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Published in: BMC Health Services Research 1/2014

Open Access 01-12-2014 | Research article

Goals of telephone nursing work - the managers’ perspectives: a qualitative study on Swedish healthcare direct

Authors: Elenor Kaminsky, Marianne Carlsson, Inger K Holmström, Jan Larsson, Mio Fredriksson

Published in: BMC Health Services Research | Issue 1/2014

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Abstract

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.
Literature
1.
go back to reference The Ministry of Health and Social Affairs [Socialstyrelsen]: Swedish health care act 1982:763. Hälso- och sjukvårdslag. 1982, 1982: 763. The Ministry of Health and Social Affairs [Socialstyrelsen]: Swedish health care act 1982:763. Hälso- och sjukvårdslag. 1982, 1982: 763.
3.
go back to reference Kaminsky E, Carlsson M, Hoglund AT, Holmstrom I: Paediatric health calls to Swedish telenurses: a descriptive study of content and outcome. J Telemed Telecare. 2010, 16 (8): 454-457. 10.1258/jtt.2010.100110.CrossRefPubMed Kaminsky E, Carlsson M, Hoglund AT, Holmstrom I: Paediatric health calls to Swedish telenurses: a descriptive study of content and outcome. J Telemed Telecare. 2010, 16 (8): 454-457. 10.1258/jtt.2010.100110.CrossRefPubMed
4.
go back to reference Swedin B: Healthcare direct: telephone nursing in collaboration. Final report from the national inquiry into coordinated telephone nursing [Vårdråd direkt: sjukvårdsrådgivningar i samverkan. Slutrapport från Utredningen om nationellt samordnad sjukvårdsrådgivning]. 2003, Landstingsförbundet: Stockholm Swedin B: Healthcare direct: telephone nursing in collaboration. Final report from the national inquiry into coordinated telephone nursing [Vårdråd direkt: sjukvårdsrådgivningar i samverkan. Slutrapport från Utredningen om nationellt samordnad sjukvårdsrådgivning]. 2003, Landstingsförbundet: Stockholm
5.
go back to reference Ernesater A, Holmstrom I, Engstrom M: Telenurses' experiences of working with computerized decision support: supporting, inhibiting and quality improving. J Adv Nurs. 2009, 65 (5): 1074-1083. 10.1111/j.1365-2648.2009.04966.x.CrossRefPubMed Ernesater A, Holmstrom I, Engstrom M: Telenurses' experiences of working with computerized decision support: supporting, inhibiting and quality improving. J Adv Nurs. 2009, 65 (5): 1074-1083. 10.1111/j.1365-2648.2009.04966.x.CrossRefPubMed
6.
go back to reference Monaghan R, Clifford C, McDonald P: Seeking advice from NHS direct on common childhood complaints: does it matter who answers the phone?. J Adv Nurs. 2003, 42 (2): 209-216. 10.1046/j.1365-2648.2003.02602.x.CrossRefPubMed Monaghan R, Clifford C, McDonald P: Seeking advice from NHS direct on common childhood complaints: does it matter who answers the phone?. J Adv Nurs. 2003, 42 (2): 209-216. 10.1046/j.1365-2648.2003.02602.x.CrossRefPubMed
7.
go back to reference Belman S, Chandramouli V, Schmitt BD, Poole SR, Hegarty T, Kempe A: An assessment of pediatric after-hours telephone care: a 1-year experience. Arch Pediatr Adolesc Med. 2005, 159 (2): 145-149.CrossRefPubMed Belman S, Chandramouli V, Schmitt BD, Poole SR, Hegarty T, Kempe A: An assessment of pediatric after-hours telephone care: a 1-year experience. Arch Pediatr Adolesc Med. 2005, 159 (2): 145-149.CrossRefPubMed
8.
go back to reference Bunn F, Byrne G, Kendall S: The effects of telephone consultation and triage on healthcare use and patient satisfaction: a systematic review. Br J Gen Pract. 2005, 55 (521): 956-961.PubMedPubMedCentral Bunn F, Byrne G, Kendall S: The effects of telephone consultation and triage on healthcare use and patient satisfaction: a systematic review. Br J Gen Pract. 2005, 55 (521): 956-961.PubMedPubMedCentral
