Encountering and counselling patients and family members in out-of-hospital emergency care in non-conveyance situations: Follow-up study in Finland

Abstract
Rather little is known about emergency care in out-of-hospital settings, for example in patients’ homes, where acute situations often emerge and require rapid action from those present. Research evidence concerning the issue is crucial for the development of emergency care services and for responding to patients’ and professionals’ needs. This study aims to describe how out-of-hospital emergency staff experience encountering and counselling patients and their family members and making non-conveyance decisions after having attended an educational intervention dealing with these issues. Data were collected by electronic questionnaires sent to all out-of-hospital emergency staff members (N=238) of a hospital district in Finland in 2014 and in 2016. Data were mainly analyzed using statistical methods. The educational intervention did not affect respondents’ self-perceived encountering and counselling skills much, although some positive development was observed. The educational intervention had some positive effect on emergency care providers’ encountering and counselling skills. Especially the attention given to family members in care situations increased. The training appears to be in the right direction, but it must be continued. The continuously increasing knowledge of patients’ and family members’ care and counselling experiences also helps staff to understand situations from client perspective, bringing a new dimension to emergency care services.