Clients with chronic and complex conditions: their experiences of community nursing services

Lesley Wilkes, Jane Cioffi, Bronwyn Warne, Kathleen Harrison, Oana Vonu-Boriceanu
Journal of Clinical Nursing 2008, 17 (7): 160-8

AIM: This qualitative study aimed to explore and describes clients' experiences of receiving care from community nurses.

BACKGROUND: Understanding of the experiences of clients with chronic and complex conditions receiving community nursing care can provide insight into their needs. International studies have identified experiences clients have had of receiving care from community nurses. However, no Australian study was found that had specifically explored with clients who had chronic and complex conditions and their experiences of receiving care from community nurses in an area health service.

DESIGN: A qualitative descriptive study conducted during 2005 explored and described clients' experiences of the nursing care provided by community nurses.

METHOD: A purposive sample of 13 volunteer participants with chronic and complex conditions was interviewed and the transcripts analysed.

RESULTS: Three main categories were identified that clients used to describe their experiences. These were: the client's relationship with the nurse, care process and being able to stay out of hospital.

CONCLUSIONS: Clients strongly indicated their satisfaction with care provided by experienced community nurses and acknowledged that nurses are playing a key role in fostering their self-management and avoiding their readmission to hospital. Areas that require further attention are the professional development of less-experienced community nurses, services at the weekend, the scope of nursing management of clients with chronic conditions and the education needs of community nurses to meet the goals of these clients.

RELEVANCE TO CLINICAL PRACTICE: This study highlights the need for nurses who work in strong autonomous clinical roles in the community to have experience in assessment, education, planning and delivery of client care before they can be competent community nurses. The possibility of adverse occurrences during weekends provides the opportunity for managers to review and plan weekday and weekend workloads and staffing.

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