Chronic Illness Narratives

Understanding clients’ perceptions of chronic illness is critical to high quality nurse practitioner (NP) care. This understanding can be challenging when primary care NP students’ experiences have focused on in-patient acute treatment of illness and limited consideration of the client’s life outside the hospital.

The purpose of this study is to examine the impact of a course assignment in which students interview individuals with chronic illnesses. An analysis of students’ interview discussions revealed recurrent student themes related to their perceptions of chronic illness.  Additionally, the analysis guided faculty  development of NP curricular content that fosters quality chronic illness care.

Sixty-five students enrolled in an Adult NP course interviewed individuals with chronic illnesses. An instructor developed interview outline was used by the students who then posted their completed interviews to an online class discussion. Discussion among students about the interviews followed. Interview assignments were then qualitatively analyzed. Each of the selected interviews were read separately by two researchers and coded to identify common narrative themes. Identified themes were then compared, contrasted and collapsed to represent the predominant themes of the interviews.

Sixty-four students submitted interviews. Clients interviewed had an average age of 49. Thirty-six were female and twenty-seven were male. Client health problems ranged from very common diseases such as high blood pressure to more rare problems such as muscular dystrophy and spinal cord injury.

Student themes demonstrated in the interviews included recognition of the importance of patient empowerment for self-care, recognition of the life encompassing affects and needs of patients with chronic illnesses, the cultural, societal and individual influences that result in differing responses to chronic illness, the patient’s desire to seek normalcy through adaptation and support, the isolating effects as well as personal growth potential of having a chronic illness, and the need for enhanced patient communication skills in order to achieve greater patient understanding and adherence to health care recommendations .

The assignment was an effective tool to help students move beyond an acute care view of chronic illness. These findings may also guide nurse practitioner curricular content development that fosters improved care of patients with chronic illnesses.