POS1480-HPR HEALTH PROFESSIONAL’S EXPERIENCES OF DELIVERING AN INTERDISCIPLINARY NURSE-COORDINATED SELF-MANAGEMENT INTERVENTION FOR PATIENTS WITH INFLAMMATORY ARTHRITIS
Authors: C. M. T. Madsen, B. A. Esbensen, N. Blum, P. F. Rønne, A. Bremander, O. Hendricks, M. Østergaard, L. Andersen, J. Primdahl
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Despite a consistent focus on treating the inflammation, patients with inflammatory arthritis (IA) still experience physical, psychological, and social challenges. Thus, we developed a complex Interdisciplinary Nurse-coordinated SELf-MAnagement (INSELMA) intervention for patients with IA (rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis) who experience substantial disease impact as an add-on to usual outpatient care at two hospitals in Denmark [1]. The six-month intervention aimed to increase self-management, reduce the impact of IA (e.g. pain, fatigue, sleep problems, and absenteeism), and increase self-efficacy, quality of life, mental well-being, work ability, and physical activity level (Figure 1). <h3>Objectives:</h3> This study aimed to explore the HPs experiences in delivering the INSELMA intervention. <h3>Methods:</h3> We employed a longitudinal qualitative explorative design. Four focus group interviews were conducted. The HPs who delivered the INSELMA intervention were interviewed twice at each hospital; at the onset of the study, after the inclusion of the final participant and again upon the completion of the last participant. Qualitative content analysis as described by Graneheim and Lundmann was applied [2]. <h3>Results:</h3> In total 12 HPs were interviewed. HPs encompassed 5 nurses, 2 occupational therapists, 3 physiotherapists and a social worker. The analysis derived four themes: 1)<i>Change in work tasks</i>. The HPs experienced diverse and unfamiliar work tasks. These included a biopsychosocial assessment, setting goals, using new questioning techniques and performing longer consultations than usual. Over time, the HPs gained experience and routine and consequently the tasks were considered less challenging and they had achieved new competences. 2)<i>New professional roles.</i> The HPs experienced themselves in a new role moving from a 'fix-it' culture to a more supportive role addressing the diverse and complex challenges faced by the patients. The new roles were experienced as challenging and wide-ranging, where especially the nurses' own barriers, routines and experience were challenged. 3)<i>Meaningful and increased coherence in pathways</i>. The opportunity to follow patients over an extended time period and the interdisciplinary collaboration were perceived as meaningful and useful to address complex issues. In addition, the HPs perceived improved coherence in the patients' care pathways and satisfaction among the participants 4)<i>Appreciated interdisciplinary collaboration</i>. The HPs acknowledged each other, particularly in relation to the new and challenging tasks. External cooperation with e.g. general practitioners and municipalities was mainly perceived positively. The HPs appreciated the opportunity to meet regularly online for learning. <h3>Conclusion:</h3> Overall, the HPs perceived the INSELMA intervention to be meaningful, but the new role and tasks were challenging. Above all, HPs perceived their participation in the intervention enhanced their professional competences. Successful delivery of the INSELMA intervention requires a combination of training and practical experience. <h3>REFERENCES:</h3> [1] Primdahl J et al. Development of a complex Interdisciplinary Nurse-coordinated SELf-MAnagement (INSELMA) intervention for patients with inflammatory arthritis. BMC Health Services Research. Accepted October 2023. [2] DOI: https://doi.org/10.1016/j.nedt.2003.10.001. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>