Designing Telemedicine for Socially Marginalized People: A Qualitative Descriptive Study of Nurses’ Perspectives on the Expected Characteristics of Telemedicine Services

The study will employ a qualitative descriptive design. This approach is appropriate because it allows for the exploration of nurses’ perceptions, experiences, meanings, and professional representations regarding a complex and multidimensional phenomenon, namely delayed access to the Emergency Department among socially vulnerable patients. Qualitative research makes it possible to examine healthcare professionals’ perspectives in depth and to understand care-related phenomena that cannot be fully assessed through quantitative indicators alone. The study does not aim to measure the effectiveness of an intervention, but rather to understand how nurses interpret this phenomenon and what role they attribute to telemedicine in potentially preventing clinical and social deterioration. The study is expected to provide a deeper understanding of Emergency Department nurses’ perceptions of socially vulnerable patients who seek care at a late stage. It is anticipated that nurses will report recognizing several signs of vulnerability during triage and the initial assessment, not only through clinical parameters but also through social and relational factors. These may include the absence of accompanying persons, poor personal hygiene, confusion regarding medication management, repeated Emergency Department visits, social isolation, communication difficulties, or personal accounts characterized by loneliness. Nurses are also expected to identify the main causes of delayed access to care as the absence of caregivers, weaknesses in community-based care networks, difficulties in seeking help, limited health literacy, emotional distress, and fragmentation between healthcare and social services. With regard to telemedicine, it is likely to be perceived as a useful tool for supporting patient monitoring, continuity of care, and the early identification of healthcare and social needs, but only when integrated into a strong human and community-based support network. For highly vulnerable individuals, technology alone may not be sufficient and could even increase exclusion if it is not accompanied by appropriate support, digital education, and the active involvement of healthcare professionals. The study may therefore highlight the need for a more proactive healthcare model in which nurses play a central role in the early identification of vulnerability, the coordination between hospital and community services, and the management of inclusive digital care pathways.