Stakeholder perceptions of components of a Parkinson disease care management intervention, care coordination for health promotion and activities in Parkinson's disease (CHAPS)

Karen I Connor, Hilary C Siebens, Brian S Mittman, Donna K McNeese-Smith, David A Ganz, Frances Barry, Lisa K Edwards, Michael G McGowan, Eric M Cheng, Barbara G Vickrey, Karen I Connor, Hilary C Siebens, Brian S Mittman, Donna K McNeese-Smith, David A Ganz, Frances Barry, Lisa K Edwards, Michael G McGowan, Eric M Cheng, Barbara G Vickrey

Abstract

Background: A recent nurse-led proactive care management intervention, Care Coordination for Health Promotion and Activities in Parkinson Disease (CHAPS), improved care quality when compared to usual care in a randomized controlled trial. Therefore, stakeholder (patient participants, nurse care managers, and Parkinson disease (PD) specialists) perceptions of key intervention components merit evaluation to inform decisions about dissemination.

Methods: This multi-site study occurred in five southwest United States Veterans Health Administration medical centers. Stakeholders were surveyed on their perceptions of CHAPS including the CHAPS Assessment, CHAPS nurse care managers, the Siebens Domain Management Model™ (a practical clinical model), and the Siebens Health Care Notebook (Notebook) (self-care tool). Participants' electronic medical records were abstracted for perceptions of the Notebook. Statistical analysis software was used to provide summary statistics; open card sorting methodology was used to identify themes and attributes in qualitative data including usability of some components.

Results: Participants, overall, highly rated their medication self-management, acknowledged some challenges with the CHAPS self-care tools, reported knowledge of PD specialist follow-up and PD red flags, and rated CHAPS nurse care managers as helpful. Nurse care manager responses indicated the CHAPS Assessment and Program highly facilitated care of their patients. Most all PD specialists would refer other patients to CHAPS. Nurse care manager and PD specialist responses indicated improved participant management of their PD. Three themes emerged in participant perceptions of the Notebook: Notebook Assets (e.g., benefits and features-liked); Deferring Notebook Review (e.g., no time to review); and Reasons for Not Using (e.g., participant preference). Shared attributes regarding the Siebens Domain Management Model and Notebook usability, reported by nurse care managers, were user-friendly, person/patient-centered, and organized. Some challenges to their use were also reported.

Conclusions: Overall, stakeholder perceptions of the proactive nurse-led CHAPS intervention indicated its value in the care of individuals with PD. Responses about the CHAPS Assessment, Siebens Domain Management Model, and Notebook self-care tool signified their usefulness. Stakeholders' constructive suggestions indicated their engagement in CHAPS. These findings support CHAPS dissemination and contribute to research in care management.

Trial registration: ClinicalTrials.gov as NCT01532986 , registered on January 13, 2012.

Keywords: Case manager; Dissemination; Health communication; Implementation; Nursing process; Parkinson disease; Patient care management.

Conflict of interest statement

The authors declare that they have no competing interests except Hilary C Siebens, MD who uses the 4-domain clinical organizing framework she designed, Siebens Domain Management Model™, in consulting work with health care organizations and others. Also, she is the author of the Siebens Health Care Notebook, a self-care tool.

Figures

Fig. 1
Fig. 1
Section Contents of Self-care Tool: Siebens Health Care Notebook. LEGEND: Section contents of the Siebens Health Care Notebook (© 2008 Hilary C Siebens MD) [24]. The first four section headings are from the Siebens Domain Management Model™, an organizing framework for patient care

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