9.
go back to reference Pettinari CJ, Jessopp L: "Your ears become your eyes": managing the absence of visibility in NHS Direct. J Adv Nurs. 2001, 36 (5): 668-675. 10.1046/j.1365-2648.2001.02031.x.CrossRefPubMed Pettinari CJ, Jessopp L: "Your ears become your eyes": managing the absence of visibility in NHS Direct. J Adv Nurs. 2001, 36 (5): 668-675. 10.1046/j.1365-2648.2001.02031.x.CrossRefPubMed
11.
go back to reference The National Board of Health and Welfare [Socialstyrelsen]: National guidelines for disease prevention methods 2011: use of tobaco, hazardous use of alcohol, insufficient physical activity and unhealthy eating habits: support for governance and management [Nationella riktlinjer för sjukdomsförebyggande metoder 2011: tobaksbruk, riskbruk av alkohol, otillräcklig fysisk aktivitet och ohälsosamma matvanor: stöd för styrning och ledning]. 2011, Stockholm: The National Board of Health and Welfare [Socialstyrelsen] The National Board of Health and Welfare [Socialstyrelsen]: National guidelines for disease prevention methods 2011: use of tobaco, hazardous use of alcohol, insufficient physical activity and unhealthy eating habits: support for governance and management [Nationella riktlinjer för sjukdomsförebyggande metoder 2011: tobaksbruk, riskbruk av alkohol, otillräcklig fysisk aktivitet och ohälsosamma matvanor: stöd för styrning och ledning]. 2011, Stockholm: The National Board of Health and Welfare [Socialstyrelsen]
16.
go back to reference Kaminsky E, Rosenqvist U, Holmström I: Telenurses' understanding of work: detective or educator?. J Adv Nurs. 2009, 65 (2): 382-390. 10.1111/j.1365-2648.2008.04877.x.CrossRefPubMed Kaminsky E, Rosenqvist U, Holmström I: Telenurses' understanding of work: detective or educator?. J Adv Nurs. 2009, 65 (2): 382-390. 10.1111/j.1365-2648.2008.04877.x.CrossRefPubMed
17.
go back to reference The Ministry of Health and Social Affairs [Socialdepartementet]: A renewed Public Health Policy. Prop. 2007, 08: 110-[En förnyad folkhälsopolitik, Prop. 2007/08:110]. 2007 The Ministry of Health and Social Affairs [Socialdepartementet]: A renewed Public Health Policy. Prop. 2007, 08: 110-[En förnyad folkhälsopolitik, Prop. 2007/08:110]. 2007
18.
19.
go back to reference Leppänen V: Power in telephone-advice nursing. Nurs Inq. 2010, 17 (1): 15-26. 10.1111/j.1440-1800.2009.00480.x.CrossRefPubMed Leppänen V: Power in telephone-advice nursing. Nurs Inq. 2010, 17 (1): 15-26. 10.1111/j.1440-1800.2009.00480.x.CrossRefPubMed
20.
go back to reference Andersson BM: Conceptions, conflicts and contradictions at the introduction of a Swedish health call centre. 2008, Sweden: Thesis University of Gothenburg Andersson BM: Conceptions, conflicts and contradictions at the introduction of a Swedish health call centre. 2008, Sweden: Thesis University of Gothenburg
21.
go back to reference Casey D: Nurses’ perceptions, understanding and experiences of health promotion. J Clin Nurs. 2007, 16 (6): 1039-1049. 10.1111/j.1365-2702.2007.01640.x.CrossRefPubMed Casey D: Nurses’ perceptions, understanding and experiences of health promotion. J Clin Nurs. 2007, 16 (6): 1039-1049. 10.1111/j.1365-2702.2007.01640.x.CrossRefPubMed
22.
go back to reference Purc-Stephenson RJ, Thrasher C: Nurses' experiences with telephone triage and advice: a meta-ethnography. J Adv Nurs. 2010, 66 (3): 482-494. 10.1111/j.1365-2648.2010.05275.x.CrossRefPubMed Purc-Stephenson RJ, Thrasher C: Nurses' experiences with telephone triage and advice: a meta-ethnography. J Adv Nurs. 2010, 66 (3): 482-494. 10.1111/j.1365-2648.2010.05275.x.CrossRefPubMed
