The Experience of Presence Among Telehealth Nurses

10.1097/JNR.0b013e3182a0b028

Janis S. Tuxbury

presence ； telehealth ； telenursing ； nursing presence

The Journal of Nursing Research

21卷3期（2013 / 09 / 01）

155 - 161

英文

Background: Telehealth technology allows for the provision of nursing care even when the patient and nurse are physically separated from each other. Telehealth has shown positive effects on healthcare costs and healthcare access. Although it can increase healthcare access and decrease healthcare costs, the use of telehealth has altered the typical pattern of nurseY patient proximity. It is unknown how the physical separation related to telehealth use may affect the experience of presence among nurses during nurseYpatient interactions.Purpose: The purpose of the research was to gain knowledge about the ways that nurses experience presence during interactions with patients using telehealth technology.Methods: A qualitative descriptive design with convenience sampling was used for this study. Sample inclusion criteria included being a registered nurse with at least 1 year of experience using telehealth technology and working in telehealth at the time of the study. Institutional review board approval was received before beginning data collection. Participants (n = 6) provided informed consent. Qualitative data were obtained by individual, audiotaped, semistructured interviews. The data were transcribed and analyzed deductively for the existence of presence. Ethnograph version 6.0 software was used to assist in organizing and analyzing the data.Results: Two examples of presence during telehealth nurseYpatient interactions were described by participants.Conclusion: This study documented for the first time the experience of presence among nurses who interact with their patients using only nonvideo telehealth technology.

1. American Telemedicine Association. (2005). Telehealth nursing fact sheet. Retrieved from http://www.americantelemed.org/files/public/membergroups/nursing/fact_sheet_final.pdf
2. Health Services Resources Administration of the United States. (2012). Telehealth. Retrieved from http://www.hrsa.gov/ruralhealth/about/telehealth/telehealth.html
3. Agency for Healthcare Research and Quality. (2008). Using telehealth to improve quality. Retrieved from http://www.healthit.ahrq.gov
4. American Telemedicine Association. (2008). Telehealth nursing: A white paper developed and accepted by the telehealth nursing special interest group. Retrieved from http://www.americantelemed.org/files/public/membergroups/nursing/
5. Presence. (n.d.). In Merriam-Webster's learner's dictionary. Retrieved from http://www.learnersdictionary.com/search/presence
6. American Academy of Ambulatory Care Nursing(2007).Telehealth nursing practice administration and standards.Pitman, NJ:Author.
7. Anguita, M.(2012).Opportunities for nurse-led telehealth and telecare.Nurse Prescribing,10(1),6-8.
8. Barnett, T.,Henderson, S.,Henry, D.,Gumpold, A.,Foote, P.,Gallop, S.(2009).Nurse-led telephone triage in an Australian rural mental health service.International Journal of Nursing Practice,15(5),389-393.
9. Bingham, E.,Bevan, S.,Leask, K.(2009).Living made easy. Interview by Sue Laird.Nursing Standard,23(31),18-20.
10. Burke, B., Jr.,Bynum, A.,Hall-Barrow, J.,Ott, R.,Albright, M.(2008).Rural school-based telehealth: How to make it happen.Clinical Pediatrics,47(9),926-929.
11. Cipriano, P. F.(2011).The future of nursing and health IT: The quality elixir.Nursing Economic,29(5),286-289.
12. Covington, H.(2005).Caring presence: Providing a safe place for patients.Holistic Nursing Practice,19(4),169-172.
13. Cusack, C. M.,Pan, E.,Hook, J. M.,Vincent, A.,Kaelber, D. C.,Middleton, B.(2007).The value proposition in the widespread use of telehealth.Journal of Telemedicine and Telecare,14(4),167-168.
14. Easter, A.(2000).Construct analysis of four modes of being present.Journal of Holistic Nursing,18,362-377.
15. Ernesäter, A.,Holmström, I.,Engström, M.(2009).Telenurses' experiences of working with computerized decision support: Supporting, inhibiting, and quality improving.Journal of Advanced Nursing,65(5),1074-1083.
16. Falkenstern, S. K.,Gueldner, S. H.,Newman, M. A.(2009).Health as expanding consciousness with families with a child with special healthcare needs.Nursing Science Quarterly,22(3),267-279.
17. Finfgeld-Connett, D.(2006).Meta-synthesis of presence in nursing.Journal of Advanced Nursing,55(6),708-714.
18. Hessel, J. A.(2009).Presence in nursing practice: A concept analysis.Holistic Nursing Practice,23(5),276-281.
19. International Council of Nurses(2007).International competencies for telenursing.Geneva, Switzerland:Author.
20. Kleiman, S.(2009).Human centered nursing: The foundation of quality care.Philadelphia, PA:F. A. Davis.
21. Lincoln, Y. S.,Guba, E. G.(1985).Naturalistic inquiry.Newbury Park, CA:Sage.
22. McMahon, M. A.,Christopher, K. A.(2011).Toward a midrange theory of nursing presence.Nursing Forum,46(2),71-82.
23. Paterson, J. G.,Zderad, L. T.(1988).Humanistic nursing.New York, NY:National League for Nursing.
24. Potter, P. J.,Frisch, N.(2007).Holistic assessment and care: Presence in the process.Nursing Clinics of North America,42(2),213-228.
25. Sävenstedt, S.,Zingmark, K.,Sandman, P. O.(2004).Being present in a distant room. Aspects of teleconsultations with older people in a nursing home.Qualitative Health Research,14(8),1046-1057.
26. Schatzman, L.,Strauss, A. L.(1973).Field research: Strategies for a natural sociology.Englewood Cliffs, NJ:Prentice-Hall.
27. Snooks, H. A.,Williams, A. M.,Griffiths, L. J.,Peconi, J.,Rance, J.,Snelgrove, S.,Cheung, W. Y.(2008).Real nursing? The development of telenursing.Journal of Advanced Nursing,61(6),631-640.
28. Waltz, C. F.,Strickland, O. L.,Lenz, E. R.(2010).Measurement in nursing and health research.New York, NY:Springer.
29. Yun, E. K.,Park, H. A.(2006).Factors affecting the implementation of telenursing in Korea.Studies in Health Technology and Informatics,122,657-659.
30. Zyblock, D. M.(2010).Nursing presence in contemporary nursing practice.Nursing Forum,45(2),120-124.

1. Yeh, Jehn-Shan,Roan, Jinsheng,Lin, I-Chun,Lin, Chihung,Hsu, Chien-Lung,Cheng, Yu-Han(2016).The Usage Behavior and Intention Stability of Nurses: An Empirical Study of a Nursing Information System.The Journal of Nursing Research,24(1),48-57.