The feasibility of assessing the Flinders Program™ of patient self-management in New Zealand primary care settings

J Prim Health Care. 2010 Dec 1;2(4):294-302.

Abstract

Introduction: The Flinders Program™ 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™ 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™ 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™ 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™. 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™ in primary care. Difficulties associated with participant recruitment and ability of practice nurses to undertake the Flinders Program™ within general practice need to be resolved.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chronic Disease
  • Feasibility Studies
  • Female
  • General Practice / organization & administration*
  • Health Resources
  • Humans
  • Male
  • Middle Aged
  • New Zealand
  • Outcome and Process Assessment, Health Care*
  • Patient Education as Topic*
  • Patient Selection
  • Pilot Projects
  • Practice Patterns, Nurses'*
  • Primary Care Nursing*
  • Program Evaluation
  • Quality of Health Care
  • Self Care / methods*
  • Self Efficacy