BackgroundCaller satisfaction with telephone advice nursing (TAN) is generally high, and the interaction is essential. However, a valid questionnaire exploring caller satisfaction in TAN with focus on perceived interaction is lacking.ObjectiveTo develop and assess content validity and test‐retest reliability of a theoretically anchored questionnaire, the Telenursing Interaction and Satisfaction Questionnaire (TISQ), that explores caller satisfaction in TAN by focusing on perceived interaction between the caller and the telenurse.MethodsThe study was performed in three stages. First, variables relevant for patient satisfaction in health care were identified through a literature search. Variables were then structured according to the Interaction Model of Client Health Behavior (IMCHB), which provided theoretical guidance. Items relevant for a TAN context were developed through consensus discussions. Then, evaluation and refinement were performed through cognitive interviews with callers and expert ratings of the Content Validity Index (CVI). Finally, test‐retest reliability of items was evaluated in a sample of 109 individuals using intraclass correlation coefficients (ICC).ResultsThe TISQ consists of 60 items. Twenty items cover perceived interaction in terms of health information, affective support, decisional control and professional/technical competence. Five items cover satisfaction with interaction and five items overall satisfaction. Remaining items reflect singularity of the caller and descriptive items of the call. The TISQ was found to exhibit good content validity, and test‐retest reliability was moderate to good (ICC = 0.39‐0.84).ConclusionsThe items in the TISQ form a comprehensive and theoretically anchored questionnaire with satisfactory content validity and test‐retest reliability.

Aims and ObjectivesInteraction between caller and telenurse in telenursing is important for caller satisfaction and subsequent compliance. Despite this, satisfaction measures with focus on interaction in telenursing are scarce and rarely anchored in nursing theory. The aim was to evaluate the psychometric properties of the Telenursing Interaction and Satisfaction Scale (TISS) with focus on data quality, factor structure, convergent validity, and reliability.Methodological Design and JustificationThis psychometric study was based on cross‐sectional data.Research Methods, Instruments, and/or InterventionsCallers to the National Medical Advisory Service in Sweden (n = 616) completed the 60‐item Telenursing Interaction and Satisfaction Questionnaire based on Cox's Interaction Model of Client Health Behavior. Twenty‐five of these items were selected to form the TISS in four subscales according to the model. Data quality was evaluated in terms of missing data patterns and score distributions. The factor structure was evaluated with confirmatory factor analysis for ordinal data, convergent validity with Spearman correlations, internal consistency with ordinal alpha, scale reliability with composite reliability coefficients, and test–retest reliability with intraclass correlations.ResultsThe amount of missing data was acceptable and equally distributed. Data deviated significantly from a normal distribution. All response options were endorsed. The factor analysis confirmed the hypothesised four‐factor structure; factor loadings ranged from 0.56 to 0.97 and factor correlations were high (0.88–0.96). Internal consistency (ordinal alpha = 0.82–0.97), scale reliability (0.88–0.99), and test–retest reliability (ICC = 0.77–0.86) were satisfactory for all scales.Study LimitationsThe study design did not allow drop‐out analysis.ConclusionsThe TISS showed satisfactory psychometric properties in the study sample. It provides a measure that enables quantitative measurement of caller satisfaction with interaction in telenursing.

Aims and objectives:The aim of this study was to explore caller satisfaction with interaction, and the association to overall satisfaction with calls. Background:In the era of expanding healthcare at distance, the telephone remains a common tool for the provision of nursing care. Interaction between telenurse and caller in telenursing is vital for safety, satisfaction and adherence reasons. Few studies have quantitatively explored interaction in calls and how it relates to overall satisfaction with calls.Design: Cross-sectional survey study with a deductive approach.Methods: A total of 466 callers to the Swedish Medical Advisory Service completed the Telenursing Interaction and Satisfaction Questionnaire. Satisfaction with four theoretically defined components of interaction were compared using repeated measures ANOVA. Associations between satisfaction with interaction and overall satisfaction with calls were evaluated with ordinal logistic regression models with and without adjustment for age, sex, health status, waiting time, time for call, main result of the call and expectations. The study followed the STROBE checklist.Results: Callers were most satisfied with affective support, followed by professionaltechnical competence, health information and decisional control-in that order. A summated score of satisfaction with interaction was positively and significantly associated with overall satisfaction with calls before and after adjustment for waiting time, main result of call and variables related to the individual caller.Conclusions: Caller satisfaction with interaction is generally high but can be improved, especially regarding decisional control. Satisfaction with interaction is important for overall satisfaction with calls.

