{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,8]],"date-time":"2025-02-08T12:40:03Z","timestamp":1739018403546,"version":"3.37.0"},"reference-count":45,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,2,8]],"date-time":"2025-02-08T00:00:00Z","timestamp":1738972800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,2,8]],"date-time":"2025-02-08T00:00:00Z","timestamp":1738972800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Prim. Care"],"DOI":"10.1186\/s12875-025-02736-x","type":"journal-article","created":{"date-parts":[[2025,2,8]],"date-time":"2025-02-08T11:59:56Z","timestamp":1739015996000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring expressed concerns and uncanny feeling in patients with shortness of breath calling out-of-hours primary care"],"prefix":"10.1186","volume":"26","author":[{"given":"Michelle","family":"Spek","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorien L.","family":"Zwart","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther","family":"de Groot","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle R.","family":"Timmerman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maarten","family":"van Smeden","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daphne C. A.","family":"Erkelens","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna S. M.","family":"Dobbe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Math\u00e9","family":"Delissen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frans H.","family":"Rutten","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roderick P.","family":"Venekamp","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,2,8]]},"reference":[{"key":"2736_CR1","unstructured":"Ramerman L. Care at out-of-hours primary care: Nivel Care registries in primary care: annual numbers 2022 and trend numbers 2018\u20132022 [Zorg op de huisartsenpost: Nivel Zorgregistraties Eerste Lijn: jaarcijfers 2022 en trendcijfers 2018\u20132022]. 2023. https:\/\/www.nivel.nl\/sites\/default\/files\/bestanden\/1004418.pdf. Accessed 20 Dec 2023."},{"key":"2736_CR2","unstructured":"Ramerman L, Verheij R. Cijfers huisartsenposten - Triage: ingangsklachten en urgentietoekenning. 2023. https:\/\/www.nivel.nl\/nl\/resultaten-van-onderzoek\/zorg-verleend-de-eerste-lijn-aard-en-omvang\/zorg-huisartsenpost\/triage-ingangsklachten-en-urgentietoekenning. Accessed 21 Nov 2023."},{"key":"2736_CR3","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1080\/13814788.2016.1213809","volume":"22","author":"K von Winckelmann","year":"2016","unstructured":"von Winckelmann K, Renier W, Thompson M, Buntinx F. The frequency and outcome of acute dyspnoea in primary care: An observational study. European Journal of General Practice. 2016;22:240\u20136.","journal-title":"European Journal of General Practice"},{"key":"2736_CR4","doi-asserted-by":"publisher","first-page":"32","DOI":"10.7196\/SAMJ.2016.v106i1.10324","volume":"106","author":"CBI Coccia","year":"2016","unstructured":"Coccia CBI, Palkowski GH, Schweitzer B, Motsohi T, Ntusi NAB. Dyspnoea: Pathophysiology and a clinical approach. S Afr Med J. 2016;106:32\u20136.","journal-title":"S Afr Med J"},{"key":"2736_CR5","doi-asserted-by":"publisher","first-page":"1227","DOI":"10.1111\/acem.13448","volume":"25","author":"ZE Hale","year":"2018","unstructured":"Hale ZE, Singhal A, Hsia RY. Causes of Shortness of Breath in the Acute Patient: A National Study. Acad Emerg Med. 2018;25:1227\u201334.","journal-title":"Acad Emerg Med"},{"key":"2736_CR6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12875-015-0373-z","volume":"16","author":"A Viniol","year":"2015","unstructured":"Viniol A, Beidatsch D, Frese T, Bergmann M, Grevenrath P, Schmidt L, et al. Studies of the symptom dyspnoea: A systematic review Epidemiology and research methodology in primary care. BMC Fam Pract. 