Who should I call?
October 17 2017
Susan Waterworth writes about her new publication in the Journal of Advanced Nursing.
We had the idea that telephone consultations between older adults and primary health care nurses were underutilised and might potentially be a service that could be developed further. We believed the service could reduce some of the access issues that older patients had experienced in obtaining health support and advice. Indeed, our systematic review had identified a gap in the literature on how older adults viewed telephone communication in primary health care and informed our subsequent research study which had the following aims:
1) To determine which aspects of primary nurse-patient telephone communication are viewed positively or negatively in terms of meeting an older person’s needs.
2) To explore how older people see the scope for primary nurse-patient telephone communication to be developed further.
However, despite the focus of our research inquiry being about nurse-patient telephone communication, our key finding identified the difficulties older people face in making any sort of decisions about whether to contact a health professional. For example, they raised concerns about nurse workloads and waiting times for call back telephone calls. This difficulty in decision-making also related to the mode of communication – by telephone or not? As well as the appropriate professional to contact – the Primary nurse or the GP? Accounting for some symptoms as age-related added to the uncertainty of decision making, as did concerns about what was a legitimate reason to make contact. Importantly some older people were not raising concerns, particularly those relating to their emotional state.
Our findings strongly support the need to design and develop primary health care services with older people, so that we can better understand their perspectives and assumptions. For example, the need for nurses in primary health care to increase their capability to meet the needs of a growing older population has been called for – indeed, they are viewed as key to improving services. However, many of our older participants did not see the real benefits of consulting a primary nurse in the GP practice. Therefore, there is a need for nurses working in primary health care to better explain their role and support older patients to consult them in a timely manner. In addition, practices need to make it clear that emotional concerns are a legitimate issue to discuss with any health professional.
For more information about this study, and for a full text copy of the paper, please contact Susan: s.waterworth@auckland.ac.nz