P1(1414 Kaminsky E, Rosenqvist U, Holmström IK. Telenurses' understanding of work: detective or educator? J Adv Nurs [Internet]. 2009[cited 2015 Aug 18];65(2):382-90. Available from: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2648.2008.04877.x/abstract
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Sender: The nurse must ask assertive questions.
•Recipient: The nurse must listen carefully to quickly determine the patient’s problem.
•Message: Acquisition of information through nonverbal signs, e.g., via the patient’s cough and breathing.
•Conclusion of the study: Communication aspects were not included in the conclusion of the study. |
P2(1515 Ernesäter A, Winblad U, Engström M, Holmström IK. Malpractice claims regarding calls to Swedish telephone advice nursing: what went wrong and why? J Telemed Telecare [Internet]. 2012[cited 2015 Aug 18];18(7):379-83. Available from: http://jtt.sagepub.com/content/18/7/379.long
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Sender: 1 - To use close-ended questions can be considered a potential threat to patients safety, while the use of open-ended questions can give a more comprehensive view of patients and, consequently, improve their safety; 2 - The importance of the message validation.
•Recipient: 1 - Failure in the communication process is the most common cause of errors identified, especially involving the process of listening to the patient; 2 - In telephone counseling, if the patient does not understand what was advised, he will not know what to do after the call, compromising his safety.
•Message: Impossibility to understand the nonverbal patient by telephone.
•Conclusion of the study: The use of open-ended questions by nurses should be encouraged, so they can better understand the patient. As the failure in the communication process was the most common cause of errors identified, a specific training in communication must be carried out to improve this skill. |
P3(55 Röing M, Rosenqvist U, Holmström IK. Threats to patient safety in telenursing as revealed in Swedish telenurses' reflections on their dialogues. Scand J Caring Sci [Internet]. 2013[cited 2015 Aug 18];27:969-76. Available from: http://onlinelibrary.wiley.com/doi/10.1111/scs.12016/epdf
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Sender: Clinical alterations of patients may complicate the communication.
•Recipient: 1 - Possibility that nurses are inconsistent when gathering patient data under stress and consequently in the assessment of symptoms; 2 - Difficulties in getting the message for not being “face-to-face” with the patient; 3 - The importance of listening and interpretation skills, and validation of the message received.
•Message: Not evidenced.
•Conclusion of the study: Inadequate data collection can affect patient safety and nurses do not seem to explore important information. Communication seems to be the key to a safe care in Telenursing and, therefore, “appropriate communication models” must be built and tested for health care practice. |
P4(1616 Polaschek L, Polaschek N. Solution-focused conversations: a new therapeutic strategy in well child health nursing telephone consultations. J Adv Nurs [Internet]. 2007[cited 2015 Aug 18];59(2):111-9. Available from: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2648.2007.04314.x/abstract
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Sender: Some patients were unable to express their problems clearly, some even did not seem to know why they were calling.
•Receiver: The nurses do not seem to explore key information when questioning the patients.
•Message: Appropriate communication strategies can help nurses to identify in the content of the parents’ message the real cause for their concern.
•Conclusion of the study: The systematic use of communication strategies has the potential to improve the nursing practice. Nurses should be trained in strategies of communication that are specific and appropriate to their specialty, to favor the recognition of patients’ problems and enable their participation in the elaboration of the care plan. |
P5(1717 Green JM, Spiby H, Hucknall C, Foster HR. Converting policy into care: women's satisfaction with the early labour telephone component of the All Wales Clinical Pathway for Normal Labour. J Adv Nurs [Internet]. 2012[cited 2015 Aug 18];68(10):2218-28. Available from: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2648.2011.05906.x/abstract
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Sender: Importance of clarity in the instructions given by the nurse.
•Receiver: Parturients satisfied with the Telenursing service said that they received clear and useful instructions.
•Message: Clear messages improve patient satisfaction.
