Employees’ views on home-based, after-hours telephone triage by Dutch GP cooperatives

Abstract

BackgroundDutch out-of-hours (OOH) centers find it difficult to attract sufficient triage staff. They regard home-based triage as an option that might attract employees. Specially trained nurses are supposed to conduct triage by telephone from home for after-hours medical care. The central aim of this research is to investigate the views of employees of OOH centers in The Netherlands on home-based telephone triage in after-hours care.MethodsThe study is a Q methodology study. Triage nurses, general practitioners (GPs) and managers of OOH centers ranked 36 opinion statements on home-based triage. We interviewed 10 participants to help develop and validate the statements for the Q sort, and 77 participants did the Q sort.ResultsWe identified four views on home-based telephone triage. Two generally favor home-based triage, one highlights some concerns and conditions, and one opposes it out of concern for quality. The four views perceive different sources of credibility for nurse triagists working from home.ConclusionHome-based telephone triage is a controversial issue among triage nurses, GPs and managers of OOH centers. By identifying consensus and dissension among GPs, triagists, managers and regulators, this study generates four perspectives on home-based triage. In addition, it reveals the conditions considered important for home-based triage.

The Adequacy of the Q Methodology for Clinical Validation of Nursing Diagnoses Related to Subjective Foci

“…An important characteristic of the Q methodology is that different people with different backgrounds can be surveyed using the same Q sample (Boffa & Pawola, ). This was identified in our research, where the same Q sample was applied to patients and nurses (Gardner et al., ; Ho & Gross, ) or teachers and students (Killam, Montgomery, Luhanga, Adamic, & Carter, ; Landeen et al., ) or between nurses and other professional groups (Backhaus, van Exel, & Bont, ; Valaitis, Akhtar‐Danesh, Eva, Levinson, & Wainman, ). The Q methodology can be applied to adults (Harvey, Good, Mason, & Reissland, ; Ho & Gross, ), teenagers (Jedeloo et al., ; Snethen, Broome, Bartels, & Warady, ), or children (Santos & Schor, ).…”

“…The construction of the Q sample is extremely important, the creation of a concourse-a collection of statements about the phenomenon of interest-is fundamental to the Q methodology (Mossey, Montgomery, Raymond, & Killam, 2012). The Q sample represents the discourse around the topic of study, which can be obtained for instance through focus groups or interviews, or from academic or gray literature (Backhaus et al, 2013).…”

“…In order to improve the content validity and accuracy, it is important to choose the Q sample origins (Cross, 2005;Montgomery, Killam, Mossey, & Heerschap, 2014). In some research, the Q sample was originated in openended questionnaires (Akhtar-Danesh, Dehghan, Morrison, & Fonseka, 2011;Jo, An, & Doorenbos, 2012); literature review (Backhaus et al, 2013;Harvey et al, 2013); focus groups (Baxter, Akhtar-Danesh, Valaitis, Stanyon, & Sproul, 2009;Ha, 2015a); semistructured interviews (Ho & Gross, 2015b;Pelletier, 2005); written narratives (Ha, 2015b;Yeun, Bang, Ryoo, & Ha, 2014); academic literature (Cross, 2005;Jo et al, 2012); observation (Marshall, West, & Aitken, 2011;McCaughan, Thompson, Cullum, Sheldon, & Thompson, 2002); and experts' opinions (Killam, Mossey, Montgomery, & Timmermans, 2013;Montgomery et al, 2014).…”

“…The Q methodology can be applied to different contexts and to all clinical environments in a variety of settings (Boffa & Pawola, 2006). Studies were performed in different contexts: public health (Akhtar-Danesh et al, 2013); primary health care (Harvey et al, 2013); hospital settings (Ho & Gross, 2015b); nursing education (Baxter et al, 2009); homes (Park, Yeoum, & Choi, 2005); or telemedicine (Backhaus et al, 2013).…”

“…From all of these researches emerge some important results: identification of consensus and disagreements (Backhaus et al, 2013); support the process of managing changes necessary to build and keep strong the upsetting interactions between primary care and public health (Akhtar-Danesh et al, 2013); identify the ideas and personality characteristics that a candidate must possess to be considered a potential super user (Boffa & Pawola, 2006); subjective viewpoints of nurses in rotating shift work (Ha, 2015b); facilitate the communication process between nurses and parents of extremely preterm infants (Gallagher, Marlow, Edgley, & Porock, 2012); understand the different subjectivities of adolescents living with a chronic condition regarding their treatment and health (Jedeloo et al, 2010); rethink ways to assess patients' hope in terms of pattern differences rather than in terms of quantity (Kim, Kim, Schwartz-Barcott, & Zucker, 2006); identify Korean elderly patients' attitudes to death and dying (Yeun, 2005); and know the views of students on the simulation improving your process (Baxter et al, 2009).…”