Orientation practices among patient education nurses: A qualitative study with general doctors and patients at a health center in Lorraine

Introduction: To cope with the increased number of patients with chronic diseases, the ASALEE scheme promotes cooperation between doctors and patient education (PE) nurses in a health center in Lorraine. They observe behaviors of absence, cancellation, and postponement of the first consultation among referred patients.
Objective: Our study explores the medical orientation practices for patients during their first PE consultation. Method: Observation of these practices was combined with semi-structured interviews.
Results: Four doctors and 17 patients were observed and interviewed, following referral to the PE nurse for six of them and to a specialist doctor for the remaining 11. 27 criteria and 72 indicators were involved, concerning PE orientation practices. 15 of these also appeared in the 22 criteria for the medical specialist. These criteria open up new prospects for improving PE, such as “Quality of the doctor-patient relationship” and “Lack of knowledge and skills in PE”.
Discussion and conclusion: The improvement of medical orientation practices in PE is enabled by professional practice analysis groups and by the social acceptability of patient empowerment and engagement.