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Implementation of nurse-delivered vestibular rehabilitation in primary care: a qualitative study of nurses' views on involvement in an innovative service

Implementation of nurse-delivered vestibular rehabilitation in primary care: a qualitative study of nurses' views on involvement in an innovative service
Implementation of nurse-delivered vestibular rehabilitation in primary care: a qualitative study of nurses' views on involvement in an innovative service
Aim: To explore practice nurses’ perceptions of vestibular rehabilitation and its place in relation to their general role development.
Background: Vestibular rehabilitation has been known for a long time to be effective for chronically dizzy patients in secondary care, but its use in primary care has been limited. A recent pragmatic trial of vestibular rehabilitation delivered by practice nurses in primary care has confirmed its utility in a community setting. This type of role is increasingly common for practice nurses, but few studies explore the nurses’ perspective.
Methods: A qualitative study was undertaken; 19 nurses took part in focus group sessions. Participants discussed their views on vestibular rehabilitation and its potential for integration with their existing role. A thematic analysis of the data was undertaken.
Findings: Four main themes were identified: creating a unique nursing role; the therapeutic role; responsibility and role boundaries; and time. Nurses were positive about developing extended roles, but sought ways to achieve this without eroding fundamental nursing skills. Vestibular rehabilitation was seen as fulfilling both the need for a distinct nursing identity and professional development. Concerns over responsibility for patient assessment and time management constraints are potential obstacles to overcome in the wider development of this therapy in primary care.
Conclusions: Understanding the perspective of nurses will be vital in future development of chronic disease management within primary care. Whilst nurses may be positive about such role expansion, the implementation of services of this type will require clarity about nurses’ responsibilities and flexibility in managing workload.
Relevance to clinical practice: Vestibular rehabilitation is simple, low-tech and appropriate for widespread development in primary care. Nurses wishing to provide vestibular rehabilitation or similar chronic disease management activities will need to work with medical colleagues to define role boundaries.
chronic disease management, dizziness, focus groups, nurse-led services, nursing role, qualitative approaches
0962-1067
1072-1081
Walsh, Bronagh
5818243e-048d-4b4b-88c5-231b0e419427
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Donovan-Hall, Maggie
5f138055-2162-4982-846c-5c92411055e0
Smith, Helen
42562879-cabb-497a-9209-ae8c6530b37d
Walsh, Bronagh
5818243e-048d-4b4b-88c5-231b0e419427
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Donovan-Hall, Maggie
5f138055-2162-4982-846c-5c92411055e0
Smith, Helen
42562879-cabb-497a-9209-ae8c6530b37d

Walsh, Bronagh, Yardley, Lucy, Donovan-Hall, Maggie and Smith, Helen (2007) Implementation of nurse-delivered vestibular rehabilitation in primary care: a qualitative study of nurses' views on involvement in an innovative service. Journal of Clinical Nursing, 16 (6), 1072-1081. (doi:10.1111/j.1365-2702.2005.01511.x).

Record type: Article

Abstract

Aim: To explore practice nurses’ perceptions of vestibular rehabilitation and its place in relation to their general role development.
Background: Vestibular rehabilitation has been known for a long time to be effective for chronically dizzy patients in secondary care, but its use in primary care has been limited. A recent pragmatic trial of vestibular rehabilitation delivered by practice nurses in primary care has confirmed its utility in a community setting. This type of role is increasingly common for practice nurses, but few studies explore the nurses’ perspective.
Methods: A qualitative study was undertaken; 19 nurses took part in focus group sessions. Participants discussed their views on vestibular rehabilitation and its potential for integration with their existing role. A thematic analysis of the data was undertaken.
Findings: Four main themes were identified: creating a unique nursing role; the therapeutic role; responsibility and role boundaries; and time. Nurses were positive about developing extended roles, but sought ways to achieve this without eroding fundamental nursing skills. Vestibular rehabilitation was seen as fulfilling both the need for a distinct nursing identity and professional development. Concerns over responsibility for patient assessment and time management constraints are potential obstacles to overcome in the wider development of this therapy in primary care.
Conclusions: Understanding the perspective of nurses will be vital in future development of chronic disease management within primary care. Whilst nurses may be positive about such role expansion, the implementation of services of this type will require clarity about nurses’ responsibilities and flexibility in managing workload.
Relevance to clinical practice: Vestibular rehabilitation is simple, low-tech and appropriate for widespread development in primary care. Nurses wishing to provide vestibular rehabilitation or similar chronic disease management activities will need to work with medical colleagues to define role boundaries.

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More information

Published date: June 2007
Keywords: chronic disease management, dizziness, focus groups, nurse-led services, nursing role, qualitative approaches

Identifiers

Local EPrints ID: 50385
URI: http://eprints.soton.ac.uk/id/eprint/50385
ISSN: 0962-1067
PURE UUID: f8778997-4ecb-4fbc-a0eb-34610b4a06d3
ORCID for Bronagh Walsh: ORCID iD orcid.org/0000-0003-1008-0545
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X

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Date deposited: 21 Feb 2008
Last modified: 16 Mar 2024 03:03

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Contributors

Author: Bronagh Walsh ORCID iD
Author: Lucy Yardley ORCID iD
Author: Helen Smith

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