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PubMed1982

A comparison of three modes of hearing aid-telephone coupling.

The stray magnetic field emitted by telephone receivers has been used by hearing aid wearers to improve telephone communication. Recent technical advances by Bell Canada have eliminated the magnetic field. The company sponsored the design of a hearing aid modification to compensate for the loss of this magnetic field. This report concerns the evaluation of the modification. The results of two experiments indicated that it did not provide a satisfactory substitute for the magnetic field. A by-product of this project was the development of a device (audiometer-telephone interface) which permits simulation of telephone listening, thus allowing clinical assessment of a patient's telephone communication ability.

Adult↗
PubMed1995

Telephone advice about an infant given by after-hours clinics and emergency departments.

AIMS: Studies have shown that telephone calls for advice constitute a significant portion of the workload of emergency departments in the United States and the United Kingdom. Reviews of the appropriateness of telephone advice given in emergency departments in the United States indicate that the information given is often inadequate or inaccurate. We performed a study to evaluate the telephone advice given in New Zealand. METHODS: We identified 30 public hospital emergency departments and 20 private accident and emergency clinics. Twenty-six towns and cities were represented. We telephoned each of them and requested advice about the management of a fictitious febrile infant. RESULTS: We were given medical advice by 36 of the centres. In the remaining 14 the caller was referred to an oncall duty doctor or general practitioner for further information. In the 36 departments providing advice, the information was given by a doctor in 5 of the cases, by a nurse in 26, and by a receptionist or unidentified respondent in 5. On average, the caller was asked 3.76 questions about the patient before advice was given. Even if a number of questions were asked, correct advice did not necessarily follow. Thirty five of the advice givers requested the age of the infant, but 16 of them gave inadequate advice despite this knowledge. We judged the advice given to be inadequate in 16 of the 36 institutions that provided it. There was no difference in the standard of advice given by private and public institutions. DISCUSSION: This study demonstrates that there are deficiencies in the quality of telephone advice given by emergency departments and private accident and emergency clinics in New Zealand.

Emergency Medical Services↗
PubMed1993

When you're only a phone call away: a comparison of the information in telephone and face-to-face interviews.

Telephone interviews offer an economical method of obtaining information, but little published experience addresses the use of telephone interviews for the sometimes lengthy questionnaires composed of scales with multiple-category items often required in developmental and behavioral research. In a study of the outcomes of very low birth weight infants, circumstances required that we administer a questionnaire, including seven scales composed of several Likert-type items each, to a substantial portion of the study population. Those contacted by telephone (n = 1067) differed from those responding face-to-face (n = 822) in being less likely to have a very low birth weight child and more likely to be white and of higher maternal education. The length of the interview was only slightly shorter by telephone (60.7 +/- 27.9 vs 66.4 +/- 21.0 minutes, p < .001), but respondent fatigue, as indicated by lower completion rates for scales at the end of the interview (92.5%) compared with those near the beginning (99.5%) did not differ by mode. Internal consistency of parental response (Cronbach's alpha) was high for most scales and did not differ by mode. Because assignment to mode was not random, other factors may influence our findings. However, high completion rates and comparable consistency of response supports the use of telephone interviews.

Adaptation, Psychological↗
PubMed1994

Agreement between telephone survey and medical record data for the elderly patient.

OBJECTIVE: This study compares agreement between telephone survey and ambulatory medical record data for an elderly patient population. METHODS: Medical records and telephone survey responses are used to compare health status (chronic medical condition, symptomatology, and functional status) of 142 elderly patients randomly selected from a family practice residency and a geriatric fellowship practice. Chart abstraction was performed by two resident and two faculty physicians after a training period designed to assure high inter-reviewer reliability. Telephone surveys were completed by two professional interviewers. Health status measures were taken from standard, published instruments. The kappa statistic was used to measure the agreement between medical record and survey data. RESULTS: Overall, there is little agreement between the medical record and the telephone survey results on chronic medical condition, symptomatology, and functional status. CONCLUSIONS: Medical records abstractions and telephone survey methodologies did not yield comparable health status data when applied to the same elderly patient population. Functional status assessment and symptomatology are particularly problematic, but even the presence or absence of chronic diseases is often inconsistent in the two data sources.

Aged↗
PubMed1993

The Cancer Information Service Telephone Evaluation and Reporting System (CISTERS): a new tool for assessing quality assurance.

