"Talking on the Phone Is Very Cold"-Primary Health Care Nurses' Approach to Enabling Patient Participation in the Context of Chronic Diseases during the COVID-19 Pandemic

COVID-19; Chronic care; Patient participation; Primary health careCOVID-19; Atenció crònica; Participació del pacient; Atenció primària de salutCOVID-19; Atención crónica; Participación del paciente; Atención primariaStrengthening patient participation is considered a crucial element of primary health care (PHC) nurses' practice when working with chronically ill patients. The COVID-19 pandemic had extraordinary effects on PHC nursing routines and how chronically ill patients' could be involved in their own care. This study investigates the adaptation of Spanish PHC nurses' approaches to supporting the participation of patients living with chronic illness during the COVID-19 pandemic. To reach this goal, we interviewed 13 PHC nurses who practiced in PHC centers in Spain. The interviews were analyzed using thematic coding. Three themes emerged from the descriptions of the nurses: (1) High COVID-19-related workload, decreasing health promotion, and chronic care, (2) Emphasis on patients' and families' self-responsibility, (3) Expanded digital and telephone communication with fewer in-person consultations. Nurses felt especially challenged to uphold the support for vulnerable groups, such as older people or patients without family support. Future research should focus on how the participation of the most vulnerable chronic patients can be supported in the context of the growing relevance of remote care.This research was funded by the Stiftung Wohlfahrtspflege NRW (Public Welfare Foundation NRW) in the frame of funds for cross-sectional analyses regarding the subject of “Gesundheitskompetenz und Selbstmanagementförderung im Lebenslauf—Bedeutung im Kontext nutzerorientierter Versorgungsmodele (förges Q)” (Promotion of health literacy and self-management in the lifecourse—meanings in the context of user-oriented care models) (Ref.: SW-620 6852–6856) within the research network “Nutzerorientierte Versorgung: Förderung der Gesundheitskompetenz und des Selbstmanagements bei chronischer Krankheit und Pflegebedürftigkeit (förges)” (User-oriented care: Promotion of health literacy and self-management for chronic conditions and need of care)