Nursing Practices to Optimise Rheumatic Fever Prevention in a High-Risk Country: An Integrative Review

Abstract

Background: New Zealand is one of the last high-income countries in the world experiencing significant rates of rheumatic fever. Nurses play a crucial role in rheumatic fever prevention; however, little is understood as to how nurses can best achieve this. Aim: To explore nursing practices that optimise rheumatic fever prevention.

Design: An integrative review. Methods: Four electronic databases (CINAHL, SCOPUS, Medline via, and Ovid) were searched for peer-reviewed empirical articles published from 2013 to 2023. Grey literature (guidelines/reports) was also sourced. Critical appraisal was applied using the Mixed-Methods Appraisal Tools and the Joanna Briggs Critical Appraisal checklist. Qualitative Research in Psychology, 3(2), 77–101, thematic analysis method was used to generate themes.

Results: Seven research articles and three national reports were included. Four themes—in-depth nursing knowledge and improving prophylaxis adherence, cultural competency, and therapeutic nurse–patient relationships—were found.

Conclusion: While nursing knowledge and ways to improve injection adherence are essential, being culturally receptive and developing therapeutic relationships are equally important. Without strong and trusting relationships, it is difficult to deliver care required for prevention success. Implications to care: When working with vulnerable populations it is important to be culturally receptive in all interactions with patients and their families. Impact: New Zealand has high rates of rheumatic fever, especially among vulnerable populations such as Pacific Islanders and Māori. Nurses are often frontline primary care providers who, when skilled with the right tools, can help reduce the prevalence of this disease.

Reporting method: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis flow chart.

Patient or public contribution: No Patient or Public Contribution was required for this research.