With more than 500,000 annual telephone inquiries from the public, health professionals, and others, the toll-free telephone-based Cancer Information Service (CIS) has rapidly evolved into a primary contact point and resource for people seeking cancer-related information. As the CIS continues to grow, quality-assurance issues are increasingly important both to maintain a high quality of responses to callers and to ensure the accuracy of information transmitted. The Cancer Information Service Telephone Evaluation and Reporting System (CISTERS), a computer-based interactive interviewing system, is being developed to provide quantitative measures of various aspects of the quality of CIS responses to telephone inquiries. In addition to supplying quantitative feedback to both the National Cancer Institute (NCI) CIS office and the regional CIS offices, CISTERS also allows program managers to identify and provide for staff training needs. CISTERS is a substantial part of NCI's commitment to quality control and assessment of needs within the CIS network and may have significant implications for the growing number of other national telephone-based, health-information helplines.

Humans↗
PubMed1994

A computer-based approach to quality improvement for telephone triage in a community AIDS clinic.

Observation of the current procedure for telephone triage in a community-based acquired immunodeficiency syndrome (AIDS) clinic and a retrospective chart audit identified opportunities for improvement in the process for the management of telephone triage encounters. Specifically, it pointed out that the nurses faced difficulties in accessing relevant clinical data, and that a large number of data were missing in the documentation for the encounter. Five design goals for a computer-based system to improve the management of the telephone triage encounter were generated by an interdisciplinary project team. A computer-based approach to management of the telephone triage encounter complemented by the development of performance standards and guidelines has the potential to improve both the process of telephone triage and the documentation of the triage encounter.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Inability to follow up ED patients by telephone: there must be 50 ways to leave your number.

OBJECTIVE: To determine the ability to complete follow-up home telephone calls to ED patients. METHODS: A retrospective review of the ability to reach 4,741 patients called during a posttreatment patient satisfaction survey of visits to a suburban community hospital ED. RESULTS: Only 54.9% of all patients called could be contacted after three or fewer phone calls. Of the 2,139 (45.1%) who could not be reached, there was no answer for 1,260 (58.9%), despite three telephone calls to a number currently in service. A significant minority (21.1%) had given nonworking numbers. Another 12.4% indicated that no one by the name of the patient lived at the number called and 2.9% of the respondents alleged that the patient was deceased. CONCLUSIONS: Almost half of the patients who present to the ED and supply home telephone numbers give telephone numbers at which they cannot be reached in follow-up. Using telephone follow-up alone to reach patients seen in the ED may be an unreliable method of communication.

Data Collection↗
PubMed1996

Effectiveness of telephone prompts when surveying general practitioners: a randomised trial.

BACKGROUND: Response rates to recent surveys of general practitioners have ranged from 44-95%. The effectiveness of a telephone prompt by a non-medical research assistant in advance of survey mail-out was unknown at the time of this study. OBJECTIVE: To determine the effectiveness of a telephone prompt by a non-medical research assistant to enhance response rates to a lengthy survey. SUBJECTS: 364 randomly selected general practitioners randomised into intervention and control groups. OUTCOME VARIABLE: Cumulative response rate at Day 18 and Day 60. DESIGN: Intervention group received a telephone call in advance of the survey. The control group received conventional mail-outs. Non-responders in both groups were telephoned at Day 28 and sent a reminder letter and questionnaire. RESULTS: 77% of the intervention group responded to the survey compared to 64% of the control group. Intention-to-treat analysis demonstrated a significantly earlier response by Day 18 (continuity corrected chi 2 = 18.15; df = 1; p < 0.001) and a significantly higher overall response by Day 60 (continuity corrected chi 2 = 5.41, df = 1, p < 0.009) from the intervention group. CONCLUSION: A telephone prompt by a non-medical research assistant will accelerate and enhance response rates to a survey of general practitioners although the differential effectiveness of a non-medical researcher compared to a medical practitioner conducting such prompts remains unstudied.

Australia↗
PubMed2006

[A telephone hotline as an easily accessible service for questions on schizophrenia].

Public relations activities of the German Research Network on Schizophrenia (GRNS) have shown that there is a demand for more information about schizophrenia disorder. This confirms international research findings that relatives of schizophrenia patients are particularly in need of information and support. In response, the GRNS has maintained a telephone hotline since 2001. The hotline is manned by clinical experts, psychiatrists, or psychologists once a week. The telephone calls are documented in a systematic manner. From 2001 to 2003, 3,909 calls were registered. This volume exceeds the limit of the hotline's resources. The telephone hotline is mainly used by relatives of psychotic patients. Most questions relate to the symptoms of schizophrenia and pharmaceutical treatment. The need for emotional support is also a high motivational factor for dialing the hotline number. The telephone hotline seems to be a worthwhile addition to the already existing crisis telephones and should be maintained even after public funding of the network expires.

Caregivers↗
PubMed1990

Urgent care center pediatric telephone advice.

Pediatric telephone advice is sought frequently by members of the community. This study was undertaken to evaluate the quality and accuracy of pediatric telephone advice given by free-standing urgent care centers. One hundred such facilities were telephoned and advice was requested by a research assistant. A case was presented that could have represented a pediatric medical emergency. Overall only 17 centers gave adequate advice. The data suggest that under some circumstances free-standing urgent care center pediatric telephone advice may be inaccurate and inappropriate. Workable policies and protocols for pediatric telephone advice should be instituted by these facilities.

