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Journal of Advanced Nursing
Article . 2024 . Peer-reviewed
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Nurses' and physicians' perspectives on implementation barriers and facilitators in a transfer program for parents of adolescents with chronic illness

Authors: Ena Lindhart Thomsen; Johanne Cecilie Koppelhus; Kirsten Arntz Boisen; Signe Hanghøj; Helena Hansson; Bente Appel Esbensen;

Nurses' and physicians' perspectives on implementation barriers and facilitators in a transfer program for parents of adolescents with chronic illness

Abstract

Abstract Aim To identify barriers and facilitators impacting the implementation of a comprehensive transfer program aimed at parents of adolescents with chronic illness in clinical practice. Design A real‐time, qualitative process evaluation. Methods Individual interviews were conducted with 10 nurses and seven physicians from paediatric and adult outpatient clinics: Nephrology, hepatology, neurology, and rheumatology. Data were analysed through the lens of normalization process theory. Results Themes were framed within the theory's four components. (1) Coherence : Healthcare professionals' views on their core tasks and on the parents' role influenced their perception of the program. (2) Cognitive participation : A named key worker, autonomy, and collaboration impacted healthcare professionals' involvement in the program. (3) Collective action : Department prioritization and understanding of the program's aim were key factors in its successful delivery. (4) Reflective monitoring : Participants experienced that the program helped parents during transfer but questioned if the program was needed by all families. Conclusion We identified three barriers: Healthcare professionals' lack of understanding of the parental role during transfer, top‐down decisions among nurses, and physicians' uncertainty about their role in joint consultations. Facilitators: Healthcare professionals' understanding of the program's purpose and expected effect, the nurses' significant role as named keyworkers, and good collaboration across paediatric and adult departments. Implications for the Profession and/or Patient Care Implementation strategies should be developed before implementing a transfer program in clinical practice. Impact Implementing a parental transfer program in clinical practice can be challenging. Therefore, for successful implementation, it is crucial to identify barriers and facilitators. Barriers and facilitators exist at the personal, professional, and organizational levels, and it is important to understand them. The results of this qualitative study could support the implementation of transfer programs in other settings. Reporting Method Consolidated criteria for reporting qualitative studies (COREQ). Patient or Public Contribution No patient or public contribution. What does this paper contribute to the wider global clinical community? Nurses' and physicians' experiences of ownership of the transfer program is essential for successful implementation. Clinics should appoint a named keyworker, preferably a nurse, as the driving force during the implementation of a transfer program. Nurses and physicians should receive training about the purpose, justification, and expected effect of a transfer program before implementation.

Keywords

Parents, Male, Adult, Adolescent, Attitude of Health Personnel, barriers, Physicians, Humans, normalization process theory, Qualitative Research, implementation science, transitional care, parents, Middle Aged, process evaluation, adolescent, Chronic Disease, facilitators, Female, chronic disease, transfer

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    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    3
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Average
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Average
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
3
Top 10%
Average
Average
Green
hybrid