The bidirectional mistrust

Abstract

Purpose The purpose of this paper is to explore and describe online communication about the experiences and attitudes toward Swedish Healthcare Direct, a national telephone advice nursing (TAN) service. Design/methodology/approach A descriptive research design was adopted using a six-step netnographic method. Three Swedish forums were purposefully selected and data from the virtual discussions were collected. Findings Three themes emerged: expectancy and performativity of the nurses, absurdity in accessibility and the scrutinizing game. The most prominent finding was the scrutinizing game, which included aspects of bidirectional mistrust from both nurses and callers. Another salient finding was the attitudes that callers held toward nurses who used a technique interpreted as “passing the buck.” Research limitations/implications The use of a nethnographic method is novel in this area of research. Consequently, the body of knowledge has regarding telephone advise nursing service has significantly been broadened. A limitation in this study is that demographic data for the posters are not available. Practical implications Bidirectional distrust is an important issue that must be acknowledged by TAN services, since it might damage the service on a fundamental level. Healthcare providers, politicians, and researchers should account for the power and availability of virtual discussions when seeking consumers’ opinions and evaluating the quality of the care provided. Originality/value This analysis of the ongoing discussions that take place on the internet provides insight into callers’ perceptions of a national TAN service. The bidirectional mistrust found from both the nurses and the callers might be a threat to callers’ compliance with the advice given and their care-seeking behavior.

A Mapping Review of Netnography in Nursing

“…Of the total number of articles, 26.4% ( n = 14) reported that their study had been reviewed by an ethics board (Alang & Fomotar, 2015; Andréasson et al, 2018; Aragão et al, 2018; Boursier et al, 2022; Cano-Hila & Argemí-Baldich, 2021; Ellinghaus et al, 2021; Gün & Şenol, 2019; Kendal et al, 2017; Lawless et al, 2020, 2022; Moura & Aschemann-Witzel, 2021; Schuman et al, 2019; Vale et al, 2019; Wallace et al, 2018), while 56.6% ( n = 30) reported that their study had not been reviewed (Ari & Mari, 2021; Baptista et al, 2021; Bayen et al, 2021; Bîră et al, 2020; Björkman & Salzmann-Erikson, 2018; Botelle & Willott, 2020; Cuomo et al, 2020; Eriksson et al, 2014; Eriksson & Salzmann-Erikson, 2013, 2016b, 2018; Gatrell, 2019; Holmgren et al, 2018; Johansson & Andreasson, 2017; Keeling et al, 2015; Liang & Scammon, 2011; Manning Hutson et al, 2022; Nemec et al, 2018; Nimrod, 2011; Numer et al, 2022; Poppi, 2021; Salzmann-Erikson, 2016, 2017; Salzmann-Erikson & Eriksson, 2011; Saxena et al, 2021; Song, 2020; Strand, 2022, p. 202; Strand & Gustafsson, 2020; Thunborg & Salzmann-Erikson, 2017; Van Hout & Hearne, 2014); four articles reported that they had applied to an ethics review board (ERB) but had been deemed exempt because their work was not considered human subjects research (De Gagne et al, 2021; Giles et al, 2015; …”

Netnography: A novel methodology for nursing research

“…Additionally, a study by Björkman and Salzmann-Erikson (2018) explored and described the online communication of parents using a telephone advice nursing service in Sweden. The authors of this article combined netnographic methodology with thematic analysis of discussion threads located on open-access online forums (Björkman & Salzmann-Erikson, 2018).…”

“…Over the last decade, nursing knowledge has grown exponentially, and nurse researchers have expanded their repertoire of research skills. However, we were only able to locate one recent nurse-led study that adopted netnography as methodology (Björkman & Salzmann-Erikson, 2018). This paper aims to advance nursing knowledge through the discussion of an underutilized research methodology.…”

Telephone nurses' strategies for managing difficult calls: A qualitative content analysis

“…The use of computer decision support systems (CDSS) can simplify telenurses' work by assuring them that they have asked relevant questions (Holmström, 2007) to complement their knowledge and provide security as well as enhance their assessment (Ernesater, Holmstrom, & Engstrom, 2009) and their credibility (Björkman & Salzmann-Erikson, 2018). The model of the process in telenursing and the Swedish CDSS contains approximately 180 medically quality assured decision bases, structured on symptoms based on five degrees of emergency.…”

“…Another risk is where telenurses have not been sufficiently educated in using CDSS; for example, Holmström, Gustafsson, Wesström, and Skoglund (2019) report that underuse and deviation from the CDSS means that the telenurses collected less information for making well-informed decisions, which might point to patient safety risks. Recent research shows that the domination of biomedical orientation in the CDSS downplays vital aspects of the human condition seen from a broader perspective (Björkman & Salzmann-Erikson, 2018). Because symptoms cannot be linked together, CDSS cannot always allow telenurses to capture a holistic view of callers' problems (Holmström et al, 2019).…”