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At least 919 records · Page 51Linked to original sources
PubMed2006

Healthcare information giving services: technologies and everyday practicalities.

This paper presents findings from observational studies of work practice in two 'information giving' services - a poisons information service and a mental health helpline - as a precursor to informing the design of such services. Our work high- lights the interactions that constitute the requesting and giving of information and the role of intermediaries in the delivery of recipient-designed information. We propose a shift of focus from the logic of information in system design to one that encompasses the practicalities of information giving.

Hotlines↗
PubMed2003

Sex difference in response to stress by lunar month: a pilot study of four years' crisis-call frequency.

BACKGROUND: This study is in response to the question of whether the moon can influence daily levels of stress. METHOD: Four years of telephone-call frequency data were obtained from a single crisis-call centre. We used the method of lunar-day numbers 1 to 29 for analysis. We also tested the concept of 'strong moons' as occurring when the Sun was near to the lunar-node axis. RESULTS: An increase in calls was recorded from females and a decrease in calls by males during the new moon period, suggesting a sex difference in response, and there were proportionally more calls by males a fortnight later. A comparable swing in the male/female call-ratio on a weekly basis over Fridays and Saturdays was noted. Limitations of staffing at the call-centre prohibited comment on seasonal correlations. CONCLUSION: Lunar-related studies of stress should endeavour to separate the data by sex or the effect can be lost. Distress-calls by women were more strongly linked to the lunar month than were those by men.

Astronomical Phenomena↗
PubMed2005

Are non-responders in a quitline evaluation more likely to be smokers?

BACKGROUND: In evaluation of smoking cessation programs including surveys and clinical trials the tradition has been to treat non-responders as smokers. The aim of this paper is to assess smoking behaviour of non-responders in an evaluation of the Swedish national tobacco cessation quitline a nation-wide, free of charge service. METHODS: A telephone interview survey with a sample of people not participating in the original follow-up. The study population comprised callers to the Swedish quitline who had consented to participate in a 12 month follow-up but had failed to respond. A sample of 84 (18% of all non-responders) was included. The main outcome measures were self-reported smoking behaviour at the time of the interview and at the time of the routine follow-up. Also, reasons for not responding to the original follow-up questionnaire were assessed. For statistical comparison between groups we used Fischer's exact test, odds ratios (OR) and 95% confidence intervals (CI) on proportions and OR. RESULTS: Thirty-nine percent reported to have been smoke-free at the time they received the original questionnaire compared with 31% of responders in the original study population. The two most common reasons stated for not having returned the original questionnaire was claiming that they had returned it (35%) and that they had not received the questionnaire (20%). Non-responders were somewhat younger and were to a higher degree smoke-free when they first called the quitline. CONCLUSION: Treating non-responders as smokers in smoking cessation research may underestimate the true effect of cessation treatment.

Adult↗
PubMed2006

Using Ontario's "Telehealth" health telephone helpline as an early-warning system: a study protocol.

BACKGROUND: The science of syndromic surveillance is still very much in its infancy. While a number of syndromic surveillance systems are being evaluated in the US, very few have had success thus far in predicting an infectious disease event. Furthermore, to date, the majority of syndromic surveillance systems have been based primarily in emergency department settings, with varying levels of enhancement from other data sources. While research has been done on the value of telephone helplines on health care use and patient satisfaction, very few projects have looked at using a telephone helpline as a source of data for syndromic surveillance, and none have been attempted in Canada. The notable exception to this statement has been in the UK where research using the national NHS Direct system as a syndromic surveillance tool has been conducted. METHODS/DESIGN: The purpose of our proposed study is to evaluate the effectiveness of Ontario's telephone nursing helpline system as a real-time syndromic surveillance system, and how its implementation, if successful, would have an impact on outbreak event detection in Ontario. Using data collected retrospectively, all "reasons for call" and assigned algorithms will be linked to a syndrome category. Using different analytic methods, normal thresholds for the different syndromes will be ascertained. This will allow for the evaluation of the system's sensitivity, specificity and positive predictive value. The next step will include the prospective monitoring of syndromic activity, both temporally and spatially. DISCUSSION: As this is a study protocol, there are currently no results to report. However, this study has been granted ethical approval, and is now being implemented. It is our hope that this syndromic surveillance system will display high sensitivity and specificity in detecting true outbreaks within Ontario, before they are detected by conventional surveillance systems. Future results will be published in peer-reviewed journals so as to contribute to the growing body of evidence on syndromic surveillance, while also providing an non US-centric perspective.

