title: Influence of self-care advice on patient satisfaction and healthcare utilization.
abstract: OBJECTIVE
  The aim of this study is to explore the influence of nurse-led self-care advice on healthcare utilization and patients' satisfaction with telephone nursing.
  
  
  BACKGROUND
  Many consultations in high-cost settings are for conditions that are manageable through self-care and callers with greater satisfaction with the nurse interaction are nearly four times more likely to engage in self-care.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Questionnaires were sent out to 500 randomly selected callers to the Swedish Healthcare Direct in Northern Sweden during March 2014. Callers were asked about their satisfaction with the consultation, their intended actions prior to consultation, the recommendation given by the nurse and the action undertaken after the call.
  
  
  RESULTS
  Young callers and persons recommended watchful waiting or recurrence if no improvements were significantly less satisfied with their care. When calling on their own behalf, both men and women rated the severity of their symptoms equally and were advised to self-care to the same extent. Self-care advice had a constricting influence on self-reported healthcare utilization, with 66·1% of cases resulting in a lower level of care than first intended. Feeling reassured after the call was the aspect of nursing care that influenced satisfaction the most.
  
  
  CONCLUSIONS
  Receiving self-care advice rather than referral to a general practitioner influences patient satisfaction negatively. Feeling reassured after consultation is strongly related to satisfaction, which in turn has been found to increase the likelihood of engaging in self-care behaviour.
authors.affiliation: Division of Nursing, Department of Health Science, Luleå University of Technology, Sweden.
authors.forename: Silje
authors.initials: S
authors.lastname: Gustafsson
authors.affiliation: Department of Engineering Sciences and Mathematics, Luleå University of Technology, Sweden.
authors.forename: Jesper
authors.initials: J
authors.lastname: Martinsson
authors.affiliation: Division of Nursing, Department of Health Science, Luleå University of Technology, Sweden.
authors.forename: Britt-Marie
authors.initials: BM
authors.lastname: Wälivaara
authors.affiliation: Division of Health and Rehab, Department of Health Science, Luleå University of Technology, Sweden.
authors.forename: Irene
authors.initials: I
authors.lastname: Vikman
authors.affiliation: Division of Nursing, Department of Health Science, Luleå University of Technology, Sweden.
authors.forename: Stefan
authors.initials: S
authors.lastname: Sävenstedt
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D012648:Self Care; D013548:Sweden; D055815:Young Adult
keywords: advice; healthcare utilization; minor illness; primary care; satisfaction; self-care; telephone nursing