The requirement to respect autonomy - The Royal New Zealand ...

ORIGINAL SCIENTIFIC PAPErSquantitative researchRespondents were asked how many assessmentsthey had completed, how long an assessment takesand to rate their confidence in the use of the Flinderstools using a 5-point Likert scale (1=Not at all confident,to 5=Totally confident). Responses to thisinclude those from respondents who may be usingonly the assessment component of the Flinders ProgramTM . Results are shown in Table 2. The majority(114; 77%) had completed six or fewer assessments,including the three assessments required to achievethe Certificate of Competence, and took one hour orless to complete an assessment, all with reasonablyhigh self-reported confidence with use of the tools.Participants who indicated that they used all orsome of the Flinders tools in their practice wereasked which they were using. The 82 respondentswho replied to this section used SMART goalsetting most frequently (Table 3). Multiple optionswere possible.Of the 16 respondents using all the Flinderstools, one respondent indicated that she wouldcomplete one Flinders assessment each week;three respondents once a fortnight and eightwould use the tools once a month on average.TrainingThe majority of respondents had completed theFlinders training since 2007 (133; 90%), with 21(14%) completing in 2009. Only seven people hadcompleted training in either 2005 or 2006. Of thosewho had completed training, 100 (68%) had completedthe three assessments and care plans requiredto receive the Flinders Certificate of Competence.BarriersLack of time was considered the major barrier tousing the Flinders Program TM . This related to thelength of time needed for a structured appointmentto complete an initial assessment within abusy working environment. A significant numberof respondents (126; 85%) stated that they hadexperienced barriers. Multiple options wereselected. (Table 4).Free text comments endorsed the identified barriers,but also indicated that time as a barrier maybe reduced as experience was gained:Table 1. Use of Flinders model/programmeUse of Model Number PercentageCurrently use model 16 11Use some of the Flinders tools 65 44Used to use 23 16Not at all 44 29Total 148 100Table 2. Number of Flinders assessments completedAssessmentscompletedNumberPercentageNone 9 6Mean ConfidenceScore (1–5)1–3 36 24 3.24–6 69 47 3.77–10 22 15 3.711–25 8 5 4.1More than 25 4 3 4.0Total 148 100Table 3. Flinders tools used in practiceFlinders tool Number using PercentageSMART goal setting 67 82Self-management care plans 53 65PIH 48 59Cue and Response 39 48At the moment time is the main barrier but as I getmore experienced in assessing I anticipate that thisbarrier will lessen.EnablersThe 82 respondents who indicated that they usedsome of the tools, also listed enablers to the useof the Flinders Program TM . Multiple options wereselected with 55 indicating that there were nospecific enablers (Table 5).When asked what might be useful to assist withimplementation, respondents indicated that a specialinterest group (40), an Internet support group(34) and ongoing contact with the course trainer(29) would be useful.DiscussionFlinders training is relatively new in NZ, withthe majority of training completed by nursesVOLUME 2 • NUMBER 4 • DECEMBER 2010 J OURNAL OF PRIMARY HEALTH CARE 291