Algorithms↗
PubMed1999

Crisis telephone consultation for deliberate self-harm patients: effects on repetition.

BACKGROUND: No interventions have been shown to be effective in reducing deliberate self-harm (DSH) repetition in this group of patients as a whole. AIMS: To investigate the effect on repetition of offering emergency telephone support in a group of hospital-admitted DSH patients. METHOD: A total of 827 DSH patients admitted to medical wards were randomly allocated to either control or intervention (green card) groups. In addition to treatment as usual, the intervention group was offered telephone support should any further crises occur. The main outcome measure was DSH repetition within six months of the index event. RESULTS: The intervention had no significant effect on the overall DSH repetition rate (odds ratio 1.20, 95% CI 0.82-1.75). Sub-group analysis suggested that response to the intervention differed according to the past history of DSH--subjects with a previous history repeating more often and first-timers appearing to benefit. CONCLUSIONS: No overall effect of the intervention was shown. Conclusions concerning sub-groups must be regarded as speculative, but they suggest that further assessment of the value of telephone support in first-timer DSH patients is indicated.

Adult↗
PubMed2005

Crisis card following self-harm: 12-month follow-up of a randomised controlled trial.

No intervention has been shown to be effective in preventing repetition of self-harm. In the 6-month follow-up of a large randomised controlled trial, we previously reported no effectiveness of the provision of a card offering 24-h crisis telephone consultation on repetition of self-harm. However, there was a possible benefit among those presenting following a first episode (OR=0.64, 95% CI 0.34-1.22). Here we report the 12-month follow-up of the trial. The results confirm no overall benefit of the intervention (OR=1.19, 95% CI 0.85-1.67). Among those with a first episode of self-harm, the possible benefit of the intervention had diminished (OR=0.89, 95% CI 0.52-1.52), although a modest effect cannot be excluded.

Crisis Intervention↗
PubMed2025

The impact of the live broadcast of Stromae's song L'enfer on social media publications, calls to the national helpline, and suicide attempt rates in France.

On January 9, 2022, Belgian pop singer Stromae performed his new hit "L'enfer" live on French TV. The song addresses his personal struggles with suicidal ideation. To evaluate the impact of Stromae's performance, we modeled the evolution of hospital admission rates for suicide attempts (SAs) in France, calls to the national suicide prevention helpline (3114), and Twitter publications mentioning the singer or the helpline. We employed the Gombay test to identify change points within each time series. We identified a significant increase in mean SA rates among women aged 20-24 years 6 days after the singer's performance. No similar effect was observed in the general population or other young age groups. The show was immediately followed by a peak in tweets referring to the singer, while Twitter activity related to the 3114 remained modest. We did not observe any increase in calls to the helpline. Celebrity testimonies about suicidal experiences can help alleviate stigma but should be accompanied by prevention messages to reduce the risk of contagion.

Humans↗
PubMed2002

Thoughts of suicide among HIV-infected rural persons enrolled in a telephone-delivered mental health intervention.

This study characterized rates and predictors of suicidal thoughts among HIV-infected persons living in rural communities of eight U.S. states. Self-administered surveys were completed by 201 HIV-infected persons living in communities of 50,000 or fewer that were located at least 20 miles from a city of 100,000 or more. All participants were clients of rural AIDS service organizations and had recently enrolled into a randomized clinical trial of a telephone-delivered, coping improvement-group intervention designed specifically for HIV-infected rural persons. At baseline, participants reported on thoughts of suicide, psychological symptomatology, life-stressor burden, ways of coping, coping self-efficacy, social support, and barriers to health care and social services. Thirty-eight percent of HIV-infected rural persons had engaged in thoughts of suicide during the past week. A logistic regression analysis revealed that participants who endorsed thoughts of suicide also reported more depressive symptoms (odds ratio [OR] = 2.19; 95% confidence interval [CI] = 1.32-3.63, p < .002), less coping self-efficacy (OR = 0.70; 95% CI = 0.56-0.88, p < .002), more frequently worried about transmitting their HIV infection to others (OR = 1.66, 95% CI = 1.14-2.40, p < .008), and experienced more stress associated with AIDS-related stigma (OR = 1.58, 95% CI = 1.07-2.35, p < .03). As AIDS prevalence rates increase in rural areas, interventions that successfully identify and treat geographically isolated HIV-infected persons who experience more frequent or serious thoughts of suicide are urgently needed.

