What does the nurse practitioner mean to you? A patient-oriented qualitative study in oncological/palliative care

Abstract

Aims and objectives: To explore what meaning patients associate with their experiences with a nurse practitioner (NP) in oncological or palliative care.

Background: Care provided by NPs results in high patient satisfaction, mostly related to the assurance of continuity of care, and to receiving information and advice on coping with the disease. Research shows that health care provided by NPs equals the quality of care provided by physicians. Patients may be even more satisfied with care provided by NPs. Because patients' views have only been examined quantitatively, underlying experiences and meanings remain unclear.

Design: A qualitative study from a phenomenological perspective.

Methods: In 2017, seventeen outpatients aged 45-79 years, receiving oncological or palliative care, were interviewed in depth. Data were analysed by Colaizzi's seven-step method and by the Metaphor Identification Procedure.

Results: Six fundamental themes emerged: the NP as a human (1) and as a professional (2), the NP providing care (3) and cure (4), NPs organising patient care (5) and the impact on patient's well-being (6). MIP analysis revealed six metaphors: NP means trust; is a travel aid; is a combat unit; is a chain; is a signpost; and is a technician.

Conclusions: NPs mean a lot to patients. NPs are valued as reliable, helpful and empathic. Patients feel empowered, at peace and in control as a result of the support, guidance and attention to them as a person as well as to aspects of the disease. Providing expert, integrated care makes patients feel safe and embraced in the NP's expertise.

Relevance to clinical practice: This qualitative insight into patients' experiences will contribute to the body of knowledge on patients' perceptions of the treatment and support provided by NPs. It adds to the further development of the NPs' profession and education.

Keywords: hospital; metaphors; nurse practitioner; nursing; oncological and palliative care; patients’ experiences; patients’ meaning; phenomenological perspective.