Registered nurses’ experiences of communication with patients when practising person–centred care over the phone: a qualitative interview study

BMC Nursing - Tập 19 Số 1 - 2020
Eva Boström1, Lilas Ali2, Andreas Fors2, Inger Ekman2, Anna-Lena Andersson2
1Department of Nursing, Umeå University, Umeå, Sweden
2Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, P.O. Box 457, 405 30, Gothenburg, Sweden

Tóm tắt

Abstract Background To explore registered nurses’ (RNs’) experiences of practising person-centred care (PCC) by telephone with people diagnosed with chronic obstructive pulmonary disease and/or chronic heart failure. Methods Qualitative interview study. Four RNs were individually interviewed before, during, and after participating in an intervention practising PCC by telephone. The interviews were analysed using qualitative content analysis. Results The results reflect three categories of their experience: realize the complexity of practising PCC by distance, gain insight into what PCC communication meant to RNs and their approach, and develop the professional role by practising PCC theory and ethics. Conclusions PCC over the telephone facilitate healthcare and support patients. Through careful listening, the RNs (1) created space for the individual patients to express their thoughts and feelings and (2) emphasized each patient’s capabilities and resources. The RNs also gained an understanding of PCC and what it means to patients and to themselves as practitioners. Potential implications are that it is important for RNs practising PCC by telephone to remould their role, to listen carefully, and to communicate as equals in conversations that respect both parties’ knowledge and expertise. Health professionals need supervision and support to fully understand the person-centred approach and provide communications that support it.

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Tài liệu tham khảo

World Health Organisation, WHO. National eHealth strategy toolkit; 2012.

Luna D, Almerares A, Mayan JC, Gonzalez Bernaldo de Quiros F, Otero C. Health informatics in developing countries: going beyond pilot practices to sustainable implementations: a review of the current challenges. Health Inform Res. 2014;20(1):3–10.

Doarn CR, Pruitt S, Jacobs J, Harris Y, Bott DM, Riley W, et al. Federal efforts to define and advance telehealth—a work in progress. Telemed e-Health. 2014;20(5):409–18.

Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, et al. 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) developed with the special contribution of the heart failure association (HFA) of the ESC. Eur Heart J. 2016;37(27):2129–200.

Vestbo J, Hurd SS, Agustí AG, Jones PW, Vogelmeier C, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2013;187(4):347–65.

Inglis SC, Clark RA, Dierckx R, Prieto-Merino D, Cleland JG. Structured telephone support or non-invasive telemonitoring for patients with heart failure. Cochrane Libr. 2015;10:CD007228.

Ali L, Fors A, Ekman I. Need of support in people with chronic obstructive pulmonary disease. J Clin Nurs. 2018;27(5–6):e1089–e96.

Kaminsky E, Röing M, Björkman A, Holmström IK. Telephone nursing in Sweden: a narrative literature review. Nurs Health Sci. 2017;19(3):278–86.

Purc-Stephenson RJ, CJJoan T. Nurses’ experiences with telephone triage and advice: a meta-ethnography. J Adv Nurs. 2010;66(3):482–94.

Holmström I, Höglund AT. The faceless encounter: ethical dilemmas in telephone nursing. J Clin Nurs. 2007;16(10):1865–71.

Pettinari CJ, LJJoan J. ‘Your ears become your eyes’: managing the absence of visibility in NHS direct. J Adv Nurs. 2001;36(5):668–75.

Wildevuur SE, Simonse LW. Information and communication technology–enabled person-centered care for the “big five” chronic conditions: scoping review. J Med Internet Res. 2015;17(3):e77.

Doyle C, Bhar S, Fearn M, Ames D, Osborne D, You E, et al. The impact of telephone-delivered cognitive behaviour therapy and befriending on mood disorders in people with chronic obstructive pulmonary disease: a randomized controlled trial. Br J Health Psychol. 2017;22:542–56.

Heckemann B, Wolf A, Ali L, Sonntag SM, Ekman I. Discovering untapped relationship potential with patients in telehealth: a qualitative interview study. BMJ Open. 2016;6(3):e009750.

Kenealy TW, Parsons MJ, Rouse APB, Doughty RN, Sheridan NF, Hindmarsh JKH, et al. Telecare for diabetes, CHF or COPD: effect on quality of life, hospital use and costs. A randomised controlled trial and qualitative evaluation. PLoS One. 2015;10(3):e0116188.

Ekman I, Swedberg K, Taft C, Lindseth A, Norberg A, Brink E, et al. Person-centered care--ready for prime time. Eur J Cardiovasc Nurs. 2011;10(4):248–51.