2015;16:1\u201311.","journal-title":"BMC Fam Pract"},{"key":"2736_CR7","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1186\/s12875-024-02347-y","volume":"25","author":"M Spek","year":"2024","unstructured":"Spek M, Venekamp RP, de Groot E, Geersing G-J, Erkelens DCA, van Smeden M, et al. Accuracy of urgency allocation in patients with shortness of breath calling out-of-hours primary care: a cross-sectional study. BMC Primary Care. 2024;25:101.","journal-title":"BMC Primary Care"},{"key":"2736_CR8","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1080\/13814788.2016.1178718","volume":"22","author":"E Keizer","year":"2016","unstructured":"Keizer E, Maassen I, Smits M, Wensing M, Giesen P. Reducing the use of out-of-hours primary care services: A survey among Dutch general practitioners. European Journal of General Practice. 2016;22:189\u201395.","journal-title":"European Journal of General Practice"},{"key":"2736_CR9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12873-020-00312-3","volume":"20","author":"L Huibers","year":"2020","unstructured":"Huibers L, Carlsen AH, Moth G, Christensen HC, Riddervold IS, Christensen MB. Patient motives for contacting out-of-hours care in Denmark: A cross-sectional study. BMC Emerg Med. 2020;20:1\u201311.","journal-title":"BMC Emerg Med"},{"key":"2736_CR10","doi-asserted-by":"publisher","first-page":"e3","DOI":"10.1136\/emermed-2011-200585","volume":"29","author":"S Agarwal","year":"2012","unstructured":"Agarwal S, Banerjee J, Baker R, Conroy S, Hsu R, Rashid A, et al. Potentially avoidable emergency department attendance: Interview study of patients\u2019 reasons for attendance. Emerg Med J. 2012;29:e3.","journal-title":"Emerg Med J"},{"key":"2736_CR11","doi-asserted-by":"publisher","first-page":"267","DOI":"10.5117\/TVT2014.3.WIDT","volume":"360","author":"C de Widt","year":"2014","unstructured":"de Widt C, Koole T, van Berkum J. Emotion in emergency calls: Emotion, responses, and effects [Emotionele 112-gesprekken: emoties, reacties en effecten]. Tijdschrift voor Taalbeheersing. 2014;360:267\u201391.","journal-title":"Tijdschrift voor Taalbeheersing"},{"key":"2736_CR12","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1016\/j.pec.2011.06.010","volume":"90","author":"MA Mazzi","year":"2013","unstructured":"Mazzi MA, Bensing J, Rimondini M, Fletcher I, van Vliet L, Zimmermann C, et al. How do lay people assess the quality of physicians\u2019 communicative responses to patients\u2019 emotional cues and concerns? An international multicentre study based on videotaped medical consultations. Patient Educ Couns. 2013;90:347\u201353.","journal-title":"Patient Educ Couns"},{"key":"2736_CR13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2288-15-1","volume":"15","author":"E Keizer","year":"2015","unstructured":"Keizer E, Smits M, Peters Y, Huibers L, Giesen P, Wensing M. Contacts with out-of-hours primary care for nonurgent problems: Patients\u2019 beliefs or deficiencies in healthcare? Knowledge, attitudes, behaviors, education, and communication. BMC Med Res Methodol. 2015;15:1\u20138.","journal-title":"BMC Med Res Methodol"},{"key":"2736_CR14","doi-asserted-by":"publisher","first-page":"e197","DOI":"10.3399\/bjgp18X695021","volume":"68","author":"H Gamst-Jensen","year":"2018","unstructured":"Gamst-Jensen H, Huibers L, Pedersen K, Christensen EF, Ersbo\u00f8ll AK, Lippert FK, et al. Self-rated worry in acute care telephone triage: A mixed-methods study. Br J Gen Pract. 