Clinical outcomes and patients’ perceptions of nurse-led healthy lifestyle clinics

Abstract

BACKGROUND AND CONTEXT: The Nurse-Led Healthy Lifestyle Clinics focussed on lifestyle issues for patients with known health inequalities. Much of the nursing was educative and preventative care. This evaluation assessed patient experiences and opinions, as well as clinical outcomes. ASSESSMENT OF PROBLEM: Information came from clinical outcome data for 2850 individuals and 424 patient satisfaction surveys. Results: Patients were aged 0–95 years (45% between 40 and 59 years); 60% Pakeha/European, 31.4% Maori, 4.2% Pacific and 4.4% other ethnicities. Only 19% of claimants (approximately 40% were Maori or Pacific) came from quintile 5 addresses, suggesting the target population was not reached effectively. Ninety-four percent of patients had a better understanding of their diagnosis, medication and treatment plan, and were more motivated to self-manage their health needs. This increase in patient empowerment is a significant outcome of the project. Clinical outcome data showed no significant differences between first and last clinic visits for average weight, blood pressure, smoking, glycosylated haemoglobin levels, waist circumference or cardiovascular risk. Significant improvements were shown in the Dartmouth Primary Care Cooperative Information results for social activity, change in health, and overall health (n=89). STRATEGIES FOR IMPROVEMENT: More effective techniques to access the target population have been implemented, as has an extended period for review of clinical outcomes. LESSONS: More focussed evaluation of clinical outcomes is necessary to provide quantitative data on the clinics. The large percentage of patients who felt more empowered to self-manage their health needs suggests the clinics were effective in this area. KEYWORDS: Nurse-led clinics; life style; program evaluation; patient satisfaction; health status disparities