McCormack B, McCance T. Person-centred nursing: theory and practice. Oxford: Wiley; 2010.

Brännström M, Boman K. Effects of person-centred and integrated chronic heart failure and palliative home care. PREFER: a randomized controlled study. Eur J Heart Fail. 2014;16(10):1142–51.

Dudas K, Olsson L-E, Wolf A, Swedberg K, Taft C, Schaufelberger M, et al. Uncertainty in illness among patients with chronic heart failure is less in person-centred care than in usual care. Eur J Cardiovasc Nurs. 2013;12(6):521–8.

Hansson E, Ekman I, Swedberg K, Wolf A, Dudas K, Ehlers L, et al. Person-centred care for patients with chronic heart failure–a cost–utility analysis. Eur J Cardiovasc Nurs. 2016;15(4):276–84.

Boström E, Isaksson U, Lundman B, Lehuluante A, Hörnsten Å. Patient-centred care in type 2 diabetes–an altered professional role for diabetes specialist nurses. Scand J Caring Sci. 2013;28(4):675–82.

Boström E, Isaksson U, Lundman B, Graneheim UH, Hörnsten Å. Interaction between diabetes specialist nurses and patients during group sessions about self-management in type 2 diabetes. Patient Educ Couns. 2013;94(2):187–92.

Wallström S, Ekman I. Person-centred care in clinical assessment. London: SAGE Publications Sage UK; 2018.

Fors A, Blanck E, Ali L, Ekberg-Jansson A, Fu M, Kjellberg IL, et al. Effects of a person-centred telephone-support in patients with chronic obstructive pulmonary disease and/or chronic heart failure–a randomized controlled trial. PLoS One. 2018;13(8):e0203031.

Fors A, Ekman I, Taft C, Björkelund C, Frid K, Larsson ME, et al. Person-centred care after acute coronary syndrome, from hospital to primary care—a randomised controlled trial. Int J Cardiol. 2015;187:693–9.

Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105–12.

ICT Services and System Development and Division of Epidemiology and Global Health. OpenCode 4.03: University of Umeå, Sweden; 2013. Available from: http://www.phmed.umu.se/english/units/epidemiology/research/open-code/. Accessed 17 Jan 2015.

Lave J, Wenger E. Situated learning: legitimate peripheral participation. Cambridge: Cambridge University Press; 1991.

Wenger E. Community of practice: learning, meaning and identity. Cambridge: Cambrige University and Identity; 1998.

Schein E. Organizational culture and leadership: Wiley; 2010.

Brennan KM. Meaning, discrepancy, and satisfaction in the nurse role. Sociol Spectr. 2009;29(5):551–71.

Edmondson AC, Higgins M, Singer S, Weiner J. Understanding psychological safety in health care and education organizations: a comparative perspective. Res Hum Dev. 2016;13(1):65–83.

Edmondson A. Psychological safety and learning behavior in work teams. Adm Sci Q. 1999;44(2):350–83.

Newman A, Donohue R, Eva NJHRMR. Psychological safety: a systematic review of the literature. Hum Res Manage Rev. 2017;27(3):521–35.

Mayor E, Bietti L. Ethnomethodological studies of nurse-patient and nurse-relative interactions: a scoping review. Int J Nurs Stud. 2017;70:46–57.

Castro EM, Van Regenmortel T, Vanhaecht K, Sermeus W, Van Hecke A. Patient empowerment, patient participation and patient-centeredness in hospital care: a concept analysis based on a literature review. Patient Educ Couns. 2016;99(12):1923–39.

Arne M, Emtner M, Janson S, Wilde-Larsson B. COPD patients' perspectives at the time of diagnosis: a qualitative study. Prim Care Respir J. 2007;16(4):215.

McCormack B, Karlsson B, Dewing J, Lerdal A. Exploring person centredness: a qualitative meta synthesis of four studies. Scand J Caring Sci. 2010;24(3):620–34.

Kolovos P, Kaitelidou D, Lemonidou C, Sachlas A, Zyga S, Sourtzi P. Patient participation in hospital care: nursing staffs' point of view. Int J Nurs Pract. 2015;21(3):258–68.

Tobiano G, Bucknall T, Marshall A, Guinane J, Chaboyer W. Nurses' views of patient participation in nursing care. J Adv Nurs. 2015;71(12):2741–52.

Ricoeur P. Oneself as another. Chicago: University of Chicago Press; 1992.

Burnard P. Teaching the analysis of textual data: an experiential approach. Nurse Educ Today. 1996;16(4):278–81.

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