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To describe the factors influencing clinical integration of self-management support by primary care nurses for people with physical chronic diseases and common mental disorders, as well as strategies for improvement.
Thorne's interpretive descriptive qualitative approach.
Semi-structured interviews lasting from 60 to 90 min were carried out virtually with nurses from Family Medicine Groups and University Family Medicine Groups across the province of Quebec (Canada) from January 2022 to January 2023. Twenty-three primary care nurses were recruited through purposive and snowball sampling from three networks. Iterative deductive and inductive thematic analysis was completed using Valentijn's Rainbow Model of Integrated Care.
The study identified several factors influencing integrated self-management support from primary care nurses across integration domains: clinical (knowledge, skills, training and experience; workload; approaches and activities; attitudes and behaviours; clinical tools), professional (interprofessional and nursing roles; collaboration; team composition), normative and functional (culture and organisational mechanisms). Improvement strategies pointed to the necessity of developing training regarding common mental disorders, adapted clinical tools, clinical support and coaching through collaboration and culture change.
These findings suggest that a cultural shift emphasising continuous improvement through targeted training and coaching is essential to enhance integrated self-management support. Identifying factors and improvement strategies will help implement future interventions and tailor current practices.
Identifying barriers and facilitators, along with proposing improvement strategies, will enable the implementation of more effective interventions and the adaptation of care practices to better support self-management. Additionally, it will influence stakeholders to modify the context surrounding integrated self-management support and interprofessional practise.
Consolidated criteria for reporting qualitative research (COREQ).
No patient or public contribution.
The objective of this scoping review is to map and synthesise existing literature on interventions aimed at promoting healthy screen use among adolescents. This review identifies the types, functions and settings of interventions, explores the diversity of targeted outcomes and highlights equity considerations and research gaps.
We conducted a scoping review in accordance with the Arksey and O’Malley framework and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines.
We systematically searched Medline, PsycINFO and ERIC from January 2013 to June 2024. Reference lists of included studies were also manually screened.
We included peer-reviewed experimental, quasi-experimental, observational and qualitative studies reporting on interventions designed to promote healthy screen use among adolescents aged 10–19 years.
One author extracted data using a structured charting form, and a second author verified all entries. Results were synthesised descriptively across key themes including target populations, theoretical frameworks, intervention components and reported outcomes.
From 6433 records, we identified 93 articles on 81 interventions, mainly conducted in high school settings in the USA and Australia. Most examined short-term interventions targeting recreational screen time. Outcomes included media literacy, cyberbullying, internet and gaming addiction, safe internet use, social media use and mental and sexual health. Seventy-eight per cent of interventions attempted to educate adolescents, while 34% offered training activities (eg, educational sessions to elevate risk awareness and skill-based training to enhance digital literacy and self-regulation). Interventions targeting external influences were used less frequently. About 20% of studies showed no statistically significant findings, highlighting the need to promote evidence-based interventions.
This review identifies a need for broader, multilevel strategies that account for contextual factors and social determinants in influencing screen use and its related health issues. Future research should explore long-term effectiveness while examining the potential moderating and mediating effects of social determinants. Equity considerations were not a primary focus of most interventions, underscoring an important gap in this literature. Future interventions could incorporate equity-focused design and evaluation to ensure they respond to the needs of diverse adolescent populations.
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