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Ryan S, Hider S, Tavernor J, Hassell A. A national survey of rheumatology telephone advice line support in the United Kingdom: frontline perspectives. Rheumatol Adv Pract 2024; 8:rkae084. [PMID: 39055540 PMCID: PMC11272169 DOI: 10.1093/rap/rkae084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 06/27/2024] [Indexed: 07/27/2024] Open
Abstract
Objectives Telephone advice lines are a key component of rheumatology services. A national survey of telephone advice line providers was undertaken to explore how this service is currently delivered and the impact on those delivering it to inform providers, policymakers and patients. Methods We conducted an online survey between March and September 2023 collecting data on demographics, how advice lines function, governance and the impact on nurses' well-being. Data were analysed using descriptive statistics. Results A total of 123 health professionals completed the survey. The majority were rheumatology nurses [n = 118 (96%)], >45 years of age [n = 112 (91%)], band ≥7 [n = 92 (76%)], with 77 (65%) reporting >10 years of experience within rheumatology. Most advice lines operated weekdays only [n = 93 (79%)], with most calls returned within 2 days [n = 81 (66%)], although some callers waited >7 days [n = 19 (15%)]. The number of calls received monthly ranged from 100 to >800, with 46 (37%) responders reporting >500 calls/month. The most common reasons for contacting advice lines were disease activity, pain and medication concerns. For most responders, governance arrangements were unclear [n = 72 (61%)]. Providing advice lines impacted on the well-being of nurses providing the service: 89 (72%) felt anxious 'sometimes to mostly' and 79 (64%) found it 'mostly-always' stressful. A total of 85 (69%) nurses had not received any training to manage advice lines. Conclusion Although telephone advice lines are provided by experienced rheumatology nurses, high demand is impacting on well-being. Having designated training could equip nurses with additional skills to manage increased capacity and monitor their own well-being.
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Affiliation(s)
- Sarah Ryan
- Haywood Academic Rheumatology Centre, Midlands Partnership University NHS Foundation Trust, Haywood Hospital, Stoke on Trent, UK
- Department of Research and Innovation, Midlands Partnership University NHS Foundation Trust, St George’s Hospital, Stafford, UK
| | - Samantha Hider
- Haywood Academic Rheumatology Centre, Midlands Partnership University NHS Foundation Trust, Haywood Hospital, Stoke on Trent, UK
- Faculty of Medicine and Health Sciences, School of Medicine, Keele University, Staffordshire, UK
| | - Jay Tavernor
- Department of Research and Innovation, Midlands Partnership University NHS Foundation Trust, St George’s Hospital, Stafford, UK
| | - Andrew Hassell
- Haywood Academic Rheumatology Centre, Midlands Partnership University NHS Foundation Trust, Haywood Hospital, Stoke on Trent, UK
- Faculty of Medicine and Health Sciences, School of Medicine, Keele University, Staffordshire, UK
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Gustafsson SR, Wahlberg AC. The telephone nursing dialogue process: an integrative review. BMC Nurs 2023; 22:345. [PMID: 37770869 PMCID: PMC10537534 DOI: 10.1186/s12912-023-01509-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 09/13/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Telephone nursing involves triage, advice, and care management provided by a nurse over the telephone. The telephone nursing dialogue process has been used clinically in telephone nursing in Sweden for several years to structure the communication and ensure a safe assessment and advice. Studies are needed to determine whether there is sufficient scientific evidence to support the method. AIM To describe the scientific basis of the phases of the telephone nursing dialogue process. DESIGN This was an integrative review. METHODS The literature searches were performed in August 2023, in the PubMed, CINAHL, Cochrane Database of Systematic Reviews and SwePUB databases. Sixty-two articles were included. Data was sorted deductively according to the five phases of the telephone nursing dialogue process and categorized inductively to form subcategories describing the content of each phase. RESULT All five phases in the telephone nursing dialogue process were supported by a range of articles (n = 32-50): Opening (n = 32), Listening (n = 45), Analysing (n = 50), Motivating (n = 48), and Ending (n = 35). During the opening of the call, the nurse presents herself, welcomes the caller and establishes a caring relationship. In the listening phase, the nurse invites the caller to tell their story, listens actively and confirms understanding. During the analyzing phase, the nurse gathers, assesses, and verifies information. In the motivating phase, the nurse reaches a final assessment, informs the caller, gives advice and creates a mutual agreement and understanding while supporting the caller. Ultimately, the nurse ends the call after checking for mutual agreement and understanding, giving safety-net advice, deciding on whether to keep monitoring the caller and rounding off the call. CONCLUSION The phases of the telephone nursing dialogue process as described in the scientific literature are well aligned with the theoretical descriptions of the telephone nursing dialogue process.
