Andreas Rantala1, Anna Ekwall2, Anna Forsberg3. 1. Department of Health Sciences, Lund University, P.O. Box 157, SE-221 00 Lund, Sweden. Electronic address: andreas.rantala@med.lu.se. 2. Department of Health Sciences, Lund University, P.O. Box 157, SE-221 00 Lund, Sweden. 3. Department of Health Sciences, Lund University, P.O. Box 157, SE-221 00 Lund, Sweden; Department of Transplantation and Cardiology, Skåne University Hospital, SE-221 85 Lund, Sweden.
Abstract
BACKGROUND: The levels of care in the Swedish healthcare system comprise self-care, primary care as well as accident and emergency care. The Swedish system of specialist ambulance nurses enables referral by prehospital triage. However, little is known about patients' experiences of not being triaged to the emergency department. AIM: To explore the subjective meaning of non-emergency ambulance care among patients who were triaged to levels of care below that of the Accident and Emergency Department. APPROACH/ METHODS: An inductive design inspired by phenomenological hermeneutics. Twelve patients were interviewed using an open-ended method. FINDINGS: Two structural analyses resulted in three themes covering the subjective meaning of being taken seriously or not being taken seriously. When taken seriously, the patient was empowered irrespective of the outcome of the medical assessment and triage process. When not taken seriously the patient doubted her/his own judgement and felt guilty and ashamed about bothering the ambulance service. CONCLUSION: N-EAC involves a strong need to be taken seriously and listened to when describing one's illness experience. When taken seriously, the patient feels as a competent person. Spending time with the patient is vital as well as listening to and inviting her/him to participate in the decision-making process. However not being taken seriously constitutes an infringement of personal autonomy.
BACKGROUND: The levels of care in the Swedish healthcare system comprise self-care, primary care as well as accident and emergency care. The Swedish system of specialist ambulance nurses enables referral by prehospital triage. However, little is known about patients' experiences of not being triaged to the emergency department. AIM: To explore the subjective meaning of non-emergency ambulance care among patients who were triaged to levels of care below that of the Accident and Emergency Department. APPROACH/ METHODS: An inductive design inspired by phenomenological hermeneutics. Twelve patients were interviewed using an open-ended method. FINDINGS: Two structural analyses resulted in three themes covering the subjective meaning of being taken seriously or not being taken seriously. When taken seriously, the patient was empowered irrespective of the outcome of the medical assessment and triage process. When not taken seriously the patient doubted her/his own judgement and felt guilty and ashamed about bothering the ambulance service. CONCLUSION: N-EAC involves a strong need to be taken seriously and listened to when describing one's illness experience. When taken seriously, the patient feels as a competent person. Spending time with the patient is vital as well as listening to and inviting her/him to participate in the decision-making process. However not being taken seriously constitutes an infringement of personal autonomy.
Authors: Elin-Sofie Forsgärde; Anders Svensson; Mattias Rööst; Bengt Fridlund; Carina Elmqvist Journal: Int J Qual Stud Health Well-being Date: 2021-12