– I hope that my research will contribute to a greater focus on reassurance for the patients who receive self-care advice. In my last study, I found concrete findings, which could be helpful for clinically operative nurses, says Silje Gustafsson, who recently defended her thesis in Nursing at Luleå University of Technology.
Creating a sense of reassurance
According to the research results, reassurance is the factor that has the largest impact on patient satisfaction after counseling. This indicates that the care nurses provide to their patients is of great importance in order to ensure high quality self-care advice. In the nurse-client interaction, it was important that the nurse really listened. Due to the difficulties of explaining symptoms over the telephone, patients feared that the nurse had not understood.
– The patients described that if the nurse does not shows that she has understood my situation, I cannot trust that the advice and the assessment is right for me, says Silje Gustafsson.
Another important aspect was to have access to self-care advice, such as counselling through the Swedish Healthcare Direct (SHD) 1177, and to receive clear and action-oriented advice. To have something concrete to do to control symptoms was reassuring and decreased anxiety. Also being welcomed and being invited to recur was reassuring.
Other reassuring factors were previous experiences with minor illness, recognizing the symptoms and have knowledge of which drugs and measures were effective for symptom control.
A gendered practice
The results also showed that self-care was a gendered practice were women are primary caregivers in the family. They often hold a caring responsibility within the family and are frequent callers to the SHD 1177 to get health advice for themselves, their partners, children and parents.
– The women in the family, often a mother or an aunt, are important, especially for the younger ones, in providing reassurance around self-care. The men also described contacting the women in the family, says Silje Gustafsson.
However, there were no gender differences in satisfaction with telephone nursing or how often patients were referred to a doctor, and symptoms rather that gender influenced self-care decisions.
Research by four studies
The first two studies were carried out with 317 participants in Sweden via a questionnaire to find out how people go about when they have minor illnesses, and their perceptions of supportive and obstructive factors in the practice of self-care.
An evaluation of the service in 1177 Health Care Guide for healthcare were also made where patients' satisfaction with self-care advice were studied.
Finally, interviews were conducted to find out what people need to feel safe to practice self-care and the advice given.
The last two studies were carried out in collaboration with the Norrbotten County Council and the 1177 Health Care Guide.