Patient-nurse-doctor interaction in general practice teleconsultations--a qualitative analysis

Area of Science:

• Medical Informatics
• Primary Care Medicine
• Qualitative Research

Background:

• Teleconsultations are increasingly used in primary care.
• Understanding the dynamics of doctor-nurse-patient interactions in teleconsultations is crucial for effective healthcare delivery.
• Previous research has not fully explored the multifaceted roles within these virtual triads.

Purpose of the Study:

• To analyze the complex interactions within doctor-nurse-patient teleconsultations in primary care.
• To identify the specific roles and contributions of nurses in these remote encounters.
• To understand the challenges and skill requirements for healthcare professionals in telemedical settings.

Main Methods:

• Qualitative analysis of 30 primary care teleconsultations conducted in northeastern Finland.
• Grounded theory approach was employed to analyze the interaction patterns.
• A consistent male doctor and trained nurses participated in the consultations.

Main Results:

• Doctor-nurse-patient interaction in teleconsultations is complex.
• The doctor faced challenges in maintaining undivided attention due to multitasking.
• The nurse adopted an active role as facilitator, patient advocate, doctor's secretary, and mediator of therapeutic influence.
• Patients frequently sought information directly from the nurse.

Conclusions:

• Interpersonal dynamics are critically important in telemedical encounters.
• Nurses play a pivotal, multifaceted role in supporting the doctor-patient relationship during teleconsultations.
• Both doctors and nurses need to develop new competencies to effectively conduct joint teleconsultations.