Experiences of text-based synchronous computer-mediated communication in primary care: a qualitative study of registered nurses' experience.

Introduction: Digital systems such as synchronous computer-mediated communication have become a complement to traditional healthcare visits in primary care. The aim was to describe district nurses' experiences of digital communication with patients via text-based synchronous computer-mediated communication. Methods: The study employed a qualitative design, and data were collected through a qualitative questionnaire that included open-ended questions, which were completed by 34 registered nurses working within primary care. The data were analysed using inductive qualitative content analysis. The Consolidated Criteria for Reporting Qualitative Research Elements were considered when conducting the study. Results: The findings indicate that chat communication presents various challenges for registered nurses, particularly in assessing patients' health status and engaging in caring communication. Digital communication via chat appears most suitable for patient encounters involving uncomplicated and clearly articulatable needs. The findings highlight the need for more knowledge, clearer guidelines, and adapted work routines to ensure that this communication modality supports safe and person-centered care. Discussion: Clearer guidelines are needed regarding when communication modality form is appropriate and when alternative modalities such as a telephone call or face-to-face contact should be used. Complementary communication pathways must be readily available, and routines should enable early transition to another modality when the patient's needs exceed what written communication can accommodate.