Co-Producing Evidence-Based Care: Nurses' and Patients' Lived Experiences in Long-Term Condition Management

共同构建循证护理:护士和患者在长期疾病管理中的亲身经历

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Abstract

AIM: To explore the lived experiences of nurses and patients co-producing evidence-based care for long-term conditions, and to understand how they make sense of this process within relational, emotional and organisational contexts. DESIGN: A qualitative study using the Interpretative Phenomenological Approach. METHODS: Semistructured interviews were conducted with 20 participants, comprising 11 registered nurses and 9 adult patients living with at least one Long-Term Condition. Participants were recruited from primary and secondary care settings across the Midlands, England. Data were collected between February and August 2023 and analysed using Interpretative Phenomenological Approach's iterative and inductive framework. RESULTS: Five experiential themes were identified: (1) weaving together different knowledges, (2) the relational foundations of co-production, (3) organisational pressures and misalignments, (4) shifting identities and power dynamics and (5) emotional and ethical complexity in co-producing care. Participants described co-production as a deeply relational and negotiated process, shaped by trust, vulnerability and shared decision-making. CONCLUSION: Co-producing evidence-based care in Long-Term Condition management involves more than implementing guidelines. It is a relational, emotional and contextual practice that requires shared interpretation of evidence, deep listening and responsiveness to individual lives. Findings suggest a need to reframe evidence-based practice as a co-creative process grounded in relational ethics and contextual awareness. IMPACT AND IMPLICATIONS: Findings emphasise the centrality of relational competence and organisational flexibility in enabling co-produced care. Findings call for educational and policy reforms that value emotional labour, professional humility and patient knowledge as essential to evidence-based nursing. Internationally, this work provides a grounded model for integrating person-centred approaches into chronic care delivery and policy. CONTRIBUTION TO THE WIDER GLOBAL CLINICAL COMMUNITY: The study offers a relational model of evidence-based practice that moves beyond protocol-driven care to one shaped through dialogue, empathy and contextual negotiation, offering practical insights for transforming professional roles and health systems globally. PATIENT AND PUBLIC INVOLVEMENT: Patient representatives contributed to study design, development of interview guides and interpretation of findings to ensure alignment with lived experiences. REPORTING METHOD: This study follows the SRQR guideline.

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