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Clinical Reasoning and Decision-Making in Patient-RN Consultations in Primary Care
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.ORCID iD: 0000-0002-0530-9408
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. (Tillämpad vård och kommunikationsforskning)ORCID iD: 0000-0001-7067-2687
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. (Tillämpad vård och kommunikationsforskning)ORCID iD: 0000-0002-9194-3244
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.ORCID iD: 0000-0002-1651-7544
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2025 (English)In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 137, article id 109095Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: In Sweden, registered nurses have a key role in initial patient assessments and prioritization in primary care. This assessment is a complex and demanding process. To meet patient and public needs, insight is needed into nurses’ communication and decision-making during these consultations. Therefore, the aim of this PhD project is to explore clinical reasoning and decision-making in patient-nurse consultations in primary care.

Methods: A prospective multicentre study was designed and data were gathered with a purposive sample of audio recorded observations of real-life communication during 150 patient‒nurse consultations, patient reported health status and stimulated recall interviews with nurses.

Findings: This PhD project will investigate communication and decision-making in 150 nurse-patient consultations with a focus on:

1.Patients’ reason-for-encounter and health problems as assessed by patients’ self-reported health concerns and functional health status (COOP-WONCA).

2.Communication of health concerns and needs as observed with the VR-CoDES (Verona Coding Definitions of Emotional Sequences) using the audio recorded consultations

3.Nurses’ clinical reasoning and decision-making using data gathered with stimulated recall interviews and analysed with a qualitative method for thematic analysis.

This project is presented as an example on how to design and gather data in communication research to investigate nurses’ communication and their exploration of health concerns during nurse-patient consultations in primary care.

Discussion: Results from this research are aimed to support nurses in their assessments, communication and clinical decision-making in primary care. In the long term, this research can contribute to increased knowledge on how the competence of registered nurses can be used and enhanced to make the best use of the primary care resources.

Place, publisher, year, edition, pages
Elsevier, 2025. Vol. 137, article id 109095
National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
URN: urn:nbn:se:hb:diva-33108DOI: 10.1016/j.pec.2025.109095ISI: 001537849900013OAI: oai:DiVA.org:hb-33108DiVA, id: diva2:1926813
Conference
The International Conference on Communication in Healthcare, Zaragoza, Spain. 9–13 September, 2024.
Available from: 2025-01-13 Created: 2025-01-13 Last updated: 2025-11-28Bibliographically approved

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Bergman, KarinHedén, LenaSundler, Annelie Johanssonvan Dulmen, SandraÖstman, Malin

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