2018;68:e197\u2013203.","journal-title":"Br J Gen Pract"},{"key":"2736_CR15","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1016\/j.ejcnurse.2009.02.005","volume":"8","author":"M Ryan","year":"2009","unstructured":"Ryan M, Farrelly M. Living with an unfixable heart: A qualitative study exploring the experience of living with advanced heart failure. Eur J Cardiovasc Nurs. 2009;8:223\u201331.","journal-title":"Eur J Cardiovasc Nurs"},{"key":"2736_CR16","doi-asserted-by":"publisher","first-page":"3215","DOI":"10.1111\/jocn.12973","volume":"24","author":"M Abshire","year":"2015","unstructured":"Abshire M, Xu J, Dennison Himmelfarb C, Davidson P, Sulmasy D, Kub J, et al. Symptoms and fear in heart failure patients approaching end of life: A mixed methods study. J Clin Nurs. 2015;24:3215\u201323.","journal-title":"J Clin Nurs"},{"key":"2736_CR17","doi-asserted-by":"publisher","first-page":"e023727","DOI":"10.1136\/bmjopen-2018-023727","volume":"8","author":"MJ Booker","year":"2018","unstructured":"Booker MJ, Shaw ARG, Purdy S, Barnes R. \u201cPrimary care sensitive\u201d situations that result in an ambulance attendance: A conversation analytic study of UK emergency \u201c999\u201d call recordings. BMJ Open. 2018;8:e023727.","journal-title":"BMJ Open"},{"key":"2736_CR18","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1159\/000504141","volume":"52","author":"L Madeira","year":"2020","unstructured":"Madeira L, Leal B, Filipe T, Rodrigues MF, Figueira ML. The Uncanny of the Illness Experience: Can Phenomenology Help? Psychopathology. 2020;52:275\u201382.","journal-title":"Psychopathology"},{"key":"2736_CR19","doi-asserted-by":"crossref","unstructured":"Jentsch E. On the Psychology of the Uncanny (1906). Angelika: Journal of the Theoretical Humanities. 1997;2:7\u201316.","DOI":"10.1080\/09697259708571910"},{"key":"2736_CR20","doi-asserted-by":"crossref","unstructured":"Sandberg MB. Ibsen\u2019s Houses. Cambridge University Press; 2015.","DOI":"10.1017\/CBO9781139523981"},{"key":"2736_CR21","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1023\/A:1009920011164","volume":"3","author":"F Svenaeus","year":"2000","unstructured":"Svenaeus F. Scientific Contribution The body uncanny-Further steps towards a phenomenology of illness. Health Care Philos. 2000;3:125\u201337.","journal-title":"Health Care Philos"},{"key":"2736_CR22","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1080\/10481885.2016.1144978","volume":"26","author":"J De Peyer","year":"2016","unstructured":"De Peyer J. Uncanny communication and the porous mind. Psychoanal Dialogues. 2016;26:156\u201374.","journal-title":"Psychoanal Dialogues"},{"key":"2736_CR23","doi-asserted-by":"publisher","first-page":"1175","DOI":"10.1111\/jocn.15168","volume":"29","author":"LT Wouters","year":"2020","unstructured":"Wouters LT, Zwart DL, Erkelens DC, Huijsmans M, Hoes AW, Damoiseaux RA, et al. Tinkering and overruling the computer decision support system: Working strategies of telephone triage nurses who assess the urgency of callers suspected of having an acute cardiac event. J Clin Nurs. 2020;29:1175\u201386.","journal-title":"J Clin Nurs"},{"key":"2736_CR24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12875-022-01794-9","volume":"23","author":"CF Stolper","year":"2022","unstructured":"Stolper CF, van de Wiel MWJ, van Bokhoven MA, Dinant GJ, Van Royen P. Patients\u2019 gut feelings seem useful in primary care professionals\u2019 decision making. BMC Primary Care. 2022;23:1\u20136.","journal-title":"BMC Primary Care"},{"key":"2736_CR25","doi-asserted-by":"publisher","first-page":"e059549","DOI":"10.1136\/bmjopen-2021-059549","volume":"12","author":"M Spek","year":"2022","unstructured":"Spek M, Venekamp R, De Groot E, Geersing GJ, Erkelens DC, Van Smeden M, et al. Optimising telephone triage of patients calling for acute shortness of breath during out-of-hours primary care: Protocol of a multiple methods study (Opticall). BMJ Open. 2022;12:e059549.","journal-title":"BMJ Open"},{"key":"2736_CR26","doi-asserted-by":"publisher","first-page":"744","DOI":"10.1093\/fampra\/cmaa064","volume":"37","author":"L Steeman","year":"2021","unstructured":"Steeman L, Uijen M, Plat E, Huibers L, Smits M, Giesen P. Out-of-hours primary care in 26 European countries: An overview of organizational models. Fam Pract. 