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Goals of telephone nursing work - the managers' perspectives: a qualitative study on Swedish healthcare direct
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. University of Gävle, Department of Health and Caring Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Mälardalens högskola, School of Health, Care and Social Welfare.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
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2014 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 14, 188- p.Article in journal (Refereed) Published
Abstract [en]

Background

Swedish Healthcare Direct (SHD) receives 6 million calls yearly and aims at increased public sense of security and healthcare efficiency. Little is known about what SHD managers perceive as the primary goals of telephone nursing (TN) work and how the organisation matches goals of health promotion and equitable healthcare, so important in Swedish healthcare legislation. The aim of the study was to explore and describe what the SHD managers perceive as the goals of TN work and how the managers view health promotion and implementation of equitable healthcare with gender as example at SHD.

Methods

The study was qualitative using an exploratory and descriptive design. All 23 managers employed at SHD were interviewed and data analysis used deductive directed content analysis.

Results

The findings reveal four themes describing the goals of TN work as recommended by the SHD managers. These are: ‘create feelings of trust’, ‘achieve patient safety’, ‘assess, refer and give advice’, and ‘teach the caller’. Most of the managers stated that health promotion should not be included in the goals, whereas equitable healthcare was viewed as an important issue. Varying suggestions for implementing equitable healthcare were given.

Conclusions

The interviewed managers mainly echoed the organisational goals of TN work. The managers’ expressed goal of teaching lacked the caller learning components highlighted by telenurses in previous research. The fact that health promotion was not seen as important indicates a need for SHD to clarify its goals as the organisation is part of the Swedish healthcare system, where health promotion should always permeate work. Time used for health promotion and dialogues in a gender equitable manner at SHD is well invested as it will save time elsewhere in the health care system, thereby facing one of the challenges of European health systems.

Place, publisher, year, edition, pages
2014. Vol. 14, 188- p.
Keyword [en]
Equitable Healthcare, Health promotion, Managers, Paediatric Health calls, Registered Nurses, Sweden, Telephone Nursing, Qualitative research
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Health Care Research
Identifiers
URN: urn:nbn:se:uu:diva-202857DOI: 10.1186/1472-6963-14-188ISI: 000335530600001OAI: oai:DiVA.org:uu-202857DiVA: diva2:634082
Available from: 2013-06-28 Created: 2013-06-28 Last updated: 2017-12-06Bibliographically approved
In thesis
1. Telephone Nursing: Stakeholder views and understandings from a paediatric and a gender perspective
Open this publication in new window or tab >>Telephone Nursing: Stakeholder views and understandings from a paediatric and a gender perspective
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Omvårdnad per telefon : Intressenters syn och förståelsefrån ett pediatrik- och ett genusperspektiv
Abstract [en]

‘First line healthcare’ is offered via telephone in many Western countries. The overall aim of this thesis is to describe Telephone Nursing (TN) from three viewpoints: telenurses, parents calling for their children, and operation managers. Four empirical studies were conducted. Telenurses described their work in five different ways: ‘Assess, refer and give advice to the caller’, ‘Support the caller’, ‘Strengthen the caller’, ‘Teach the caller’ and ‘Facilitate the caller’s learning’, which all constitute a TN ‘work map’. Authentic paediatric calls between parents and telenurses revealed that 73% of callers were mothers and children were aged between 5 days and 14.5 years. The top three contact reasons were ear and skin problems, and fever, with a median call length of 4.4 minutes. More than half of the calls resulted in referrals and 48% received self-care advice. The likelihood of fathers being given referrals as a result of their call was almost twice as high as that for mothers, while mothers were almost twice as likely to receive self-care advice as fathers. Parents described their degree of worry and trust that influenced their decisions whether to contact SHD or not. Their calls were carefully prepared, and the parent calling often depended on family routine. Parents reported to follow recommendations. Most relied upon their own intuition if further worried, but some indicated they would never seek healthcare unless it was recommended. Operation managers described four main goals of TN work: ‘create feelings of trust’, ‘achieve patient safety’, ‘assess, refer and give advice’, and ‘teach the caller’. Equitable healthcare was regarded as important, whereas health promotion was not considered as part of the goals.

Conclusion: The studied TN viewpoints present concordance and discrepancies. Paediatric health calls appear mostly to be a woman-to-woman activity. Telenurses’ increased gender competence might increase TN safety. For that matter, telenurses’ collaboration with parents and making parents aware of holding the ultimate responsibility for their child’s condition is important. Goals of TN work and their relationship with healthcare obligations such as equitable healthcare and health promotion need further clarification. The viewpoints described in this thesis may contribute to the development of TN.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2013. 75 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 933
Keyword
Children; Equitable Healthcare; Gender; Health Promotion; Managers; Paediatric; Paediatric Health Calls; Parents; Registered Nurses; Telenurse; Telephone Nursing; Qualitative Research
National Category
Medical and Health Sciences
Research subject
Health Care Research
Identifiers
urn:nbn:se:uu:diva-200204 (URN)978-91-554-8746-1 (ISBN)
Public defence
2013-10-25, Auditorium Minus, Gustavianum, Uppsala Universitet, Akademigatan 3, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Funder
Swedish Research Council, 522-2005-7461
Available from: 2013-10-02 Created: 2013-05-22 Last updated: 2017-03-13Bibliographically approved

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