23.
go back to reference Farquharson B, Allan J, Johnston D, Johnston M, Choudhary C, Jones M: Stress amongst nurses working in a healthcare telephone-advice service: relationship with job satisfaction, intention to leave, sickness absence, and performance. J Adv Nurs. 2012, 68 (7): 1624-1635. 10.1111/j.1365-2648.2012.06006.x.CrossRefPubMed Farquharson B, Allan J, Johnston D, Johnston M, Choudhary C, Jones M: Stress amongst nurses working in a healthcare telephone-advice service: relationship with job satisfaction, intention to leave, sickness absence, and performance. J Adv Nurs. 2012, 68 (7): 1624-1635. 10.1111/j.1365-2648.2012.06006.x.CrossRefPubMed
24.
go back to reference Bolton SC: Multiple roles? Nurses as managers in the NHS. Int J Public Sect Manage. 2003, 16 (2): 122-130. 10.1108/09513550310467975.CrossRef Bolton SC: Multiple roles? Nurses as managers in the NHS. Int J Public Sect Manage. 2003, 16 (2): 122-130. 10.1108/09513550310467975.CrossRef
25.
go back to reference McConnell CR: The Health Care Professional as a Manager: Balancing Two Important Roles. Health Care Manag (Frederick). 2008, 27 (3): 277-284. McConnell CR: The Health Care Professional as a Manager: Balancing Two Important Roles. Health Care Manag (Frederick). 2008, 27 (3): 277-284.
26.
go back to reference Paliadelis PS: The working world of nursing unit managers: responsibility without power. Aust Health Rev. 2008, 32 (2): 256-264. 10.1071/AH080256.CrossRefPubMed Paliadelis PS: The working world of nursing unit managers: responsibility without power. Aust Health Rev. 2008, 32 (2): 256-264. 10.1071/AH080256.CrossRefPubMed
27.
go back to reference Winblad U: Do physicians care about patient choice?. Soc Sci Med. 2008, 67 (10): 1502-1511. 10.1016/j.socscimed.2008.07.016.CrossRefPubMed Winblad U: Do physicians care about patient choice?. Soc Sci Med. 2008, 67 (10): 1502-1511. 10.1016/j.socscimed.2008.07.016.CrossRefPubMed
28.
go back to reference Patton MQ: Qualitative research & evaluation methods. 2004, London: SAGE, 4 Patton MQ: Qualitative research & evaluation methods. 2004, London: SAGE, 4
29.
go back to reference Polit DF, Beck CT: Nursing research: generating and assessing evidence for nursing practice. 2008, Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 8 Polit DF, Beck CT: Nursing research: generating and assessing evidence for nursing practice. 2008, Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 8
30.
go back to reference Clark JP: How to peer review a qualitative manuscript. Peer Review in Health Sciences. Edited by: Godlee F, Jefferson T. 2003, London: BMJ Books, 219-235. Second Clark JP: How to peer review a qualitative manuscript. Peer Review in Health Sciences. Edited by: Godlee F, Jefferson T. 2003, London: BMJ Books, 219-235. Second
32.
go back to reference World Health Organization: World Medical Association Declaration of Helsinki - Ethical Principles for Medical Research Involving Human Subjects. Bull World Health Organ. 2001, 9 (4): 373-374. World Health Organization: World Medical Association Declaration of Helsinki - Ethical Principles for Medical Research Involving Human Subjects. Bull World Health Organ. 2001, 9 (4): 373-374.
33.
go back to reference Hsieh H-F, Shannon SE: Three Approaches to Qualitative Content Analysis. Qual Health Res. 2005, 15 (9): 1277-1288. 10.1177/1049732305276687.CrossRefPubMed Hsieh H-F, Shannon SE: Three Approaches to Qualitative Content Analysis. Qual Health Res. 2005, 15 (9): 1277-1288. 10.1177/1049732305276687.CrossRefPubMed