Background:The provision of nursing over the telephone is an appreciated asset in many parts of the world. Interaction between telenurse and caller is important for caller satisfaction, and satisfaction in turn is positively related to outcomes such as adherence, engagement in self-care and well-being. Despite the long history of telehealth services, research about interaction in telenursing is still in a developmental stage. Aim:The overall aim of the thesis was to develop a questionnaire that enables valid and reliable exploration of telenurse-caller interaction, and caller satisfaction with calls, and to explore interaction and its importance for caller satisfaction.In addition, data was coded and analysed in relation to phases in the conversation process for telenursing: opening, listening, analysing, motivating, and ending. Results:The 60 item TISQ, including the TISS, showed good content validity in the telenursing setting with a Scale-CVI of 0.91 (I). Test-retest reliability of single items was moderate to good (I). TISS-data deviated significantly from a normal distribution, but all response options were endorsed (II). The confirmatory factor analysis confirmed the four-factor structure of the TISS, and factor correlations were high (rs = 0.88 to 0.96) (II). A higher order model showed marginally deteriorated model fit values (II). Ordinal alpha, scale reliability, and test-retest reliability were satisfactory for all scales, and convergent validity was satisfactory (II).Callers expressed the highest level of satisfaction with affective support, while their satisfaction with decisional control was comparatively lower (III). Callers' satisfaction with interaction was positively associated with overall satisfaction with calls, even when considering experienced waiting time, main result of the call, fulfilment of expectations, age, gender, selfrated health status and time of call (III). A total of 97% of manifest words in conversations were identified as nursing interaction based on the IM-CHB (IV). Health information was the primary focus, particularly during the listening and analysing phases (IV). Affective support was the least prominent component, and callers' reactions to advice were seldom discussed (IV). The opening phase was the shortest, and analysing phase the most word consuming (IV). Conclusions:The TISQ, including the TISS, provide a valid and reliable questionnaire for the study of telenurse-caller interaction, and caller satisfaction with calls. Caller satisfaction with the interaction can be measured using the four subscales in the TISS. In cases where there is a problem with multicollinearity, a total scale score from the TISS can be utilized. All four components of interaction in the IMCHB play a crucial role in determining overall caller satisfaction with calls. Therefore, the development of interaction in telenursing need to consider all four components. The exchange of health information presents challenges for both telenurses and callers, and affective support can be provided to caller...

Background: In telenursing, interaction between caller and telenurse is crucial for outcomes such as adherence, safety and satisfaction. There is a recurring demand for improved interaction in telenursing and a lack of measurement scales focusing on caller satisfaction with interaction. The purpose of this study was to develop and evaluate psychometric properties of the Telenursing Interaction and Satisfaction Scale (TISS).Methods: This instrumental development stud was based on cross-sectional data. Callers to the National Medical Advisory Service in Sweden (n=616) completed a 60-item questionnaire, the Telenursing Interaction and Satisfaction Questionnaire (TISQ). Twenty-five of these items were selected to form the TISS. Selected items represent four dimensions of interaction according to the Interaction Model of Client Health Behavior; health information, professional-technical competence, affective support and decisional control. Data quality was evaluated in terms of missing data patterns and score distributions. Factor structure of the scale was evaluated with confirmatory factor analysis, convergent validity with Spearman correlations, internal consistency with ordinal alpha, scale reliability with composite reliability coefficients, and test-retest reliability with intraclass correlations. Results: The amount of missing data was acceptable and equally distributed. The completeness of data was the highest for the subscale of professional-technical competencies (94%) and the lowest for the TISS total scale (80%). Data deviated significantly from a normal distribution, but all response options were endorsed. The CFA confirmed the hypothesized four-factor structure. Factor loadings ranged from 0.56 to 0.97, and factor correlations were high (0.88-0.96). Internal consistency (ordinal alpha = 0.82-0.97), scale reliability (0.88-0.99) and test-retest reliability (ICC = 0.77-0.86) were satisfactory for all scales.Conclusion: The TISS holds satisfactory psychometric properties in the study sample. Findings support the use of four sub-scales for measuring caller satisfaction with interaction in telenursing. A total-score can be calculated and used in situations where multi-collinearity is a problem.