Department of Medical and Health Sciences, Linköping University, SE-581 83 Linköping, Sweden.
J Telemed Telecare. 2011;17(7):397-402. doi: 10.1258/jtt.2011.110213.
We investigated satisfaction with a Swedish telenursing service and the health-care-seeking behaviour among callers who received a less urgent level of health care than they expected. A postal questionnaire was sent to a random selection of callers (n = 273) to Swedish Healthcare Direct in October 2008. The 'cases' were 18 callers where the telenurse recommended a lower level of health care than the caller expected and who were not in complete agreement with the nurse. The 'controls' were 22 callers who either received a lower recommendation, or were in disagreement with the recommendation. There were no differences between cases, controls and other callers regarding background factors or the telenurse classification of emergency. However, both cases and controls considered their need for health care as more urgent than the other callers. An independent test of the nurses' reception, ability to listen and to take notice of the callers' health problem, showed that nurses who had served cases, had received a significantly lower rating than other nurses. For nurses who had served controls, there was no such difference in rating. Cases and controls had fewer subsequent care visits than other callers, in the three days following the call, although the proportion of emergency visits was higher among cases and controls compared to other callers. If the caller and the nurse disagree about the nurse's recommendations, the consequence can be a dissatisfied caller and more visits to unnecessary high levels of health care. Further training of the nurses may improve the telenurse service.
我们调查了对瑞典远程护理服务的满意度，以及在接受的医疗保健水平低于预期的呼叫者中的寻医行为。2008 年 10 月，向瑞典医疗保健热线的随机选择的呼叫者（n=273）发送了一份邮寄问卷。“案例”是 18 名呼叫者，他们的远程护士建议的医疗保健水平低于呼叫者的预期，并且与护士不完全一致。“对照组”是 22 名呼叫者，他们要么收到较低的建议，要么不同意建议。在背景因素或护士对紧急情况的分类方面，案例、对照组和其他呼叫者之间没有差异。然而，案例和对照组都认为他们对医疗保健的需求比其他呼叫者更紧急。对护士接待、倾听和注意呼叫者健康问题的能力的独立测试表明，为案例服务的护士的评分明显低于其他护士。对于为对照组服务的护士，评分没有差异。与其他呼叫者相比，案例和对照组在呼叫后的三天内就诊次数较少，尽管案例和对照组的急诊就诊比例高于其他呼叫者。如果呼叫者和护士对护士的建议存在分歧，结果可能是呼叫者不满意，并增加对不必要的高水平医疗保健的就诊次数。对护士进行进一步培训可能会提高远程护理服务的质量。