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Affiliation(s)
- Silje Rysst Gustafsson
- Division of nursing and medical technology, Department of Health, Learning and Technology, Luleå University of Technology, Luleå, SE-971 87, Sweden.
| | - Anna Carin Wahlberg
- Division of Nursing, Department of Neurobiology, Care sciences and Society, Karolinska Institutet, Stockholm, SE- 171 77, Sweden
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Carroll Á, Collins C, McKenzie J, Stokes D, Darley A. Application of complexity theory in health and social care research: a scoping review. BMJ Open 2023; 13:e069180. [PMID: 36921939 PMCID: PMC10030763 DOI: 10.1136/bmjopen-2022-069180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
BACKGROUND Complexity theory has been chosen by many authors as a suitable lens through which to examine health and social care. Despite its potential value, many empirical investigations apply the theory in a tokenistic manner without engaging with its underlying concepts and underpinnings. OBJECTIVES The aim of this scoping review is to synthesise the literature on empirical studies that have centred on the application of complexity theory to understand health and social care provision. METHODS This scoping review considered primary research using complexity theory-informed approaches, published in English between 2012 and 2021. Cochrane Database of Systematic Reviews, MEDLINE, CINAHL, EMBASE, Web of Science, PSYCHINFO, the NHS Economic Evaluation Database, and the Health Economic Evaluations Database were searched. In addition, a manual search of the reference lists of relevant articles was conducted. Data extraction was conducted using Covidence software and a data extraction form was created to produce a descriptive summary of the results, addressing the objectives and research question. The review used the revised Arksey and O'Malley framework and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Reviews (PRISMA-ScR). RESULTS 2021 studies were initially identified with a total of 61 articles included for extraction. Complexity theory in health and social care research is poorly defined and described and was most commonly applied as a theoretical and analytical framework. The full breadth of the health and social care continuum was not represented in the identified articles, with the majority being healthcare focused. DISCUSSION Complexity theory is being increasingly embraced in health and care research. The heterogeneity of the literature regarding the application of complexity theory made synthesis challenging. However, this scoping review has synthesised the most recent evidence and contributes to translational systems research by providing guidance for future studies. CONCLUSION The study of complex health and care systems necessitates methods of interpreting dynamic prcesses which requires qualitative and longitudinal studies with abductive reasoning. The authors provide guidance on conducting complexity-informed primary research that seeks to promote rigor and transparency in the area. REGISTRATION The scoping review protocol was registered at Open Science Framework, and the review protocol was published at BMJ Open (https://bit.ly/3Ex1Inu).
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Affiliation(s)
- Áine Carroll
- School of Medicine, University College Dublin, Dublin, Ireland
- Academic Department, National Rehabilitation University Hospital, Dublin, Ireland
| | - Claire Collins
- Henley Business School, University of Reading, Reading, UK
| | - Jane McKenzie
- Henley Business School, University of Reading, Reading, UK
| | - Diarmuid Stokes
- College of Health Sciences, University College Dublin, Dublin, Ireland
| | - Andrew Darley
- School of Medicine, University College Dublin, Dublin, Ireland
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Skogevall S, Kaminsky E, Håkansson J, Holmström I. One for all or all for one? An integrative review of research on frequent callers. PEC INNOVATION 2022; 1:100070. [PMID: 37213782 PMCID: PMC10194234 DOI: 10.1016/j.pecinn.2022.100070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 07/22/2022] [Accepted: 08/01/2022] [Indexed: 05/23/2023]
Abstract
Objective Telephone health services is an increasing and integral part of health care in several countries. Callers who call repeatedly, in the current study "frequent callers" are present in all kinds of healthcare services, often constitute a considerable proportion of the total amount of calls and are complicated to help. The aim was to provide a comprehensive overview of research on frequent callers at a variety of telephone health services. Methods An integrative literature review. Literature was searched for the period 2011-2020 in CINAHL Plus, MEDLINE, APA PsycArticles, APA PsycInfo, and PubMed, and resulted in the inclusion of 20 articles. Results Studies on frequent callers (FCs) were found in the context of emergency medical services, telephone helplines, primary healthcare, and specialist medicine clinics. Frequent calling was associated with psychiatric comorbidity, and the reasons for calling were often multifaceted. Conclusion The strategies suggested for handling calls involved an individual approach, which could be enabled through multidisciplinary work. Innovation The main findings indicate a need for a systematic approach and guidelines to enable optimal help for FCs. Cooperation among healthcare instances seems to contribute to a more individual care for FCs.
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Affiliation(s)
- S. Skogevall
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
- Corresponding author at: School of Health, Care and Social Welfare, Mälardalen University, Postbox 883, SE-72123 Västerås, Sverige.
| | - E. Kaminsky
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - J. Håkansson
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - I.K. Holmström
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Hultsjö S, Ovox SM, Olofsson C, Bazzi M, Wärdig R. Forced to move on: An interview study with survivors who have lost a relative to suicide. Perspect Psychiatr Care 2022; 58:2215-2223. [PMID: 35148431 PMCID: PMC9790501 DOI: 10.1111/ppc.13049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 01/24/2022] [Accepted: 01/29/2022] [Indexed: 12/30/2022] Open
Abstract
PURPOSE To explore the loss of a relative due to suicide. DESIGN AND METHODS Ten survivors of relatives who had taken their lives were interviewed. Data was analyzed from a phenomenological perspective. FINDINGS The survivors described how they witnessed the darkness that took over their relative's lifeworld. During the time before and after the suicide, the survivor felt barred from having a role in the relative's care. PRACTICE IMPLICATIONS Understanding and exploring implicit dynamics, such as "a feeling of darkness taking over," "a sense of relief," or "putting on a mask" could be important for developing person-centered suicide care.
