Impact on Health, Resources, and Satisfaction: A Qualitative Study of Primary Health Care Case-Management Nurses
Abstract
:1. Introduction
2. Materials and Methods
2.1. Research Design
2.2. Setting and Sampling
2.3. Data Collection
2.4. Data Analysis
2.5. Ethical Consideration
2.6. Trustworthiness
3. Results
3.1. Sociodemographic Characteristics of the Sample
3.2. Analysis Categories
3.3. Impact on Health
3.3.1. Patients
It was us that promoted the idea of inventing things ourselves to improve the patients’ quality of life, which was (and still is) our main goal.(24_AHD_62_F)
… we solve problems because we can be in contact with many people, access to this and contribute to what we call “one-stops”, not going through any usual circuit but through a parallel one and improving access to the hospital or to the tests, or even for performing complementary tests.(18_SHD_58_M)
… in the complex chronic patients we’re working with… our intervention is influential to prevent relapses, to allow for good health management, good therapy regime management.(6_SSHD_57_F)
… I’ve taught patients to do some good diabetes self-controls, control their blood pressure, control their weight, control diuresis, check the pill for when their feet are swollen, control heart failure; if you teach patients to control all this, their quality of life improves a lot.(19_SHD_60_F)
At the personal level, I’m really sensitized about the topic of Palliative Care, which falls into what the CMN target population would be, these patients benefit from what I do.(16_SHD_59_M)
The assistance provided by a professional gives quality of life, free access without an appointment; all this really benefits the patients… and exerts an impact on the population.(13_SHD_57_F)
What patients need is to feel that the health service is there with them… we’re there for the patients, we’re reference professionals.(27_NSHD_57_F)
They find peace of mind, they know that there’s a person there and that she/he will go tell them what to do, be with them throughout their health process.(1_ESHD_62_F)
… when patients need some home treatment to get better, we do it, so as not to take them to Seville….(23_AHD_43_F)
3.3.2. Caregivers
… our goal is to improve quality of life, not only the patients’ but the families’ too and, ultimately, do our share in the community where we work.(20_SSHD_57_M)
… the issue of the women caregivers that doesn’t even depend on material resources but many times on accessibility, closeness, care quality and warmth; I believe that this really improves these caregivers’ quality of life and, consequently, the patients’.(16_SHD_59_M)
… the caregivers themselves tell you so, their satisfaction level, how coping with the care measures and with that situation improves thanks to your intervention… our intervention is positive….(6_SHD_57_F)
Man, I believe that, first of all and especially, there’s a group that it’s the issue of women caring for extremely dependent patients.(16_SHD_59_M)
3.4. Impact on Resources
3.4.1. Computer Tools
… perhaps we lack tools….(28_NSHD_49_F)
but we should definitely be a guide in certain things. It’s true that there are many expenses that can be imputed to our everyday performance, which is high-cost because complexity requires so.(11_SHD_50_F)
3.4.2. Effectiveness/Efficiency of the CMNs
Well I’m, I’d be some sort of health tool for the population and the impact on the direct assistance I offer, my management interactions with other levels, with other peers to achieve health results, fewer admissions, improvements in perceived quality of life and support for the caregivers.(18_SHD_58_M)
As for quality of life, we can see the impact at the health level; as case managers, we coordinate and work multidisciplinarily, then you put a mechanism to work, if you have to refer someone to rehab, if you have to refer them to other teams or to the nutrition area, etc. You then notice the positive repercussion on the patents, I’ve already seen it and I still do.(14_SHD_56_F)
It seems that we have some sort of access pathway to more information than the rest of the Nursing staff, The assistance provided by a professional gives quality of life, free access without an appointment; all this really benefits the patients.(13_SHD_57_F)
As for quality of life, we can see the impact at the health level; You then notice the positive repercussion on the patents, I’ve already seen it and I still do.(14_SHD_56_F)
… for our time availability, for our training and competences, for the resources; no doubt that quality was in fact improved, easing for more complex patients that’d be institutionalised before to stay at their homes instead.(11_SHD_50_F)
Man, I think it’s a very positive resource, very positive when it comes to the good things, trying to plan a complex discharge before it comes from the hospital, for example, coordinating my work with the PHC team.(17_SHD_55_F)
… is to increase accessibility to all the resources and to everything the system can offer to these complex patients with significant care and support needs, as well as guidance on this care and for the professionals too.(23_AHD_43_F)
3.4.3. Material Resources