2021;37:744\u201350.","journal-title":"Fam Pract"},{"key":"2736_CR27","unstructured":"Van Uden CJT, Giesen PHJ, Metsemakers JFM, Grol RPTM. Development of out-of-hours primary care by General Practitioners (GPs) in The Netherlands: From small-call rotations to large-scale GP cooperatives. Fam Med. 2006;38."},{"key":"2736_CR28","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1093\/fampra\/cmq097","volume":"28","author":"Y van Ierland","year":"2011","unstructured":"van Ierland Y, van Veen M, Huibers L, Giesen P, Moll HA. Validity of telephone and physical triage in emergency care: The Netherlands Triage System. Fam Pract. 2011;28:334\u201341.","journal-title":"Fam Pract"},{"key":"2736_CR29","doi-asserted-by":"publisher","first-page":"108","DOI":"10.7326\/0003-4819-155-2-201107190-00006","volume":"155","author":"P Giesen","year":"2011","unstructured":"Giesen P, Smits M, Huibers L, Grol R, Wensing M. Quality of after-hours primary care in the Netherlands: A narrative review. Ann Intern Med. 2011;155:108\u201313.","journal-title":"Ann Intern Med"},{"key":"2736_CR30","unstructured":"Netherlands Triage Standard [Nederlandse Triage Standaard]. 2021. https:\/\/www.de-nts.nl. Accessed 27 Aug 2021."},{"key":"2736_CR31","doi-asserted-by":"publisher","first-page":"737","DOI":"10.7326\/M16-2776","volume":"166","author":"M Smits","year":"2017","unstructured":"Smits M, Rutten M, Keizer E, Wensing M, Westert G, Giesen P. The development and performance of after-hours primary care in the Netherlands a narrative review. Ann Intern Med. 2017;166:737\u201342.","journal-title":"Ann Intern Med"},{"key":"2736_CR32","unstructured":"HUS in 2021. https:\/\/husjaarverslag.pageflow.io\/hus-in2021#330908. Accessed 20 Nov 2023."},{"key":"2736_CR33","unstructured":"Annual report UNICUM 2021 [Jaarverslag UNICUM 2021]. https:\/\/www.unicum-huisartsenzorg.nl\/assets\/uploads\/downloads\/Jaarverslag-UNICUM-2021.pdf. Accessed 20 Nov 2023."},{"key":"2736_CR34","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1177\/1461445618754436","volume":"20","author":"W Stommel","year":"2018","unstructured":"Stommel W, te Molder H. Empathically designed responses as a gateway to advice in Dutch counseling calls. Discourse Stud. 2018;20:523\u201343.","journal-title":"Discourse Stud"},{"key":"2736_CR35","unstructured":"Council for International Organizations of Medical Sciences. International ethical guidelines for health-related research involving humans. 2016."},{"key":"2736_CR36","first-page":"14","volume":"81","author":"General Assembly of the World Medical Association","year":"2014","unstructured":"General Assembly of the World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. J Am Coll Dent. 2014;81:14\u20138.","journal-title":"J Am Coll Dent"},{"key":"2736_CR37","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1023\/A:1018790003416","volume":"22","author":"TD Borkovec","year":"1998","unstructured":"Borkovec TD, Ray WJ, Im SJ. Worry: A Cognitive Phenomenon Intimately Linked to Affective, Physiological, and Interpersonal Behavioral Processes. Cognit Ther Res. 1998;22:561\u201376.","journal-title":"Cognit Ther Res"},{"key":"2736_CR38","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1016\/j.pec.2010.03.017","volume":"82","author":"C Zimmermann","year":"2011","unstructured":"Zimmermann C, Del Piccolo L, Bensing J, Bergvik S, De Haes H, Eide H, et al. Coding patient emotional cues and concerns in medical consultations: The Verona coding definitions of emotional sequences (VR-CoDES). Patient Educ Couns. 