The feasibility of assessing the Flinders Program(TM) of patient self-management in New Zealand primary care settings
Horsburgh, Margaret; Bycroft, Janine; Mahony, Faith; Roy, Dianne; Miller, Denise; Goodyear-Smith, Felicity; Donnell, Erin
Citation:Horsburgh, M., Bycroft, J., Mahony, F., Roy, D., Miller, D., Goodyear-Smith, F., & Donnell, E. (2010). Journal of Primary Health Care, 2(4), 294-302. Retrieved from http://www.rnzcgp.org.nz
Permanent link to Research Bank record:http://hdl.handle.net/10652/1739
Introduction: The Flinders Program(TM) has been adopted in New Zealand as a useful and appropriate approach for self-management with primary care clients who have chronic conditions. The Flinders Program(TM) has not been evaluated in New Zealand settings. Aim: To assess the feasibility of undertaking a substantive long-term trial to gauge the effectiveness of primary care nurses using the Flinders Program(TM) to improve health outcomes for New Zealand populations. Methods: A pilot study was undertaken considering four components of feasibility of conducting a long-term trial: practice recruitment, participant recruitment, delivery of the intervention and outcome measures. This included comparing 27 intervention and 30 control patients with long-term health conditions with respect to change in self-management capacity—Partners in Health (PIH) scale—quality of care using the Patient Assessment of Chronic Illness Care (PACIC) scale and self-efficacy across six months. Intervention participants received care planning with practice nurses using the Flinders Program(TM) in general practices, while control participants received usual care in comparable practices. Results: General practice and participant recruitment was challenging, together with a lack of organisational capacity and resources in general practice for the Flinders Program(TM). The measures of self-management capacity (PIH), quality of care (PACIC) and self-efficacy were useful and valuable primary outcome measures. Discussion: The overall findings do not support a substantive trial of the Flinders Program(TM) in primary care. Difficulties associated with participant recruitment and ability of practice nurses to undertake the Flinders Program(TM) within general practice need to be resolved.