Community nurses' self-management support in older adults: A qualitative study on views, dilemmas and strategies

Marian J. T. van het Bolscher-Niehuis, Madeleen J. Uitdehaag, Anneke L. Francke

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Providing self-management support is an appropriate task for community nurses. However, the support of self-management sometimes triggers tensions in practice. The aim of this study was to explore community nurses' views of self-management, the dilemmas community nurses face when providing support of self-management by older adults and the strategies they use to solve these challenges. A qualitative study was performed to collect data. Twenty-one community nurses from the eastern part of the Netherlands were recruited through purposive sampling. The interviews were audiotaped, transcribed verbatim and a thematic analysis was carried out. The results show that community nurses find it difficult to give a clear, definitive description of the concept of self-management. They relate self-management to ‘taking control of your own life’, ‘making your own choices and decisions’ and ‘being self-reliant’. Situations in which older adults exhibit considerable or little self-direction or self-reliance can lead to conflicts in self-management support, namely: 1) ‘striving for optimal health and well-being versus respecting older adults' choices’ and 2) ‘stimulating self-reliance and self-direction versus accepting a dependent attitude’. Different strategies are applied to resolve these scenarios. In the first case, strategies of ‘adapting’, ‘persuading’ and ‘taking control’ are used, and for the second case ‘empowering’, challenging’ and ‘tolerating’ are used. Creating a clear and shared understanding of ‘self-management’ and facilitating community nurses to reflect on their dilemmas and strategies might help them in supporting self-management by older adults.
Original languageEnglish
JournalHealth and Social Care in the Community
DOIs
Publication statusPublished - 2019

Cite this

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title = "Community nurses' self-management support in older adults: A qualitative study on views, dilemmas and strategies",
abstract = "Providing self-management support is an appropriate task for community nurses. However, the support of self-management sometimes triggers tensions in practice. The aim of this study was to explore community nurses' views of self-management, the dilemmas community nurses face when providing support of self-management by older adults and the strategies they use to solve these challenges. A qualitative study was performed to collect data. Twenty-one community nurses from the eastern part of the Netherlands were recruited through purposive sampling. The interviews were audiotaped, transcribed verbatim and a thematic analysis was carried out. The results show that community nurses find it difficult to give a clear, definitive description of the concept of self-management. They relate self-management to ‘taking control of your own life’, ‘making your own choices and decisions’ and ‘being self-reliant’. Situations in which older adults exhibit considerable or little self-direction or self-reliance can lead to conflicts in self-management support, namely: 1) ‘striving for optimal health and well-being versus respecting older adults' choices’ and 2) ‘stimulating self-reliance and self-direction versus accepting a dependent attitude’. Different strategies are applied to resolve these scenarios. In the first case, strategies of ‘adapting’, ‘persuading’ and ‘taking control’ are used, and for the second case ‘empowering’, challenging’ and ‘tolerating’ are used. Creating a clear and shared understanding of ‘self-management’ and facilitating community nurses to reflect on their dilemmas and strategies might help them in supporting self-management by older adults.",
author = "{van het Bolscher-Niehuis}, {Marian J. T.} and Uitdehaag, {Madeleen J.} and Francke, {Anneke L.}",
year = "2019",
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Community nurses' self-management support in older adults: A qualitative study on views, dilemmas and strategies. / van het Bolscher-Niehuis, Marian J. T.; Uitdehaag, Madeleen J.; Francke, Anneke L.

In: Health and Social Care in the Community, 2019.

Research output: Contribution to journalArticleAcademicpeer-review

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