34.
go back to reference Christensen T, Ivarsson WA: Organisational theory for public sector [Organisationsteori för offentlig sektor]. 2005, Malmö: Liber Christensen T, Ivarsson WA: Organisational theory for public sector [Organisationsteori för offentlig sektor]. 2005, Malmö: Liber
35.
go back to reference Johansson H, Weinehall L, Emmelin M: "It depends on what you mean": a qualitative study of Swedish health professionals' views on health and health promotion. BMC Health Serv Res. 2009, 9 (1): 191-10.1186/1472-6963-9-191.CrossRefPubMedPubMedCentral Johansson H, Weinehall L, Emmelin M: "It depends on what you mean": a qualitative study of Swedish health professionals' views on health and health promotion. BMC Health Serv Res. 2009, 9 (1): 191-10.1186/1472-6963-9-191.CrossRefPubMedPubMedCentral
36.
go back to reference Robinson S, Hill Y: The health promoting nurse. J Clin Nurs. 1998, 7 (3): 232-238. 10.1046/j.1365-2702.1998.00151.x.CrossRefPubMed Robinson S, Hill Y: The health promoting nurse. J Clin Nurs. 1998, 7 (3): 232-238. 10.1046/j.1365-2702.1998.00151.x.CrossRefPubMed
37.
go back to reference Fältholm Y, Jansson A: Telephone advisory services—nursing between organisational and occupational professionalism. N Technol Work Employ. 2008, 23 (1–2): 17-29.CrossRef Fältholm Y, Jansson A: Telephone advisory services—nursing between organisational and occupational professionalism. N Technol Work Employ. 2008, 23 (1–2): 17-29.CrossRef
38.
go back to reference Eckes T: Trautner HM. 2000, Lawrence Erlbaum Associates: The developmental social psychology of gender Eckes T: Trautner HM. 2000, Lawrence Erlbaum Associates: The developmental social psychology of gender
39.
go back to reference Connell RW, Messerschmidt JW: Hegemonic masculinity. Gend Soc. 2005, 19 (6): 829-859. 10.1177/0891243205278639.CrossRef Connell RW, Messerschmidt JW: Hegemonic masculinity. Gend Soc. 2005, 19 (6): 829-859. 10.1177/0891243205278639.CrossRef
40.
go back to reference Höglund AT, Holmström I: It's easier to talk to a woman. Aspects Gend Swedish Telenursing J Clin Nurs. 2008, 17 (22): 2979-2986. Höglund AT, Holmström I: It's easier to talk to a woman. Aspects Gend Swedish Telenursing J Clin Nurs. 2008, 17 (22): 2979-2986.
41.
go back to reference Graneheim UH, Lundman B: Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004, 24 (2): 105-112. 10.1016/j.nedt.2003.10.001.CrossRefPubMed Graneheim UH, Lundman B: Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004, 24 (2): 105-112. 10.1016/j.nedt.2003.10.001.CrossRefPubMed
42.
go back to reference Lincoln YS, Guba EG: Naturalistic inquiry. 1985, Beverly Hills, Calif: Sage Publications Lincoln YS, Guba EG: Naturalistic inquiry. 1985, Beverly Hills, Calif: Sage Publications
43.
go back to reference Hamberg K, Johansson E, Lindgren G, Westman G: Scientific rigour in qualitative research - examples from a study of women's health in family practice. Fam Pract. 1994, 11 (2): 176-181. 10.1093/fampra/11.2.176.CrossRefPubMed Hamberg K, Johansson E, Lindgren G, Westman G: Scientific rigour in qualitative research - examples from a study of women's health in family practice. Fam Pract. 1994, 11 (2): 176-181. 10.1093/fampra/11.2.176.CrossRefPubMed
Metadata
Title
Goals of telephone nursing work - the managers’ perspectives: a qualitative study on Swedish healthcare direct
Authors
Elenor Kaminsky
Marianne Carlsson
Inger K Holmström
Jan Larsson
Mio Fredriksson
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2014
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-14-188

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