Teleconsultation with discharged elderly patients with severe COPD: Telecare and technologically mediated nursing consultations - A practice-philosophical analysis of care and digital proximity

Telemedicine is increasingly being introduced with the overall expectation that it can solve some of the basic challenges faced by the health system regarding a growing number of chronically ill patients with several service needs. This article focuses on Danish hospital staff nurses’ and discharged patients’ experiences with teleconsultations related to chronic obstructive pulmonary disease. It deals with the effect of teleconsultations on the relationship between nurses and patients, and with some specific characteristics of telemedicine while being part of nursing practice. The Purpose of the study is to explore 1) how technology constitutes, and is constituted by, the relationship between patient and nurse in teleconsultations; and 2) how teleconsultations are perceived by patients and nurses.
The study has been conducted as a postphenomenological analysis of empirical data collected from fieldwork, focusing on telecare consultations between specialist nurses and patients.
Study findings show that patients and nurses alike consider technology-mediated nursing consultations as qualified care, enabling a close relationship between patient and nurse. Technological mediation of nursing practices changes the way nurses perform and it also changes their professional identity. The nurses amplify their audio-visual perceptions, communicative skills and by including the patient as their assistant. Correspondingly, their patients take on an active role in observation and measurement of their condition, and their self-image changes accordingly for them to become actively self-managing patients.