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"If I didn't trust Swedish Healthcare Direct, I would never call" - views of making pediatric health calls
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.
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, Health Services Research.
2013 (English)In: Clinical Nursing Studies, ISSN 2324-7959, Vol. 1, no 3, 57-69 p.Article in journal (Refereed) Published
Abstract [en]

The focus of the presented research is parents' expectations and experiences of calling Swedish Healthcare Direct (SHD)regarding pediatric health issues. Telenursing is a rapidly expanding service and SHD handles up to 2.4 million pediatrichealth calls yearly. Mothers make the majority of the calls and reportedly receive self-care advice more than fathers.Parents' views are important for the development and safe use of telenursing health services. The study is qualitative, withan exploratory and descriptive design. Twenty-one interviews with parents were analysed using content analysis.According to the interviewees, the decision to contact SHD or not is influenced by their degree of worry or trust in the service. Calls are carefully prepared, and who will call is often predetermined and affected by gender. Parents want to be given a chance to speak first in their communication with telenurses. They want to be listened to carefully and to be accorded respect, to have their needs fully explored and to have their concerns relieved. Most parents follow telenurses'recommendations, a few exclusively. Some primarily trust their own intuition. Learning is frequent, implying the publichealth potential of calls, not least for foreign-born callers. Exploring parents' expectations provides insight into parents'worries, potential to increase parents' learning and may develop their trust in telenurses' recommendations. Telenurses'awareness of gender impact can further develop the telenursing health service in providing safe care on equal terms for avulnerable patient group, children.

Place, publisher, year, edition, pages
2013. Vol. 1, no 3, 57-69 p.
Keyword [en]
Children, Communication, Gender, Interviews, Parents, Pediatric, Primary care, Telenursing
National Category
Medical and Health Sciences
Research subject
Health Care Research
Identifiers
URN: urn:nbn:se:uu:diva-202853DOI: 10.5430/cns.v1n3p57OAI: oai:DiVA.org:uu-202853DiVA: diva2:634064
Available from: 2013-06-28 Created: 2013-06-28 Last updated: 2014-01-23Bibliographically 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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Publisher's full texthttp://www.sciedupress.com/journal/index.php/cns/article/view/2677/1763

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Kaminsky, ElenorCarlsson, MarianneRöing, MartaHolmström, Inger

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