Collaboration Between Nurse Practitioners in Response to the Needs of Frail Patients at Home: A Qualitative Study in the French Alps

Abstract

The increasing elderly population in France presents significant challenges for healthcare, particularly in rural areas where access to care is limited. This study aimed to explore the needs of frail elderly individuals living at home and assess the potential for collaboration between Advanced Practice Nurses (APNs) specialized in Stabilized Chronic Conditions (SCPs) and Psychiatry and Mental Health (PMHs) to enhance care. This qualitative, cross-sectional study involved frail patients (scoring >5 on the Clinical Frailty Scale) who were followed up in a general practice in the French Alps under the Asalée agreement. Data were collected through 8 semi-structured interviews conducted in the patients’ homes by APNs who asked 3 open-ended questions. A double-blind inductive approach was employed using thematic verbatim analysis. Key themes identified included access to care, frailty, the importance of family or caregivers, perceptions of mental health, and the contribution of APNs. Patients expressed support for collaborative care by SCP and PMH APNs, which appeared to improve home care. Frail elderly patients in rural areas have specific needs, particularly in mental health, that APNs could effectively address. A collaborative approach between SCP and PMH APNs, in partnership with the family doctor, offers a promising strategy. Adopting this model could be beneficial for improving health outcomes in rural areas.