A national helpline needs your help.
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Hotlines↗
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Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
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Discursive psychology as a qualitative approach for analysing interaction in medical settings.
PURPOSE: To introduce some features of the perspective of discursive psychology that may be useful for studying interaction in a range of medical settings. OVERVIEW: Discursive psychology considers the way psychological words and displays play a practical part in the activities that are performed in particular settings. It offers a way of understanding the role of psychological issues that is distinct from, and is sometimes obscured by, traditional social cognitive approaches. The approach is illustrated by the example of crying on a child protection helpline. The way crying is built from different elements, the way these elements are organised, and the way they are receipted are all highlighted. Crying is both performing and potentially disrupting actions. The virtues of high quality transcription, and of understanding the way crying is situated in the turn organisations of conversation, are demonstrated. EVALUATION: Discursive psychology involves particular ways of considering reliability and validity. The broader potential for such an approach in medical settings is discussed.
Child↗
An ethnographic study of three mental health triage programs.
Triage processes are commonly used to manage the interface between demand for, and supply of, health services. This dimension of service provision is particularly pertinent for mental health services in Australia, where demand outweighs services available. This paper draws on the experiences of using participant observation to explore mental health triage processes. Findings highlight the complexities of the researcher role and benefits of using an ethnographic approach to explore mental health triage patterns. Insider participant observation brings many challenges but also, in this study, enabled the researcher to uncover some roles and processes underpinning triage decisions in mental health services.
Anthropology, Cultural↗
Outcomes of a nurse-led telephone triage service in Australia.
This paper reports on a study which comprised the first comprehensive evaluation of the Kids Kare Line telephone triage service in which experienced registered nurses respond to parents' requests for health-care advice for their child. This service is located in an acute care hospital in regional New South Wales, Australia. One hundred and one parents who telephoned the Kids Kare Line responded to a telephone-administered survey designed to determine the service's efficiency and effectiveness. Responses demonstrated that parents sought advice about a range of issues, of which the management of fever was the most frequent. All but five parents considered their call to have been answered promptly, all parents understood the advice provided to them and 96% of parents were satisfied with this advice. Fifty parents identified that they had not used another service or health practitioner for the same issue subsequent to their Kids Kare Line telephone call.
Adolescent↗
Paediatric outreach services.
Paediatric outreach services are provided in Australia and overseas to regional and rural communities. More recently telehealth services have been established to support the delivery of paediatric services and clinical management at distant sites. It is suggested that with the large distances separating centres in Australia that a combination of telehealth clinics and outreach visits may provide the most efficient means of delivering paediatric specialty and subspecialty care to these centres.
Australia↗
In the public interest: autonomy and resistance to methods of standardising nurses' advice and practices from a health call centre in Perth, Western Australia.
The history of nursing is replete with examples of nurses battling for autonomy over their education, knowledge and work practices. The latest battleground is HealthDirect, Australia's first medial call centre, where nurses are required to meet externally imposed clinical standards while satisfying legal and financial obligations. These objectives are arguably achieved when nurses assess callers' health problems via computerised algorithms that determine an appropriate plan of action. That way, nurses' subjective responses to callers are ruled out. To ensure nurses comply with the standard processes, calls are monitored randomly and surreptitiously in formal and informal ways. This paper explores how nurses respond to standard procedures and surveillance, in order to argue that nurses' input partially drives reform processes. Nurses continue to seek autonomy over the advice they give and how their work is evaluated but are constrained by structural power relations.
Algorithms↗
Evaluation of an after hours telephone support service for rural palliative care patients and their families: A pilot study.
OBJECTIVE: To report on the introduction and evaluation of an after hours telephone support service for palliative care patients and their families at home. DESIGN: Descriptive evaluation using an audit of telephone logbook, text analysis of reflective journals, questionnaire and interviews. SETTING: Palliative care call service in Grafton, New South Wales, Australia. SUBJECTS: The participants were health professionals using the Palliative Care Service in Grafton (48 in total) and nurses providing the palliative care service (21 in total). RESULTS: Twelve calls were taken by the nurses during the pilot study. Three major themes emerged from the analysis: preparation involving publishing the after hours telephone support service (AHTSS) and nurse workshop; benefits such as support to families and health service resourcing; and nurses' experiences regarding personal impact and building support for each other. CONCLUSION: It appears from the evaluation responses of health professionals and nurses that knowing the service was there was a great security and reduced the sense of isolation predominant in the experience of rural families caring for a palliative care patient at home. Based on the positive evaluation, the area health service provided ongoing funding for the service and is exploring avenues to extend the program into other areas. The service now requires a re-evaluation at 18 months and will form the second phase of the study that is currently being organised.
After-Hours Care↗
Health infrastructure in very remote areas: an analysis of the CRANA Bush Crisis Line database.
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Australia↗
Early intervention in case of child abuse: co-operation between the hot-line and local facilities.
