An interpretive description of the knowledge, attitudes and experiences of family practice nurses towards sleep health care within Australia

Abstract

In Australia, sleep disorder management is primarily provided by specialist sleep services, and increasing demand is leading to long wait times for care. Evidence has shown that less complex sleep health management can successfully be conducted within the primary care setting, however this has yet to have been widely translated into clinical practice. Research shows that nurses working within family practice in Australia (practice nurses) commonly do not work to their full scope of practice and are keen to expand their role. In recent years, practice nurses have successfully incorporated enhanced chronic disease management into their clinical practice. This study aimed to investigate if this change could be extended to sleep health care by exploring the willingness, capacity and opportunity for practice nurses to integrate more comprehensive sleep health into their practice. Methods: A descriptive, exploratory study employing the Interpretive Description methodology. Semi-structured interviews were conducted with Australian practice nurses and who have experience caring for adults reporting sleep difficulties. Maximum variation purposive sampling techniques were used to recruit participants. Recruitment continued until data saturation occurred. Thematic analysis of interview transcripts was conducted to identify recurrent patterns and themes within the data. Results: Fourteen nurses participated in the study (13 female, 1 male; 12 educated to Bachelor’s degree or above; mean [range] at time of interview: years as a nurse 20.8 [2.5-46], years as a practice nurse 10.5 [0.5-43]). Three major themes were identified: 1) Practice nurses and sleep health care - the current state of play; 2) Willing and able? Practice nurses’ readiness and ability to engage in more comprehensive sleep health care; and 3) The impact of organisational and structural factors on the role of the practice nurse within sleep health care. Participants unanimously reported interest in having greater involvement in sleep health care, however they reported an inflexible funding system, low prioritization of sleep in family practice and a lack of available sleep-related education as factors limiting their ability to offer more comprehensive sleep health care to their patients. Conclusion: Practice nurses recognize the importance of providing sleep health care however insufficient knowledge and a lack of confidence limit their involvement. Increased access to sleep-related education could provide them with the knowledge and confidence to be more involved in sleep health care. This could ultimately improve access and outcomes for the many individuals experiencing sleep disorders and sleep difficulties within the primary care setting.