•Conclusion of the study: Most of the parturients who reported being satisfied with the Telenursing service related the satisfaction to the telephonic contact, which provided them clear, useful, and confident instructions. On the other hand, women who did not have their expectations/troubles solved avoided using the service. |
P6(1818 Schmidt KL, Gentry A, Monin JK, Courtney KL. Demonstration of facial communication of emotion through telehospice videophone contact. Telemed J E Health [Internet]. 2011[cited 2015 Aug 18];17(5):399-401. Available from: http://online.liebertpub.com/doi/abs/10.1089/tmj.2010.0190
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Sender: Patients can recognize and respond to nonverbal signals, even with technology.
•Recipient: Patients can recognize and respond to nonverbal signals, even with technology.
•Message: The demonstration of feelings through nonverbal signals such as smile, can be perceived via videophone.
•Conclusion of the study: Nonverbal communication can be recognized via videophone. |
P7(66 Ernesäter A, Holmström IK, Engström M. Telenurses' experiences of working with computerized decision support: supporting, inhibiting and quality improving. J Adv Nurs [Internet]. 2009[cited 2015 Aug 18];65(5):1074-83. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19399984
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Sender: The patient must provide information about his condition safely and correctly.
•Recipient: 1 - Some patients do not hear the nurse because they want a doctor’s appointment. 2 - Decision support system helps the nurse to be heard by the patient.
•Message: 1 - Decision support system lacks important information about signs and symptoms. 2 - The patient must provide correct and relevant information about his condition. |
P7(66 Ernesäter A, Holmström IK, Engström M. Telenurses' experiences of working with computerized decision support: supporting, inhibiting and quality improving. J Adv Nurs [Internet]. 2009[cited 2015 Aug 18];65(5):1074-83. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19399984
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Conclusion of the study: The use of computerized systems may mecanize and undermine the communication between nurses and patients. |
P8(1919 Höglund AT, Holmström IK. 'It's easier to talk to a woman': aspects of gender in Swedish telenursing. J Clinic Nurs [Internet]. 2008[cited 2015 Aug 18];17:2979-86. Available from: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2702.2008.02345.x/abstract
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Sender: The father speaks on behalf of the sick wife or child and is unable to describe the symptoms.
•Recipient: 1 - The assertiveness of the father bothers the nurse, and the latter prefers to talk to the mother. 2 - The father does not know how to answer the questions of the nurse, which complicates the assessment.Message: The father verbally assaults the nurse and belittles her work.
•Conclusion of the study: Communication aspects were not included in the conclusion of the study. |
P9(2020 Pettinari CJ, Jessopp L. 'Your ears become your eyes': managing the absence of visibility in NHS Direct. J Adv Nurs [Internet]. 2001[cited 2015 Aug 18];36(5):668-75. Available from: http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2648.2001.02031.x/abstract
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Sender: 1 - The visual absence may be beneficial for patients who need anonymity due to embarrassing medical conditions. 2 - The use of “therapeutic silence” is very difficult to be done by telephone. 3 - The nurse monitors and modulates the voice quality to overcome the lack of visual references.
•Recipient: 1 - The patient may have difficulty in interpreting the silence. 2 - The nurse develops techniques to listen to the nonverbal signals of the patient to the detriment of the absence of visual references.
•Message: To select patients without visual references is the main challenge in the consultations by telephone. It may be more difficult to establish a relationship of trust due to the absence of visual contact.
•Conclusion of the study: The lack of visual references influences the evaluation of the nurse, it can also decrease the speed of clinical reasoning, limit or contraindicate interventions. Many nurses have developed abilities and communication skills to manage the absence of visual references. With the aid of a computer program, the nurses become more perceptive, improve their ability to hear, and listening becomes selective. |
P10(2121 Whitten P, Mair F, Collins B. Home telenursing in Kansas: patients' perceptions of uses and benefits. J Telemed Telecare [Internet]. 1997[cited 2015 Aug 18];3(suppl. 1):67-9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9218390
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Sender: The participants felt comfortable talking through technology and they did not find differences between talking to a nurse in person or by the telecommunication system.
•Recipient: Aspects of communication about the receiving of messages were not included.
•Message: 1 - Patients felt that nurses were “nice, sweet and gentle” when transmitting the information. 2 - The content of the conversations is restricted to the health of the patient.
•Conclusion of the study: The use of telehealth technology did not seem to have any negative effect on communication. The participants did not find differences between talking to a nurse in person or by the telecommunication system. |
