Healthcare professionals' perspectives on factors influencing provision of chronic care self-management support by nurses: an exploratory qualitative study from the South Asian context.

backgroundNurses play a critical role in supporting the self-management of patients with chronic illnesses. However, there is a lack of evidence on this important topic from the South Asian context. This study aimed to understand what influences nurses' role in the provision of self-management support in chronic care within the South Asian context.

methodsAn exploratory, descriptive qualitative study was conducted at two private university hospitals and one public university hospital in Pakistan. Purposive sampling was employed. Fifty-four healthcare professionals, with at least one year of experience in chronic non-communicable disease care, participated. Data were collected using a self-developed semi-structured interview guide. Seven focus groups (with nurses and nursing faculty) and 16 individual interviews (with nurse managers and physicians) were conducted. Thematic analysis was done. We adhered to the consolidated criteria for reporting qualitative studies (COREQ) for reporting the current study.

resultsNurses' supportive role in chronic illness self-management appears to be influenced by interdependent external and internal factors. Their motivation to perform supportive roles seems fragile and heavily dependent on external factors. Amongst the other factors, due to the institutions' narrow perspective on self-management support, nurses face a mismatch between their expected and documented roles. Moreover, trust in positioning nurses in a supportive role seems superficial and situation-driven.

conclusionsThe factors influencing nurses' supportive role in self-management reflected a unique perspective from the South Asian context. The study suggests implementing measures that can be undertaken at the nurses and healthcare system levels, to strengthen nurses' role in the provision of self-management support in chronic care, in the South Asian context. It also emphasizes the need for training interventions to increase nurses' motivation and self-efficacy, and to reduce their reliance on external factors affecting on their role performance. CLINICAL TRIAL NUMBER: Not applicable.