Registered nurses’ experiences of communication with patients when practising person–centred care over the phone: a qualitative interview study

Abstract

Background: To explore registered nurses' (RNs') experiences of practising person-centred care (PCC) by telephone with people diagnosed with chronic obstructive pulmonary disease and/or chronic heart failure. Methods: Qualitative interview study. Four RNs were individually interviewed before, during, and after participating in an intervention practising PCC by telephone. The interviews were analysed using qualitative content analysis. Results: The results reflect three categories of their experience: realize the complexity of practising PCC by distance, gain insight into what PCC communication meant to RNs and their approach, and develop the professional role by practising PCC theory and ethics. Conclusions: PCC over the telephone facilitate healthcare and support patients. Through careful listening, the RNs (1) created space for the individual patients to express their thoughts and feelings and (2) emphasized each patient's capabilities and resources. The RNs also gained an understanding of PCC and what it means to patients and to themselves as practitioners. Potential implications are that it is important for RNs practising PCC by telephone to remould their role, to listen carefully, and to communicate as equals in conversations that respect both parties' knowledge and expertise. Health professionals need supervision and support to fully understand the person-centred approach and provide communications that support it.

The interactive work of narrative elicitation in person‐centred care: Analysis of phone conversations between health care professionals and patients with common mental disorders

“…HCPs practising PCC via phone described how listening attentively to a patient meant not only reflecting on the wording of what they expressed but also paying attention to their tone of voice and expressions of mood, and allowing silences to occur. 19 Finally, regarding the other two patterns of patient-driven narrative sequences and co-constructive narrative sequences, we reflect on the former as a rather classical illness account owned by the patient in terms of both content and moral, a story narrated by the patient with the HCP giving listener support. The coconstructed narrative sequences display a collaborative stance towards understanding the expressions of illness and their meaning in the patient's life.…”

“…However, lacking visual cues can increase the significance of the voice as a medium. HCPs practising PCC via phone described how listening attentively to a patient meant not only reflecting on the wording of what they expressed but also paying attention to their tone of voice and expressions of mood, and allowing silences to occur 19 …”

“…Previous studies on narrative elicitation in PCC have highlighted it as a complex interactive process requiring communicative skills, sensitivity and openness to an array of potential stories 17,18 . Health care professionals (HCPs) have described different communicative strategies they employ to encourage patients to narrate their experiences, for example, sitting down, having a calm demeanour, listening attentively and asking open‐ended and follow‐up questions 16,17,19,20 . However, incorporating aspects outside the medical realm into the health care encounter can put both patients and HCPs in a position of unease and uncertainty as to what is expected of them as narrators and listeners to lifeworld concerns 18,21 .…”

“…tions directed both at the factual circumstances at work (Lines 1-2, 24,[26][27] and at the patient's understanding of what happened (Lines[18][19]29). Here the HCP does not use open-ended questions, which are traditionally seen as the ideal practice for encouraging narrating 29.…”

General Medicine in the Time of Coronavirus Disease 2019 (Covid-19) and Beyond: Is it Falling Apart, Changing or Reinforcing? The Theory of the Braid Group

“…Telemedicine is an opportunity for the doctor to be more of a person and less of a hierarchical superior of the patient; it is a opportunity to make general practice on a human scale [46]. On the other hand, it is evident that in the telecare setting, the clinical interview will emphasize more the aspects of attentive listening (by phone, for example): Listening carefully and communicating as equals in conversations that respect the knowledge and experience of both parties [47,48].…”