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There’s No “I” in “Self-Care”

Nurse Practitioners (NPs) pride themselves on their unique connection with patients. They believe that the nursing process encourages a holistic approach to patient care, often based on a convivial process where patients are apt to share their experiences and seek the counsel of their trusted health care provider. In this light, it is not surprising that when we spoke with NPs, every one said they believe in patient empowerment – and that involving patients in treatment plans improves compliance and outcomes. What is surprising is that less than half of those surveyed thought patients should be encouraged to do research and gather their own information about their conditions and treatment options. In a health care system where patients, more than ever before, are taking control over their health, how can we explain this disconnect?

NPs resoundingly believe in patient empowerment.

They see the value in self-care and routinely screen for and encourage self-care strategies to engage patients in their own treatment. NPs are supportive of self-education and point patients towards credible information like credentialed websites and office handouts or provide information about self-help groups. They are also comfortable with a wide-range of self-care treatments, ranging from OTC medicines to alternative therapies that help put patients on the path to wellness. NPs know that for changes to be made, patients have to feel in control – of themselves, their information and their treatment options.

Most NPs find that self-care is a signal of patients who really seek change.

NPs take self-care, whether bringing information to office visits or reporting self-care treatments, as markers for more engaged patient interactions. This often leads to more robust information sharing and collaboration in treatment plans.

“I try to direct my patients to NIH or more credible websites.  Don’t discourage [internet research] because that shows a desire, that they do care about their care…that gives me motivation to be more aggressive about their care.” (Family Practice NP)

Nurse Practitioners see self-care as a partnership, not an independent approach.

They caution against unfettered use of “Dr. Google” but see an empowered patient as a thoughtful one who seeks out credible information. Moreover, NPs aim to encourage appropriate use, as well as reduce misuse, and therefore, prefer self-care that considers a wide-range of HCP-endorsed options. NPs are there to encourage patients as they embark on a path to wellness, but also to modify treatment plans and offer sound advice. To create an analogy, patients are the drivers and HCPs are the navigators.

“[Self-care] is care with professional advice… they don’t do everything on their own.  You educate them on how to manage diabetes, weight control, exercise, diet, but you’re going to be there to prescribe metformin if they need that.” (Family Practice NP)

Our research shows that NPs are strong advocates for patient empowerment. Connecting with patients and offering education to promote health and wellness are at the core of NP’s unique role in health care. However, they are wary of unsupported self-care, as it exposes potential risk, such as inappropriate and/or delayed assessment, diagnosis or treatment.  According to NPs, self-care works best when patients are considered equal partners in their care – shifting the balance toward either side is a benefit to neither NPs nor patients.

Note about methodology:  The above results are based upon qualitative research conducted by APCO Insight among Nurse Practitioners on June 24, 2016 at the AANP National Conference. 

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