Adaptation, Psychological↗
PubMed2006

Need for cognition and message complexity in motivating fruit and vegetable intake among callers to the cancer information service.

This field experiment examined the impact of an individual's need for cognition (NFC; the tendency to enjoy thinking deeply about issues), complex versus simple messages, and the interaction of NFC and message type on encouraging fruit and vegetable consumption. Callers to the Cancer Information Service of the National Cancer Institute (N=517) were asked to participate in the experiment at the end of their call. Individual NFC was assessed, and participants were assigned randomly to receive a telephone message promoting fruit and vegetable consumption that was either complex and multifaceted or simple and straightforward. Similarly constructed brochures were mailed immediately following the call, and additional brochures were mailed 2 and 3 months later. Although NFC did not predict intake, complex messages were more effective than simple messages in motivating fruit and vegetable consumption 1 and 4 months later.

Adult↗
PubMed2005

Prioritizing interventions to improve rates of thrombolysis for ischemic stroke.

BACKGROUND: Thrombolytic treatment has been shown to be effective in the treatment of ischemic stroke when initiated within 3 hours of symptom onset, yet few patients receive thrombolytics. OBJECTIVE: To estimate expected increases in use of thrombolytics for ischemic stroke given the following interventions: educating patients to present earlier, optimizing Emergency Medical Services (EMS) response/transport times, optimizing hospital systems, and extending the treatment window. METHODS: As part of a Centers for Disease Control-sponsored Coverdell Acute Stroke Pilot Registry, the authors prospectively identified all patients with an initial diagnosis of ischemic stroke at 11 hospitals in California over a 3-month period. Timing of symptom onset, EMS response, hospital arrival, treatment, and reasons for nontreatment were evaluated, and hypothetical treatment rates for thrombolysis for interventions on the stroke-care continuum were derived based on observed rates of eligibility and treatment. RESULTS: Of 374 patients with ischemic stroke, 88 (23.5%) arrived at the emergency department within 3 hours of symptom onset, of whom 16 (4.3%) received thrombolysis. If all patients with known onset times had called 911 immediately, the expected overall rate of thrombolytic treatment within 3 hours would have increased from 4.3 to 28.6%. Expected rates of thrombolysis were lower for other interventions: instantaneous prehospital response 5.5%, perfect hospital care 11.5%, and extension of time window to 6 hours 8.3%. If all patients with known onset had arrived within 1 hour and been optimally treated, 57% could have been treated. CONCLUSION: Campaigns that educate patients to seek treatment sooner should be major components of system-wide interventions to increase rates of thrombolysis for acute ischemic stroke.

Brain Ischemia↗
PubMed2001

Telephone advice nursing--callers' experiences.

We studied telephone callers' experiences of contacting a medical call centre. A questionnaire was administered to 203 persons. It was completed by 144 (71%), of whom 81 (56%) chose to comment on their experience in the space provided. The comments were analysed using a qualitative method and were categorized as relating to either the practical or the emotional aspects of the call. Sixty-nine per cent of comments described a satisfactory experience. The unsatisfactory comments mostly concerned access problems. The callers emphasized the importance of receiving appropriate advice and being treated in a kindly manner. In addition, there were dimensions of security and insecurity in nearly all the categories. The findings highlight the telephone nurses' communication skills and their ability to deal with callers as individuals, to make them feel more secure. The selection, education and training of telephone nurses should place more emphasis on their supportive and communicative roles.

Adult↗
PubMed2002

A four-year study of telephone support for oncology patients using a non-supervised call centre.

