Heart failure patients' experiences of mobile phone-based telemonitoring in self-care: a qualitative systematic review protocol.

REVIEW QUESTION/OBJECTIVE: The objective of this systematic review is to explore heart failure patients' experiences of mobile-phone based telemonitoring in self-care.

Health promotion practices delivered by primary health care nurses: Elements for success in Finland.

AIM: The aim of this study was to identify and reach a consensus on the elements needed for the success of health promotion practices delivered by registered nurses (RNs) who receive clients in primary health care among primary health care participants in eastern Finland. BACKGROUND: Advanced practice nurses are a reaction to the changing health needs of society. These nurses have come to play a significant part in improving health-promotive care in the primary health care setting. METHODS: A mixed method two-stage Delphi technique was applied. RESULTS: A health-promoting organizational culture (e.g., the respectful management of health promotion) and nurses' health orientation and development (e.g., nurses' professional growth and work well-being) were found as the main elements required for the success of the health promotion practices in primary health care. CONCLUSIONS: A health-promoting organizational culture with the strategic and respectful leadership of health promotion is significant in the implementation of the health promotion practices delivered by RNs in primary health care.

Primary health care registered nurses' types in implementation of health promotion practices.

UNLABELLED: Aim This study aimed to identify and reach consensus among primary health care participants [registered nurses (RNs) who receive clients, directors of nursing, senior physicians, health promotion officers, and local councillors] on the types of service provider that RNs who receive clients represent in the implementation of health promotion practices in primary health care in Eastern Finland. BACKGROUND: There is an increasing focus on public health thinking in many countries as the population ages. To meet the growing needs of the health promotion practices of populations, advance practice has been recognized as effective in the primary health care setting. The advance practice nurses share many common features, such as being RNs with additional education, possessing competencies to work independently, treating clients in both acute and primary care settings, and applying a variety of health promotion practices into nursing. METHODS: The two-stage modified Delphi method was applied. In round one, semi-structured interviews were conducted among primary health care participants (n=42) in 11 health centres in Eastern Finland. In round two, a questionnaire survey was conducted in the same health centres. The questionnaire was answered by 64% of those surveyed (n=56). For data analysis, content analysis and descriptive statistics were used. Findings This study resulted in four types of service provider that RNs who receive clients represented in the implementation of health promotion practices in the primary health care setting in Eastern Finland. First, the client-oriented health promoter demonstrated four dimensions, which reached consensus levels ranging between 82.1 and 89.3%. Second, the developer of health promotion practices comprised four dimensions, which reached consensus levels between 71.4 and 85.7%. Third, the member of multi-professional teams of health promotion practices representing three dimensions, with consensus levels between 69.6 and 82.1%. Fourth, the type who showed interest towards health policy reached a consensus level of 55.4% in this study.

Identifying nurse practitioners' required case management competencies in health promotion practice in municipal public primary health care. A two-stage modified Delphi study.

AIMS AND OBJECTIVES: The aims of this study were to identify and reach consensus among municipal primary health care participants on nurse practitioners' (NPs') required case management competencies in health promotion practices in eastern Finland. BACKGROUND: The NP's role as a case manager of patients with chronic conditions has been found to have positive outcomes in health promotion, such as reduced hospital lengths of stay and readmission rates. However, the challenging work of health promotion requires NPs to have multidimensional competencies in health promotion, including communication, advocacy, assessment, planning, consultation and implementation. DESIGN: A two-stage modified Delphi study. METHODS: Round 1 semi-structured interviews were conducted among municipal primary health care participants (n = 42) in 11 health centres from April-July 2009, and the round 2 questionnaire survey was conducted in the same health centres in eastern Finland in January and March 2011. The questionnaire was answered by 64% of those surveyed (n = 56). Content analysis and descriptive statistics were used for data analysis. RESULTS: We identified a total of 18 required case management competencies for NPs' health promotion practices in municipal primary health care. In 17 of these competencies (such as knowledge, skills and ability to work independently in health promotion), a consensus was reached (51% or over). However, the need to be interested in municipal decision-making (44·6%) did not reach consensus. CONCLUSION: Consensus was clearly achieved for 17 competencies that NPs were required to have, and these indicated the knowledge or abilities of health promotion. Nevertheless, there was no agreement on the NPs' need to be interested in municipal decision-making. RELEVANCE TO CLINICAL PRACTICE: NPs need a variety of case management skills and abilities to realise health promotion in municipal primary health care and they need to be supported by primary health care leaders to develop health promotion activities.