… the patient I asked the walker for keeps falling, and when the walker arrives he’ll need a chair, he already needs a surgical intervention and has lost quality of life.(26_NSHD_52_F)
I believe that, although it’s true that I get the impression that the resources are really, really scarce. I’m not saying there are fewer, but the population that needs them increases by the minute.(16_SHD_59_M)
… the impact in terms of quality-cost, sure, we borrow a whole lot of materials, we really need to ask for a lot of materials and not stay still.(22_AHD_49_M)
… I feel nothing but pride if I can recycle 150 wheelchairs at the end of the year, I feel proud of that because I’m teaching the health system to use resources and to share as necessary.(26_NSHD_52_F)
3.5. Impact on Professional Satisfaction
3.5.1. Positive Professional Satisfaction
… I feel satisfied and that I adapt more to what’s required from a Case Manager, I’m more focused on Case Management.(18_SHD_58_M)
What prevents me from leaving is the users, the reward I get from users and also from my peers.(31_ESHD_63_F)
… I also get satisfaction for being like some role model for the other professionals; they always see me as a person that offers them another view or way of doing things, but that’s just because they want to put me in that position: they might as well do everything themselves and not me.(13_SHD_57_F)
… I really value working as a team with doctors, nurses, social workers and all the other professionals.(10_SHD_61_F)
I believe that satisfaction comes from that first, from knowing that I can get close to patients that need it and that I can help them; this is the first satisfaction I see in my job.(16_SHD_59_M)
I do believe that we have some important power there and the population acknowledges that; this is the satisfaction part they do recognise, when it’s really complicated cases that we’re talking about.(11_SHD_50_F)
I love working with Palliative Care patients, no job can be more rewarding: the fact of being there, offering companionship, the simple detail of human warmth that I believe is Nursing’s best; we’re caregivers, the thing of you lending a hand to a caregiver and that warmth you pass on to her, that’s wonderful, grief follow-up.(3_SSHD_62_F)
3.5.2. Negative Professional Satisfaction
… I believe that we’re a figure with a whole lot more potential and that I’ve sometimes felt that, that we’re somewhat between vocationally and professionally trained because nobody… come on, they throw any task upon us and we delve into it.(30_ESHD_63_F)
… it’s satisfactory at the professional level, but it could be a whole lot more and we could give much more.(5_SSHD_63_F)
… we should insist again on clearly explaining which our roles are and, especially, what we’re here for; given our competences, we should also be some methodological and research support for the units….(11_SHD_50_F)
… I’m talking to you from my area; it’s very hard for us, a lot of work, we serve a very large population. I have some geographical dispersion You do what you can and I tell you, a lot via telephone calls and, for me that I like to be close to the patients, I do most of them in home visits….(29_ESHD_57_F)
Sometimes I feel dissatisfied because I can’t give my best, even if it doesn’t depend on me.(2_SSHD_58_F)
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
CMN | Case-Management Nurse |
PHC | Primary Health Care |
SRQR | Standards for Reporting Qualitative Research |
WHO | World Health Organisation |
PAHO | Pan-American Health Organisation |
CM | Case Management |
HD | Health District |
AHD | Aljarafe Health District |
ESHD | East Seville Health District |
NSHD | North Seville Health District |
SHD | Seville Health District |
SSHD | South Seville Health District |
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Category | Subcategories | Frequency of Verbatim Statements |
---|---|---|
Impact on health | Patients | 28 |
Caregivers | 13 | |
Impact on resources | Computer tools | 4 |
Effectiveness/efficiency of the CMNs | 65 | |
Material resources | 9 | |
Impact on professional satisfaction | Positive professional satisfaction | 157 |
Negative professional satisfaction | 98 | |
374 |
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Molina-Gil, M.J.; Guerra-Martín, M.D.; Diego-Cordero, R.D. Impact on Health, Resources, and Satisfaction: A Qualitative Study of Primary Health Care Case-Management Nurses. Healthcare 2025, 13, 974. https://doi.org/10.3390/healthcare13090974
Molina-Gil MJ, Guerra-Martín MD, Diego-Cordero RD. Impact on Health, Resources, and Satisfaction: A Qualitative Study of Primary Health Care Case-Management Nurses. Healthcare. 2025; 13(9):974. https://doi.org/10.3390/healthcare13090974
Chicago/Turabian StyleMolina-Gil, María José, María Dolores Guerra-Martín, and Rocío De Diego-Cordero. 2025. "Impact on Health, Resources, and Satisfaction: A Qualitative Study of Primary Health Care Case-Management Nurses" Healthcare 13, no. 9: 974. https://doi.org/10.3390/healthcare13090974
APA StyleMolina-Gil, M. J., Guerra-Martín, M. D., & Diego-Cordero, R. D. (2025). Impact on Health, Resources, and Satisfaction: A Qualitative Study of Primary Health Care Case-Management Nurses. Healthcare, 13(9), 974. https://doi.org/10.3390/healthcare13090974