A non-supervised call centre was used to allow oncology patients to contact their personal doctors 24 hours a day. Incoming patient calls to the centre were automatically routed to the doctor's mobile phone or office telephone. Over four years, an average of 407 calls were made each year, by an average of 274 oncology patients. The average number of emergency hospital visits was 24 per year (0.09 per patient), compared with 42 per year (0.16 per patient) during the year before the telephone service began. The average number of outreach visits was 783 (2.9 per patient) per year during the study, in comparison with 722 (2.8 per patient) before it began. The average number of non-emergency hospital admissions was 41 (0.15 per patient) per year in comparison with 42 (0.17 per patient) before the study. Calls were short (typically 3-5 min) and the majority (88%) were made on the patient's initiative. Outreach patients in receipt of chemotherapy were the principal users (making 88% of all calls). Excluding the initial investment cost, the income received was approximately the same as the running costs of the call centre in two of the three years for which data were available.

Hotlines↗
PubMed2003

How has NHS Direct changed primary care provision?

We studied a general practice cooperative in west London that served 900,000 patients. The telephone triage service subsequently became a pilot for the national service, NHS Direct. Both quantitative and qualitative data were used for the study. The quantitative data consisted of the (anonymized) patient computer records available on the telephone triage service for the first two weeks in December 1998, December 1999 and December 2000. Two significant events were identified. The first, which emerged principally from analysis of the quantitative call data, were changes in patient outcomes during the period that spanned the arrival of NHS Direct. The second, revealed mainly through analysis of the qualitative data, were changes in the behaviour, perceptions and work experience of the triage nurses. Significant behavioural and attitudinal transitions occur when primary care organizations are modified.

After-Hours Care↗
PubMed2004

Automatic message handling for a national counselling service.

An automatic email handling system (AutoRouter) was introduced at a national counselling service in Australia. In 2003, counsellors responded to a total of 7421 email messages. Over nine days in early May 2004 the administrator responsible for the management of the manual email counselling service recorded the time spent on managing email messages. The AutoRouter was then introduced. Since the implementation of the AutoRouter the administrator's management role has become redundant; an average of 12 h 5 min per week of staff time has been saved. There have been further savings in supervisor time. Counsellors were taking an average of 6.2 days to respond to email messages (n = 4307), with an average delay of 1.2 days from the time counsellors wrote the email to when the email was sent. Thus the response was sent on average 7.4 days after receipt of the original client email message. A significant decrease in response time has been noted since implementation of the AutoRouter, with client responses now taking an average of 5.4 days, a decrease of 2.0 days. Automatic message handling appears to be a promising method of managing the administration of a steadily increasing email counselling service.

Adolescent↗
PubMed2006

Equity of access to health care. Evidence from NHS Direct in the UK.

In the UK National Health Service (NHS), NHS Direct, the national 24-h telephone helpline, has been available in England and Wales since 2000 and has been termed a 'single gateway' to health care. We conducted a population survey of 15,004 people in areas covered by the service, which included questions about NHS Direct use and socio-economic characteristics. After removing undeliverable questionnaires, the survey response rate was 60% (8750/14,516). In all, a quarter of respondents had ever used NHS Direct (26%, 95% confidence interval 25-27), ranging from 32% of the population in Preston/Chorley (888/2,794) and Newcastle and North Tyneside (515/1,621) to 17% (2,215/8,536) in Sheffield, which had introduced the service 20 months later. Logistic regression showed that those from poorer socioeconomic groups or with communication difficulties were less likely to have used the service than others. Overcoming this apparent bias against those likely to have the greatest need is an unsolved problem not confined to telemedicine.

Adolescent↗
PubMed1998

A pan-European social alarm system.

SAFE 21 is a pan-European research and development project which will take social alarms into the twenty-first century. It is run by a consortium of eight organizations, with financial support from the European Commission. SAFE 21 will use existing infrastructure to deliver a much broader range of services and extend availability to users who are currently excluded. The project aims: to develop a social alarm that will work from anywhere inside the home, using a neck-worn speech-pendant and outside the home making use of radio cellphone and global positioning technology; to demonstrate how telemedicine can be incorporated at marginal costs, by exploiting the existing social alarm infrastructure; to demonstrate a shared control centre that facilitates emergency services, medical, welfare and social professionals working together to support a broad-based social alarm system; to provide access to social alarms for deaf users, who are currently excluded.

Computer Communication Networks↗