2011;82:141\u20138.","journal-title":"Patient Educ Couns"},{"key":"2736_CR39","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13049-020-00743-8","volume":"28","author":"H Gamst-Jensen","year":"2020","unstructured":"Gamst-Jensen H, Frischknecht Christensen E, Lippert F, Folke F, Egerod I, Huibers L, et al. Self-rated worry is associated with hospital admission in out-of-hours telephone triage - A prospective cohort study. Scand J Trauma Resusc Emerg Med. 2020;28:1\u20139.","journal-title":"Scand J Trauma Resusc Emerg Med"},{"key":"2736_CR40","doi-asserted-by":"publisher","first-page":"107770","DOI":"10.1016\/j.pec.2023.107770","volume":"113","author":"M Spek","year":"2023","unstructured":"Spek M, van Charldorp TC, Vinck VV, Venekamp RP, Rutten FH, Zwart DL, et al. Displaying concerns within telephone triage conversations of callers with chest discomfort in out-of-hours primary care: A conversation analytic study. Patient Educ Couns. 2023;113:107770.","journal-title":"Patient Educ Couns"},{"key":"2736_CR41","doi-asserted-by":"publisher","first-page":"276","DOI":"10.11613\/BM.2012.031","volume":"22","author":"M McHugh","year":"2012","unstructured":"McHugh M. Interrater reliability: the kappa statistic. Biochem Med (Zagreb). 2012;22:276\u201382.","journal-title":"Biochem Med (Zagreb)"},{"key":"2736_CR42","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1080\/10810730.2015.1080325","volume":"21","author":"K Brandes","year":"2016","unstructured":"Brandes K, Linn AJ, Smit EG, Van Weert JCM. Unraveling the Determinants of Cancer Patients Intention to Express Concerns. J Health Commun. 2016;21:327\u201336.","journal-title":"J Health Commun"},{"key":"2736_CR43","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/j.pec.2015.07.021","volume":"99","author":"AV Mellblom","year":"2016","unstructured":"Mellblom AV, Korsvold L, Ruud E, Lie HC, Loge JH, Finset A. Sequences of talk about emotional concerns in follow-up consultations with adolescent childhood cancer survivors. Patient Educ Couns. 2016;99:77\u201384.","journal-title":"Patient Educ Couns"},{"key":"2736_CR44","unstructured":"Pooler J. Technology and Talk in Calls to NHS Direct. Loughborough University; 2010."},{"key":"2736_CR45","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1016\/j.socscimed.2014.12.013","volume":"126","author":"J Murdoch","year":"2015","unstructured":"Murdoch J, Barnes R, Pooler J, Lattimer V, Fletcher E, Campbell JL. The impact of using computer decision-support software in primary care nurse-led telephone triage: Interactional dilemmas and conversational consequences. Soc Sci Med. 2015;126:36\u201347.","journal-title":"Soc Sci Med"}],"container-title":["BMC Primary Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12875-025-02736-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12875-025-02736-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12875-025-02736-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,8]],"date-time":"2025-02-08T12:00:10Z","timestamp":1739016010000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcfampract.biomedcentral.com\/articles\/10.1186\/s12875-025-02736-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,8]]},"references-count":45,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["2736"],"URL":"https:\/\/doi.org\/10.1186\/s12875-025-02736-x","relation":{},"ISSN":["2731-4553"],"issn-type":[{"value":"2731-4553","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,8]]},"assertion":[{"value":"1 August 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 January 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 February 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The Medical Research Ethics Committee (MREC) Utrecht (reference number 21\/361) has reviewed our study protocol. The MREC concluded that this study is not within the scope of the WMO and granted an exemption for this study. Personal data and research data was de-identified according to the European General Data Protection Regulation.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"32"}}