{"title":"Nurse-Led Telenursing in Inflammatory Bowel Disease: A Qualitative Study Using Sociotechnical Systems Mapping.","authors":"Aki Kawakami, Makoto Tanaka, Kayoko Sakagami","doi":"10.1111/jocn.70601","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>To explore the sociotechnical factors underlying the perceived benefits and challenges of nurse-led telenursing for inflammatory bowel disease.</p><p><strong>Design: </strong>A qualitative study using a two-phase analytic approach.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with 20 registered nurses providing outpatient inflammatory bowel disease telenursing across 11 facilities in Japan between June 2023 and June 2024. Inductive content analysis identified perceived benefits and challenges, which were then mapped to sociotechnical system domains (people, processes, technologies and environment) to examine interactions and identify potentially modifiable system-level levers.</p><p><strong>Results: </strong>Four themes were identified: clinical assessment challenges; variability in triage decision-making; workload burden and workflow fragmentation; and barriers to access and patient-context misalignment. Challenges and benefits reflected interactions among system components. Key issues included limitations of voice-only symptom assessment, variability associated with the absence of standardised protocols, and inefficiencies arising from fragmented workflows. These interaction patterns highlighted potential system-level levers, including information structuring, decision standardisation, workflow integration, and flexible care pathways.</p><p><strong>Conclusion: </strong>The quality of inflammatory bowel disease telenursing appears to depend on sociotechnical alignment rather than communication modality alone, particularly for timely recognition of and response to disease flares.</p><p><strong>Implications for practice: </strong>Structured assessment, standardised but adaptable triage and workflow redesign may strengthen early identification and management of exacerbations in nurse-led telenursing.</p><p><strong>Impact: </strong>This study presents a transparent qualitative approach linking frontline nursing experiences to system-level insights that may inform telehealth service design in chronic disease care.</p><p><strong>Reporting method: </strong>Standards for reporting qualitative research.</p><p><strong>Patient or public contribution: </strong>Patients and members of the public were not involved in the design, conduct, analysis, interpretation, or reporting of this study.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Nursing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/jocn.70601","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
Abstract
Aim: To explore the sociotechnical factors underlying the perceived benefits and challenges of nurse-led telenursing for inflammatory bowel disease.
Design: A qualitative study using a two-phase analytic approach.
Methods: Semi-structured interviews were conducted with 20 registered nurses providing outpatient inflammatory bowel disease telenursing across 11 facilities in Japan between June 2023 and June 2024. Inductive content analysis identified perceived benefits and challenges, which were then mapped to sociotechnical system domains (people, processes, technologies and environment) to examine interactions and identify potentially modifiable system-level levers.
Results: Four themes were identified: clinical assessment challenges; variability in triage decision-making; workload burden and workflow fragmentation; and barriers to access and patient-context misalignment. Challenges and benefits reflected interactions among system components. Key issues included limitations of voice-only symptom assessment, variability associated with the absence of standardised protocols, and inefficiencies arising from fragmented workflows. These interaction patterns highlighted potential system-level levers, including information structuring, decision standardisation, workflow integration, and flexible care pathways.
Conclusion: The quality of inflammatory bowel disease telenursing appears to depend on sociotechnical alignment rather than communication modality alone, particularly for timely recognition of and response to disease flares.
Implications for practice: Structured assessment, standardised but adaptable triage and workflow redesign may strengthen early identification and management of exacerbations in nurse-led telenursing.
Impact: This study presents a transparent qualitative approach linking frontline nursing experiences to system-level insights that may inform telehealth service design in chronic disease care.
Reporting method: Standards for reporting qualitative research.
Patient or public contribution: Patients and members of the public were not involved in the design, conduct, analysis, interpretation, or reporting of this study.
期刊介绍：
The Journal of Clinical Nursing (JCN) is an international, peer reviewed, scientific journal that seeks to promote the development and exchange of knowledge that is directly relevant to all spheres of nursing practice. The primary aim is to promote a high standard of clinically related scholarship which advances and supports the practice and discipline of nursing. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, JCN seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Emphasis is placed on promoting critical debate on the art and science of nursing practice.
JCN is essential reading for anyone involved in nursing practice, whether clinicians, researchers, educators, managers, policy makers, or students. The development of clinical practice and the changing patterns of inter-professional working are also central to JCN''s scope of interest. Contributions are welcomed from other health professionals on issues that have a direct impact on nursing practice.
We publish high quality papers from across the methodological spectrum that make an important and novel contribution to the field of clinical nursing (regardless of where care is provided), and which demonstrate clinical application and international relevance.
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