DOI: 10.3390/healthcare14121779 ISSN: 2227-9032

The Role of Advanced Practice Nurses in the Care of Multimorbid and Complex Chronically Ill Young and Middle-Aged Adults in Hospital Settings—Perspectives on Experience of APNs: A Qualitative Study

Gabriele Bales, Birgit Schönfelder, Reto W. Kressig, Hanna Mayer

Background/Objectives: The rising prevalence of multimorbid and complex chronically ill young and middle-aged adults necessitates the implementation of innovative care models and the creation of roles that can meet the complex healthcare needs of this patient group. Advanced Practice Nurses (APNs) can play a crucial role in the care of multimorbid and complex chronically ill young and middle-aged adults in APN-led clinics; however, in Switzerland, these roles are still evolving. The aim of this study was to explore APNs’ perspectives on the planned development of their roles in an APN-led clinic. Methods: To gain insights into the experiences of APNs in caring for this patient group, a qualitative study design was chosen. Data were collected through interviews with APNs from Switzerland, the USA, and Canada. In total, 19 APNs (12 from Switzerland and 7 from the United States and Canada) participated in the study. The data were collected through semi-structured online interviews. These data were analyzed using reflective thematic analysis in accordance with the approach presented by Braun and Clarke. Results: The analysis identified 10 themes that describe the competencies, components, and framework conditions required for the work of APNs in an APN-led clinic for multimorbid and complex chronically ill young and middle-aged adults within the Swiss clinical context. Required competencies include direct clinical practice, guidance and coaching, collaboration, and psychosocial support. Essential components include person-centered care, transitional care, and continuity of care. Key framework conditions include regulations of the legal and regulatory framework and eligibility for reimbursement of services, resources, and extended competencies and scope of practice. Conclusions: The perspectives of the APNs involved in this study show that multimorbid and complexly chronically ill young and middle-aged adults require complex and long-term care that extends beyond the hospital setting. The findings of this study show that Swiss APNs may be well positioned to contribute to this role.

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