title: Telephone nurses' communication and response to callers' concern--a mixed methods study.
abstract: OBJECTIVE
  The aim of this study was to describe telephone nurses' and callers' communication, investigate relationships within the dyad and explore telephone nurses' direct response to callers' expressions of concern
  
  
  BACKGROUND
  Telephone nurses assessing callers' need of care is a rapidly growing service. Callers with expectations regarding level of care are challenging.
  
  
  METHODS
  RIAS and content analysis was performed on a criterion sampling of calls (N=25) made by callers who received a recommendation from telephone nurses of a lower level of care than expected.
  
  
  RESULTS
  Telephone nurses mainly ask close-ended questions, while open-ended questions are sparsely used. Relationships between callers' expressions of Concern and telephone nurses responding with Disapproval were found. Telephone nurses mainly responded to concern with close-ended medical questions while exploration of callers' reason for concern was sparse.
  
  
  CONCLUSIONS
  Telephone nurses' reluctance to use open-ended questions and to follow up on callers' understanding might be a threat to concordance, and a potential threat to patient safety.
authors: University of Gavle, Faculty of Health and Occupational Studies, Gavle, Sweden; Uppsala University, Department of Public Health and Caring Sciences, Health Services Research, 751 05, Uppsala, Sweden. Electronic address: anaerr@hig.se.
authors: Annica
authors: A
authors: Ernesäter
authors: University of Gavle, Faculty of Health and Occupational Studies, Gavle, Sweden; Uppsala University, Department of Public Health and Caring Sciences, Health Services Research, 751 05, Uppsala, Sweden.
authors: Maria
authors: M
authors: Engström
authors: Uppsala University, Department of Public Health and Caring Sciences, Health Services Research, 751 05, Uppsala, Sweden.
authors: Ulrika
authors: U
authors: Winblad
authors: Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
authors: Mikael
authors: M
authors: Rahmqvist
authors: Uppsala University, Department of Public Health and Caring Sciences, Health Services Research, 751 05, Uppsala, Sweden; Mälardalen University School of Health, Care and Social Welfare, 721 23, Vasteras, Sweden.
authors: Inger K
authors: IK
authors: Holmström
mesh_terms: D003142:Communication; D024802:Nurse's Role; D009730:Nursing Assessment; D013548:Sweden; D013689:Telephone
keywords: Communication; RIAS; Sweden; Telephone advice nursing; Triage