The Patient's First Point of Contact

NCT06067672 | Recruiting

• 1 other identifier: FO2023/171
• Study Type: observational
• Target: 150
• Locations: 1 country
• Sites: 1

Brief Summary

The overall objective of this observational study is to investigate practices of communication and decision-making during nurses' initial assessment of patients' health problems in primary care, examine working mechanisms in good practices and develop feasible solutions. The specific aims are:

1. 1.To investigate patients' expectations and experiences with the communication and decision-making during their first contact with a registered nurse (RN) in primary care.
2. 2.To investigate patient-RN communication on the level of patient involvement.
3. 3.To investigate RNs' actual communication, assessments and decision-making, value conflicts and the challenges and strategies they use in prioritizing.
4. 4.To analyse the underlying working mechanisms of good communication practices.
5. 5.To develop methodologies for facilitating efficient processes in assessing, managing, and prioritizing patients in primary care for RNs.

Conditions

Nurse-Patient Relations

Keywords

Communication; Decision-making; Nurse; Primary care

Outcome Measures

Primary Outcomes (2)

• Patient-reported expectations and experiences of the communication during consultations

  Data will be gathered with the following questionaries: QUOTE-COMM, QUality Of care Through the patients' Eyes, and The COOP/WONCA, measuring functional health status. The QUOTE-COMM is used to gather patient reported data on expectations and experiences of communication aspects during consultations. At baseline the importance of (expectations) of various communication aspects are rated, and after experiences from the consultation, to evaluate to what extent RNs met patients' expectation. The COOP/WONCA is used at baseline to measure health status.

  At baseline (day 1), after visit (day 1) and at 2-4 weeks

• Communication processes and patient involvement as observed during consultations

  Data will be gathered with audio recordings during real time consulltations. The observations with audio recordings will be coded with OPTION5, observing patient involvement in decision making, and the Verona Coding definition of emotional sequences, VR-CoDES. The OPTION5 scale is a reliable and valid instrument for investigating patient involvement in decision making. The Verona Coding Definitions on Emotional Sequences (VR-CoDES) is a reliable and valid instrument for coding of sequences of communication involving negative emotions, e.g., elicitations and expressions of patient cues and concerns, and RNs responses.

  Day 1.

Secondary Outcomes (1)

• Assessment and decision-making processes, and related priorities and value conflicts - from observations and RN experiences

  Through study completion, an average of 1 year

Interventions

Observations to investigate the current practices of communication and decision-making during Nurse-patient consultations OTHER

No intervention

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Audio-recorded observations from a purposive sample of 150 patient-nurse consultations, including 30 nurses and 150 patients will be recruited at primary care centres in three different geographic areas of the southwest of Sweden.

You may qualify if:

• Registered Nurses at primary care centres and patients seeking primary care for a new health concern or a new episode of a problem

You may not qualify if:

• Patients visiting the primary care nurse with a chronic or continuous health problem

Sponsors & Collaborators

• University of Boras: lead
• Mälardalen University: collaborator
• Netherlands Instititute for Health Services Research: collaborator
• Vastra Gotaland Region: collaborator

Study Sites (1)

University of Borås

Borås, 50190, Sweden

RECRUITING

Related Publications (2)

• Ostensson S, Acuna Mora M, Darcy L, Saarnio Huttu L, Van Dulmen S, Sundler AJ. Patient-Registered Nurse Communication: Exploring Patients' Expectations and Experience in Primary Care Consultations. Health Expect. 2025 Aug;28(4):e70353. doi: 10.1111/hex.70353.

  PMID: 40696861 DERIVED

• Sundler AJ, Heden L, Holmstrom IK, van Dulmen S, Bergman K, Ostensson S, Ostman M. The patient's first point of contact (PINPOINT) - protocol of a prospective multicenter study of communication and decision-making during patient assessments by primary care registered nurses. BMC Prim Care. 2023 Nov 29;24(1):249. doi: 10.1186/s12875-023-02208-0.

  PMID: 38031004 DERIVED

MeSH Terms

Conditions

Communication

Condition Hierarchy (Ancestors)

Behavior

Study Officials

• Annelie Sundler, Professor

  University of Borås

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Annelie Sundler, Professor

CONTACT

+4633 4354000; annelie.sundler@hb.se

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: September 25, 2023
• First Posted: October 5, 2023
• Study Start: August 15, 2023
• Primary Completion (Estimated): December 31, 2027
• Study Completion (Estimated): December 31, 2027
• Last Updated: October 5, 2023

Record last verified: 2023-10

Data Sharing

• IPD Sharing: Will not share

Locations

SE (1)