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Affiliation(s)
- Sally Hultsjö
- Department of Psychiatry, Ryhov County Hospital, Jönköping, Sweden.,Division of Nursing and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Säidi M Ovox
- Department of Psychiatrics, Motala Hospital, Motala, Sweden
| | - Caroline Olofsson
- Department of Psychiatry, Ryhov County Hospital, Jönköping, Sweden.,Division of Nursing and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Mohammad Bazzi
- Department of Psychiatry, Ryhov County Hospital, Jönköping, Sweden.,Division of Nursing and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Rikard Wärdig
- Division of Nursing and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Skogevall S, Holmström IK, Kaminsky E, Håkansson Eklund J. Telephone nurses' perceived stress, self-efficacy and empathy in their work with frequent callers. Nurs Open 2021; 9:1394-1401. [PMID: 34528768 PMCID: PMC8859069 DOI: 10.1002/nop2.889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 02/13/2021] [Accepted: 02/19/2021] [Indexed: 11/19/2022] Open
Abstract
Aim To examine telephone nurses' perceived stress, self‐efficacy and empathy in their work with answering calls from frequent callers. Design The study is a quantitative questionnaire survey study with a comparative design. Methods Telephone nurses (N = 199) answered a survey containing three instruments: Perceived Stress Scale, General Self‐Efficacy Scale and Jefferson's Scale of Empathy. Correlation analysis, multiple regression analysis and analysis of variance were performed to test the research questions. Results Significant negative correlations were found between stress involving calls from FCs and self‐efficacy (r = −.238), and significant negative correlations between stress involving calls from frequent callers and empathy (r = −.185). It was further revealed that telephone nurses who had worked less than 30 years scored higher on Jefferson's Scale of empathy than those who had worked more than 30 years, F(1, 183) = 4.98, η2 = 0.027.
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Affiliation(s)
- Sofia Skogevall
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Inger K Holmström
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Elenor Kaminsky
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Olsson A, Thunborg C, Björkman A, Blom A, Sjöberg F, Salzmann-Erikson M. A scoping review of complexity science in nursing. J Adv Nurs 2020. [PMID: 32281684 DOI: 10.1111/jan.14382] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 03/03/2020] [Accepted: 03/25/2020] [Indexed: 11/26/2022]
Abstract
AIM To describe how complexity science has been integrated into nursing. DESIGN A scoping review. DATA SOURCE/REVIEW METHOD Academic Search Elite, Scopus, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, PubMed and Web of Science were searched November 2016, updated in October 2017 and January 2020. The working process included: problem identification, literature search, data evaluation, synthesizing and presentation. RESULTS Four categories were found in the included 89 articles: (a) how complexity science is integrated into the nursing literature in relation to nursing education and teaching; (b) patients' symptoms, illness outcome and safety as characteristics of complexity science in nursing; (c) that leaders and managers should see organizations as complex and adaptive systems, rather than as linear machines; and (d) the need for a novel approach to studying complex phenomena such as healthcare organizations. Lastly, the literature explains how complexity science has been incorporated into the discourse in nursing and its development. CONCLUSION The review provided strong support for use in complexity science in the contemporary nursing literature. Complexity science is also highly applicable and relevant to clinical nursing practice and nursing management from an organizational perspective. The application of complexity science as a tool in the analysis of complex nursing systems could improve our understanding of effective interactions among patients, families, physicians and hospital and skilled nursing facility staff as well as of education. IMPACT Understanding complexity science in relation to the key role of nurses in the healthcare environment can improve nursing work and nursing theory development. The use of complexity science provides nurses with a language that liberates them from the reductionist view on nursing education, practice and management.
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Affiliation(s)
- Annakarin Olsson
- Faculty of Health and Occupational Studies, Department of Caring Science, University of Gävle, Gävle, Sweden
| | - Charlotta Thunborg
- Department of Neurobiology, Care Sciences and Society, Division of Clinical geriatrics, Karolinska Institutet, Stockholm, Sweden.,School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Annica Björkman
- Faculty of Health and Occupational Studies, Department of Caring Science, University of Gävle, Gävle, Sweden.,Health Services Research, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Anneli Blom
- Centre for Clinical Research, Västmanland County Hospital, Västerås, Sweden
| | - Fredric Sjöberg
- Unit of Anaesthesiology and Intensive Care, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Martin Salzmann-Erikson
- Faculty of Health and Occupational Studies, Department of Caring Science, University of Gävle, Gävle, Sweden
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