The Center for Child Abuse Prevention (CCAP), a citizens' organization, was started in May 1991 with such members as pediatricians, psychiatrists, lawyers and people working at child welfare offices. A hot-line dealing with child abuse was set up immediately after the establishment of CCAP on 20 May 1991, and in the 2 years it has been in operation this hot-line has received 3189 calls out of which we picked 30 cases that CCAP was consulted about by helping persons or therapists affiliated with such facilities as hospitals, public health centers, etc. in order to evaluate how CCAP co-operates with these organizations. We reviewed the CCAP records of these 30 cases, comparing them with the materials concerning other hot-line calls, while at the same time interviewing the helping persons and therapists who had called in those cases, ascertaining their motives and the later course of the cases. This follow-up study was begun in June 1992 so that the longest follow-up period from the first call was 2 years and 7 months and the shortest 7 months. A total of 73.3% of these 30 cases required emergency intervention, and 53.4% were extremely severe, life-threatening cases of child abuse. The age distribution of these 30 victimized children peaked between 4 and 6, and 13 and 15 years. The perpetrator was the biological mother in 55.9% of the cases, the biological father in 29.4% and the stepfather in 8.9%. The abuse was physical in 58.3% of the cases, sexual in 8.9%, emotional in 5.6%, and involved neglect in 22.2%. These percentages differ from the general trend seen in the total hot-line cases, but were very similar to those reported by the Child Guidance Center. In the majority (56.7%) of the cases CCAP was consulted about, CCAP went beyond its hot-line service and co-operated to intervene, organizing network sessions in which the helping persons and therapists involved could discuss how best to deal with the problem at hand in five of these cases. In 22 of these 30 cases, the persons involved are still co-operating with CCAP after successful intervention through which the victimized children were rescued from critical situations. It is vitally important to set up networks between the professionals of the various support agencies involved if we are to intervene successfully in cases of child abuse.(ABSTRACT TRUNCATED AT 400 WORDS)
Adolescent↗
Child abuse viewed through the hot-line in Osaka, Japan.
Cases of child abuse identified by a hot-line telephone service and by a survey of health and welfare agencies are reported. Many consultations to the telephone hot-line were from mothers concerned about maltreating their own children. In such cases, the extent of abuse was often mild to moderate, and many of those mothers were troubled about child care in the relatively segregated context of the nuclear family. In only a few cases did the callers indicate that the children's life was in danger. In the administrative survey, however, deaths occurred in 5% of the cases, and the abused children frequently had physical and psychological symptoms. There were also more frequent and more serious family problems in the administrative survey compared to the telephone consultation cases. The findings of these surveys suggest that many children and parents are suffering from child abuse in Japan, that many cases are currently not being identified by health and welfare agencies, and that a wide range of measures, from protection of severely abused children to prevention of abuse, are necessary.
Adolescent↗
Grassroots efforts of Japanese women to promote services for abused women.
The purpose of this study was to identify and describe the personal experiences of six Japanese female volunteers who formed a support group to provide services for abused women. The interpretation of the women's stories also increased understanding about the process of forming and developing a grassroots organization to take needed action. The interpretive phenomenological approach guided the study. The findings illustrate that a group of community volunteers can identify and effectively address a significant social issue on their own initiative.
Attitude of Health Personnel↗
The use of a Teleport system in parent and adolescent support.
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Adolescent↗
Establishment and evaluation of a statewide drug and alcohol specialist advisory service.
The New South Wales Drug and Alcohol Specialist Advisory Service aims to provide prompt, relevant and reliable advice on the clinical management of drug- and alcohol-related problems to health professionals throughout New South Wales. We gauged the performance of the Service against present indicators by interviewing 120 callers who had contacted the Service during its first two years. Accessibility and the quality of information provided were rated highly. Of the 120 respondents, 105 (90 per cent) rated the speed of response to their calls as very good or excellent, and 109 (91 per cent) considered the advice given to be very relevant to their needs. Nearly all (97 per cent) indicated their intention to reuse the Service, and 78 (65 per cent) nominated it as their preferred source of clinical advice on drug and alcohol problems. The Service has established itself as an accessible and reliable source of advice on the management of drug and alcohol problems, especially for rural health professionals. This model of a telephone-based consultancy could have application in other medical specialities.
Alcoholism↗
Teachable moments in diet and nutrition for family and friends calling the Cancer Helpline.
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Attitude to Health↗
Impact on callers to a men's domestic violence helpline.
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Behavior↗
Dialing 911: a call to action.
Cardiovascular disease and stroke are the nation's leading causes of disability and death. Scientific advances have provided newer treatments that, when applied effectively and in time, save a significant number of lives. Multiple factors in our system of delivery impede our ability to apply effective treatments, but with an analysis of the components of care, each of us can take leadership roles in our communities to improve the chain of survival. These elements and the science supporting each are briefly reviewed.
Cardiovascular Diseases↗
A randomized, controlled trial to measure the frequency of use of a hospital telephone line for new parents.
New parents have fewer supports today than in previous decades due to factors such as short postpartum hospital stay, fragmentation of services, and long-distance families. This controlled trial evaluated the frequency of use of a 24-hour, in-hospital telephone line by 130 parents randomly invited to use the service and 130 who were not aware of this service. A special line with a separate extension was installed on the postpartum unit. Randomly arranged, sealed envelopes were given to 260 women at the time of discharge, containing a congratulations message or description of a new 24-hour telephone line for advice given by postpartum nurses. Of 53 calls requesting help, 36 were received on the special line and 17 on regular ward telephones; 28 percent of those invited to call back did so, and 13 percent of those without an invitation called on the regular extension, (P = 0.015). Recommendations for future program planning are based on the results of this study.
Breast Feeding↗