.
.
The UK
FINE Trial:
Challenges of nurse delivery of psychological interventions for long-term conditions in primary care: a qualitative exploration of the case of chronic fatigue syndrome/myalgic encephalitis
Sarah Peters1*, Alison Wearden1, Richard Morriss2, Christopher F Dowrick3, Karina Lovell4, Joanna Brooks5, Greg Cahill3 and Carolyn Chew-Graham6
http://www.implementationscience.com/content/6/1/132
'A particularly difficult challenge of interacting with patients for the nurses and their supervisors was managing patients’ resistance to the treatment. This arose from patients not accepting the rationale for the treatment and occurred for both types of psychological treatments, though for different reasons.
(Nurse): .‘I used to go there and she would totally block me, she would sit with her arms folded, total silence in the house...she pulled out of the trial…it was tortuous for both of us.’......
(Supervisor): ‘There have been one or two times where I have been worried because they have got angry at the patients…that anger has been communicated to the patients. Their frustration has reached the point where they sort of boiled over… there is sort of feeling that the patient should be grateful and follow your advice, and in actual fact, what happens is the patient is quite resistant and there is this thing like you know, “The bastards don’t want to get better”…I think it’s a difficult thing for all therapists and I think basically over the time you just basically learn to cope with it, and but they have not had time.’
Managing patients’ emotions was an extremely demanding aspect of their new role.
‘That anger…it’s very wearing and demoralizing.’ (Nurse)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
http://www.implementationscience.com/content/6/1/132
Challenges of nurse delivery of psychological interventions for long-term conditions in primary care: a qualitative exploration of the case of chronic fatigue syndrome/myalgic encephalitis
Sarah Peters1*, Alison Wearden1, Richard Morriss2, Christopher F Dowrick3, Karina Lovell4, Joanna Brooks5,
Greg Cahill3 and Carolyn Chew-Graham6
’They felt they were nurses and they felt, not frauds exactly working as counsellors, but you know not at home in that field really. I think part of my role was a kind of normative role helping them to feel their way into the persona really of being a counsellor... rather than just dealing with the nitty gritty of the patients.’ (Supervisor)
Despite their newly found knowledge and skills in these two specific therapies, not having a background as psychological or behavioural therapists meant that the nurses had a relatively limited range of therapeutic skills to draw upon, particularly for more challenging or complex cases.
’They don’t know the kind of therapeutic tricks which you have, which you pick up from being a therapist.’ (Supervisor)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
It appears that one of the primary issues of the
FINE TRIAL was
not “managing patients emotions”…
....but
managing the nurses’ emotions…..!!!!
.