a Faculty of Health and Occupational Studies, Department of Health and Caring Sciences , University of Gavle , Gavle , Sweden.
b Department of Public Health and Caring Sciences , Uppsala University, Health Services Research , Uppsala , Sweden.
Int J Qual Stud Health Well-being. 2019 Dec;14(1):1633174. doi: 10.1080/17482631.2019.1633174.
: Our aim was to describe Swedish Healthcare Direct (SHD) and its features as a complex system. : Qualitative interviews were conducted with 20 SHD telenurses, covering their experiences and skills when encountering and advising callers with mental illness. Complexity science was used as an theoretical framework to enhance understanding of the complex nature of telenursing. : SHD was described as a complex system as nurses were constantly interacting with other agents and agencies. During these interactions, dynamic processes were found between the agents in which the nurses adapted to every new situation. They were constantly aware of their impact on the care-seekers, and perceived their encounters with callers with psychiatric illness as "balancing on a thin line". SHD was also described as both an authority and a dumping ground. The openness of the system did not give the nurses possibility to control the number of incoming calls and the callers' intentions. : These new insights into SHD have important implications for organization developers and nursing management in terms of overcoming linear thinking.
我们的目的是描述瑞典医疗保健热线（SHD）及其作为复杂系统的特点。我们对 20 名 SHD 电话护士进行了定性访谈，涵盖了他们在遇到和建议有精神疾病的来电者时的经验和技能。复杂性科学被用作一个理论框架，以增强对电话护理复杂性质的理解。SHD 被描述为一个复杂的系统，因为护士不断与其他代理和机构进行互动。在这些互动中，发现了代理之间的动态过程，护士在这些过程中适应每一个新的情况。他们时刻意识到自己对寻求护理者的影响，并将与精神病患者的接触视为“在薄线上平衡”。SHD 也被描述为权威和倾倒场。系统的开放性使护士无法控制来电数量和来电者的意图。这些对 SHD 的新见解对于组织开发者和护理管理具有重要意义，有助于克服线性思维。
