'Carer and gatekeeper' -: conflicting demands in nurses' experiences of telephone advisory services
'Carer and gatekeeper' -: conflicting demands in nurses' experiences of telephone advisory services
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DOI：
10.1046/j.1471-6712.2002.00075.x
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发表时间：
2002-06-01
影响因子：
1.9
通讯作者：
Dall'Alba, G
中科院分区：
文献类型：
--
作者：
Holmström, I;Dall'Alba, G
在瑞典，数百万人致电初级卫生保健的电话咨询服务。患者似乎对他们得到的建议和咨询很满意，但很少有关于护士提供电话咨询服务的经验的文章。然而，护士应该是有耐心的，敏感的，并拥有广泛的医学、护理和教育学知识。这项研究的目的是描述护士在提供电话咨询服务时如何体验患者遇到的情况。一个由五名护士组成的战略性样本接受了采访，并被要求描述他们如何通过电话体验患者遭遇的中心方面。访谈记录采用经验现象学心理学方法进行分析。护士在提供电话咨询服务时遇到病人的经历可以表现为既是照顾者又是看门人的相互冲突的要求。这些相互冲突的要求包括：在时间紧迫的情况下阅读字里行间的内容；在害怕误解情况的情况下教育患者自我护理；遇到患者的满意和不满意。既是职业护理员又是看门人的矛盾要求给护士们带来了压力。电话咨询服务的组织似乎阻碍了高质量的护理。
Millions of calls are made to the telephone advisory services in primary health care in Sweden. The patients seem happy with the advice and counselling they receive, but little has been written about nurses' experiences of performing telephone advisory services. Yet, the nurses are expected to be patient, sensitive and have a broad knowledge of medicine, nursing and pedagogy. The aim of this study was to describe how nurses experience the patient encounter when performing telephone advisory services. A strategic sample of five nurses were interviewed and asked to describe how they experienced the central aspects of the patient encounter by telephone. The transcribed interviews were analysed by the Empirical Phenomenological Psychological method. The nurses' experience of the patient encounter when performing telephone advisory services can be characterized in terms of the conflicting demands of being both carer and gatekeeper. The constituents of these conflicting demands were: reading between the lines while pressed for time; educating patients for self-care while fearful of misinterpreting the situation; encountering patients' satisfaction and dissatisfaction. The conflicting demands of being both professional carer and gatekeeper caused stress among the nurses. The organization of the telephone advisory services seems to hinder high-quality care.