nurse-coordinated multidisciplinary self-management intervention for patients with rheumatoid arthritis, psoriatic arthritis or axial spondyloarthritis. Based on individual biopsychosocial assessments, a rheumatology nurse facilitated goal setting and coordinated interdisciplinary support. The aim of this study was to explore the patients’ experience of participating in the six-months INSELMA intervention. Methods: Individual semi-structured interviews were conducted with 15 of the participants after their final follow-up. Thematic analysis was applied. Results: The analysis derived four overall themes. (1) A new opportunity at the right time. The participants’ disease impacted all areas of daily life. Participation in INSELMA was experienced as an opportunity to improve symptoms and together reduce long-held challenges they had fought alone, until now. (2) The importance of person-centred goals. The participants found it meaningful to work with their individual goals, which encompassed physical, psychological, and social factors. Having time between consultations to work with goals at home was important. (3) Empathy, partnership and a little nudging from health professionals are essential. The empathic nurses’ continuous support and coaching helped participants become aware of their own resources. The participants highlighted having access to support from a physiotherapist and occupational therapist with rheumatology experience as important. (4) I got more than I could have hoped for. Most of the participants experienced decreased symptom load and improvement in physical strength, mobility, sleep, and mood as well as increased energy, knowledge, and self-management ability. The participants expressed new hope for the future with an improved ability to manage their symptoms and work towards new goals. Conclusion: The participants found the INSELMA intervention meaningful and feasible. They experienced decreased disease impact and increased activity levels, facilitated by empathy and self-management support from health professionals.
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- author
- Blum, Nadine Schäffer ; Esbensen, Bente Appel ; Østergaard, Mikkel ; Bremander, Ann LU ; Hendricks, Oliver ; Lindgren, Luise Holberg ; Andersen, Lena ; Jensen, Kim Vilbaek and Primdahl, Jette
- organization
- publishing date
- 2024
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Complex intervention, Goal setting, Health literacy, Person-centred, PSFS, Qualitative research, Rehabilitation, Self-efficacy
- in
- BMC Rheumatology
- volume
- 8
- issue
- 1
- article number
- 10
- publisher
- BioMed Central (BMC)
- external identifiers
-
- pmid:38429851
- scopus:85186470269
- ISSN
- 2520-1026
- DOI
- 10.1186/s41927-024-00379-6
- language
- English
- LU publication?
- yes
- id
- eb0ea35c-29b7-48c7-8093-95a539896418
- date added to LUP
- 2024-03-15 12:15:55
- date last changed
- 2024-04-12 07:38:59
@article{eb0ea35c-29b7-48c7-8093-95a539896418,
abstract = {{<p>Background: Despite continuous improvements in anti-rheumatic pharmacological treatment, people with chronic inflammatory arthritis still report substantial disease impact. Based on the framework for complex interventions, we thus developed INSELMA, a novel nurse-coordinated multidisciplinary self-management intervention for patients with rheumatoid arthritis, psoriatic arthritis or axial spondyloarthritis. Based on individual biopsychosocial assessments, a rheumatology nurse facilitated goal setting and coordinated interdisciplinary support. The aim of this study was to explore the patients’ experience of participating in the six-months INSELMA intervention. Methods: Individual semi-structured interviews were conducted with 15 of the participants after their final follow-up. Thematic analysis was applied. Results: The analysis derived four overall themes. (1) A new opportunity at the right time. The participants’ disease impacted all areas of daily life. Participation in INSELMA was experienced as an opportunity to improve symptoms and together reduce long-held challenges they had fought alone, until now. (2) The importance of person-centred goals. The participants found it meaningful to work with their individual goals, which encompassed physical, psychological, and social factors. Having time between consultations to work with goals at home was important. (3) Empathy, partnership and a little nudging from health professionals are essential. The empathic nurses’ continuous support and coaching helped participants become aware of their own resources. The participants highlighted having access to support from a physiotherapist and occupational therapist with rheumatology experience as important. (4) I got more than I could have hoped for. Most of the participants experienced decreased symptom load and improvement in physical strength, mobility, sleep, and mood as well as increased energy, knowledge, and self-management ability. The participants expressed new hope for the future with an improved ability to manage their symptoms and work towards new goals. Conclusion: The participants found the INSELMA intervention meaningful and feasible. They experienced decreased disease impact and increased activity levels, facilitated by empathy and self-management support from health professionals.</p>}},
author = {{Blum, Nadine Schäffer and Esbensen, Bente Appel and Østergaard, Mikkel and Bremander, Ann and Hendricks, Oliver and Lindgren, Luise Holberg and Andersen, Lena and Jensen, Kim Vilbaek and Primdahl, Jette}},
issn = {{2520-1026}},
keywords = {{Complex intervention; Goal setting; Health literacy; Person-centred; PSFS; Qualitative research; Rehabilitation; Self-efficacy}},
language = {{eng}},
number = {{1}},
publisher = {{BioMed Central (BMC)}},
series = {{BMC Rheumatology}},
title = {{Patients’ experience of a novel interdisciplinary nurse-led self-management intervention (INSELMA)—a qualitative evaluation}},
url = {{http://dx.doi.org/10.1186/s41927-024-00379-6}},
doi = {{10.1186/s41927-024-00379-6}},
volume = {{8}},
year = {{2024}},
}