Algorithms↗
PubMedDate not supplied

Accuracy of recall memory in elderly patients in response to telephone support calls.

During the Gulf War, 93 elderly patients (mean age 74 years) received telephone-based support calls from a hospital-based home care facility. Accuracy of memory recall of these telephone support calls was assessed 6 weeks after the termination of the war by means of a postal questionnaire. The relative accuracy of the recall memory of these patients or their caregivers to the telephone calls received exhibited a sensitivity of 75%, a specificity of 78%, a positive predictive value of 60% and a negative predictive value of 88%. Patients who had received four calls demonstrated better memory recall than those receiving less than four. Thus, relying upon patient's memory alone may be insufficient for evaluating survey data in the elderly. In addition, we found that only patients who correctly remembered receiving four individual telephone support calls tended to exhibit a decrease in the anxiety level. This study emphasizes the importance of repeated interventional telephone calls as a method of increasing recall accuracy and decreasing anxiety in aged patients.

Journal Article↗
PubMed1997

Telephone triage: 5 years' experience.

Triaging by telephone has long been a 'bone of contention' among emergency nurses in Victoria, Australia, with some nurses adamant that telephone advice is appropriate and other nurses equally adamant that telephone advice should not be given at all. Almost unanimously agreed upon by both groups is that documentation of the call, and/or the advice given, is time consuming and may pose a legal risk to the nurse if something untoward should happen to the patient. This paper relates our experience including our policy on telephone triage with an analysis of 5 years of documented telephone calls from January 1991 to January 1996.

Counseling↗
PubMed2003

The effects of cellular telephone use on serum PSA levels in men.

BACKGROUND: The increasing use of cellular telephones is known to have harmful effects on human health. The aim of this prospective study was to determine whether cellular telephone use affected serum PSA levels in men. METHODS: Participants included 20 men with ages ranging from 22 to 65 years who had never previously used cellular telephones. Blood samples were taken prior to and 30 days after the beginning of cellular telephone use. Serum was separated from the blood samples and stored in a deep freezer until the end of the study, at which time serum free and total PSA levels were determined by tandem radioimmunoassay. The results were statistically analyzed by the Wilcoxon Paired Signed Rank Test. RESULTS: Average free and total PSA values were 2.070 ng/ml and 0.500 ng/ml before the study, and 2.0 ng/ml and 0.505 ng/ml at the end of the study, respectively. No significant difference was determined between the initial and final values (p > 0.05). CONCLUSIONS: The results indicate that cellular telephone use does not significantly affect PSA values in the short term. Nevertheless, we think that there is a need for longer-term studies on this subject.

Adult↗
PubMed2002

Influence of D-net (EUROPEAN GSM-standard) cellular telephones on implanted pacemakers in children.

This study was designed to evaluate possible interactions between digital cellular telephones and implanted pacemakers in children. The study comprised 95 patients (53 males and 42 females) with a mean age of 11.5 +/- 4.6 years (range 1-22 years). The average time from pacemaker implantation was 2.5 years (range 1 month-12 years). Fourteen (15%) devices were dual chamber and the remaining were single chamber pacemakers. The following companies manufactured the pacemakers tested: Medtronic (n = 42), Telectronics (n = 9), Vitatron (n = 16), Pacesetter (n = 19), CPI (n = 8), and Biotronik (n = 1). All the patients were tested in the supine position during continuous ECG monitoring. After completion of the routine pacemaker check, the effects of the European Global system for mobile communication (GSM) was tested using two cellular telephone models (Ericsson GA 628 and Siemens S 25, 2-W power). For this purpose, atrial and ventricular sensitivity settings were programmed to the most sensitive values, and the tests were carried out in the unipolar and bipolar sensing modes. The evaluation was performed during ringing, switching on/off, and conversation phase with the cellular telephone positioned over the pulse generator and around the pacemaker pocket. A malfunction of the pacemaker was not observed in any patient. Only 1 (1%) of 95 patients showed a brief oversensing problem during calls with the cellular telephone. In this case, an AAIR pacemaker was implanted transvenously in a subcutaneous pocket and the sensing defect occurred only with the unipolar sensing mode and was not reproducible. Once the source of interference was removed, no sensing defect was detected and the patient remained asymptomatic. No symptoms were experienced in this study. The authors believe that pacemaker dependent patients with nonprotected pulse generators manufactured at the beginning of 1990s may be tested by their physicians for possible interferences before they use a digital cellular telephone.

Cell Phone↗
PubMed2004

Cellular telephone use and risk of acoustic neuroma.

