Background: Not much is known about emergency care delivered in patients� homes or other out-of-hospital\nsettings. This study aims to describe out-of-hospital emergency staff�s experiences of encountering and counseling\npatients and their family members.\nMethods: A descriptive cross-sectional design was applied. Data were collected from a hospital district in Finland\nfrom emergency care staff via an electronic survey questionnaire specifically developed for this purpose (N = 142\nreponse rate 59%) and analyzed using descriptive statistics.\nResults: Respondents succeeded in encountering (up to 3.88/4) and counseling (up to 3.89/4) patients and family\nmembers. Challenges were related to introducing themselves to family members (3.20/4), to interacting with patients\nfrom different cultures (3.38/4) and to allowing family members to be present in care situations (2.29/4). Providing\nemotional support (2.56/4), especially to family members, and confirming (3.16/4) and ensuring continuity of care\ninstructions (3.00/4) were found to be challenging.\nConclusions: High-level counseling in acute out-of-hospital situations demands that care providers can put themselves\ninto the patient�s and family�s situation, ensure follow-up care and provide care instructions to both patients and\nfamilies. The presence and participation of family members is essential in acute care situations outside hospital contexts.\nEnsuring that these contents are included and practiced during basic and continuing emergency care education for\nnurses and other emergency staff is crucial for developing counseling practices.
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