Telephone nurses' communication and response to callers' concern--a mixed methods study

Area of Science:

• Healthcare communication
• Nursing practice
• Patient safety

Background:

• Telephone nursing services are expanding rapidly.
• Managing caller expectations regarding care levels presents challenges.

Purpose of the Study:

• To analyze communication dynamics between telephone nurses and callers.
• To investigate the relationship between nurse-callers' communication patterns.
• To examine nurses' responses to callers' expressed concerns.

Main Methods:

• Utilized Recorded and Immediate Assessment (RIAS) and content analysis.
• Analyzed a sample of 25 calls where callers received a lower care recommendation than expected.

Main Results:

• Telephone nurses predominantly used closed-ended questions, with limited use of open-ended questions.
• A correlation was observed between callers' expressions of concern and nurses' responses indicating disapproval.
• Nurses' responses to concerns often involved closed-ended medical questions, with sparse exploration of the caller's underlying reasons.

Conclusions:

• Reluctance to use open-ended questions and verify caller understanding may threaten concordance.
• Potential risks to patient safety were identified due to communication patterns.