Despite limited evidence, cellular telephones have been claimed to cause cancer, especially in the brain. In this Danish study, the authors examined the possible association between use of cellular telephones and development of acoustic neuroma. Between 2000 and 2002, they ascertained 106 incident cases and matched these persons with 212 randomly sampled, population-based controls on age and sex. The data obtained included information on use of cellular telephones from personal interviews, data from medical records, and the results of radiologic examinations. The authors obtained information on socioeconomic factors from Statistics Denmark. The overall estimated relative risk of acoustic neuroma was 0.90 (95% confidence interval: 0.51, 1.57). Use of a cell phone for 10 years or more did not increase acoustic neuroma risk over that of short-term users. Furthermore, tumors did not occur more frequently on the side of the head on which the telephone was typically used, and the size of the tumor did not correlate with the pattern of cell phone use. The results of this prospective, population-based, nationwide study, which included a large number of long-term users of cellular telephones, do not support an association between cell phone use and risk of acoustic neuroma.

Adult↗
PubMed1994

Responses to telephone inquiries made to craniofacial treatment teams.

This report is a follow-up to an earlier research project concerning composition and function of self-identified teams listed in the ACP-CFA 1990 Membership-Team Directory. We address the types of responses provided by personnel answering telephones for teams listed in a recent Directory. Sixty of the 228 teams listed in the continental United States were randomly selected and divided into 2 groups of 30 each. One group was telephoned by an ACP-CFA member who is the parent of a patient with cleft palate; the other group was telephoned by a graduate student in speech-language pathology. Data indicate that Directory listing does not assure access to information pertinent to cleft lip, palate, and craniofacial anomalies; different type and manner of responses were made to the 2 callers; and inadequate information was often provided by the personnel who answer the telephones. Implications include the need for more training of personnel in responding to telephone inquiry and cautious use of the directory listings as a resource for referral.

Chi-Square Distribution↗
PubMed2001

Prospective study of telephone consultation and communication in pediatric infectious diseases.

BACKGROUND: Subspecialists are often called on to provide informal or "curbside" telephone consultation. There is limited documentation of the time spent on, content, nature and source of such consultations by pediatric infectious disease (PID) specialists. Nursing staff frequently assist physicians by triaging telephone calls. No previous studies have examined this aspect of their role in subspecialty practice. METHODS: We prospectively recorded all telephone calls to a newly established PID program for 1 year. Results were entered into a database and analyzed using the ABSTAT software. RESULTS: A total of 621 calls were received by the PID specialist and 1,260 by the PID nurse from March 1, 1999, through February 29, 2000. The mean number of calls per month was 51.8 +/- 24.8 for the physician and 105 +/- 43.3 for the nurse. The mean time spent per call was 9.6 +/- 5.9 min for the physician and 3.3 +/- 1.4 min for the nurse. A total of 103.5 h were spent directly on telephonic consultation/communication by the physician and 68.7 h by the nurse, respectively. Of the calls to the physician 78.6% came from other physicians, 51.5% being pediatricians in practice and 57% involving case management. Calls to the nurse were primarily from the laboratory (26.3%), with 93% regarding patients seen on the inpatient or outpatient service. CONCLUSIONS: Telephone consultation/communication is an integral and important part of a PID practice.

Communicable Diseases↗
PubMed2007

Telephone follow-up for patients with amyotrophic lateral sclerosis.

The relentless evolution of amyotrophic lateral sclerosis (ALS), a severe neurodegenerative disorder of the upper and lower motoneurons, leads to an increasing level of disability. Most patients, during the course of the disease, become unable to attend the tertiary clinical care center and are thus prevented from enrolling in clinical trials or benefiting from specialized care and management. The main objective of this study was to verify whether the ALS functional rating scale (ALSFRS) could be reliably administered by telephone to patients, when unable to attend the ALS clinic, or to their caregivers. ALSFRS is a validated instrument that assesses the functional status and the disease progression in ALS. We first administered the functional rating scale directly in the clinic to 30 patients, with definite or probable ALS, and to their respective caregivers, and found a very high agreement between the two groups for the total score and the majority of the rating items. Next, we showed, in both patients and caregivers, a high degree of correlation between the total score of the ALSFRS measured by telephone and that reported in the clinic. This indicates that ALSFRS is a reliable instrument for monitoring the disease progression in homebound patients, even when the person contacted by telephone is the caregiver. We also performed a telephone clinic, based on an unstructured interview, with 16 ALS patients at an advanced stage of the disease and unable to attend the ALS clinic. On some occasions, the person interviewed was the caregiver. The symptoms most frequently reported were a worsening of muscle strength, swallowing and breathing problems, constipation, and inability to clear lung secretions. Several patients asked for assistive and adaptive equipment. All patients and caregivers found the telephone clinic very useful and considered it a good complement to the management and care programme.

Activities of Daily Living↗