Callers' Ability to Understand Advice Received from a Telephone Health‐Line Service: Comparison of Self‐Reported and Registered Data

Abstract

Objective. To validate users' perception of nurses' recommendations to look for another health resource among clients seeking teleadvice. To analyze the effects of different users' and call characteristics on the incorrectness of the self-report. Data Sources/Study Setting. This study is a secondary analysis of data obtained from 4,696 randomly selected participants in a survey conducted in 1997 among users of Info-Sante´CLSC, a no-charge telenursing health-line service (THLS) available all over the province of Québec. Study Design/Data Collection. Self-reported advice from follow-up survey phone interviews, conducted within 48 to 120 hours after the participant's call, were compared to the data consigned by the nurse in the computerized call record. Covariables concerned characteristics of callers, context of the calls, and satisfaction about the nurses' intervention. Association between these variables and inaccurate reports was identified using multinomial logistic regression analyses. Principal Findings. Advice to consult were recorded by the nurse in 42 percent of cases, whereas 39 percent of callers stated they had received one. Overall disagreement between the two sources is 27 percent (12 percent by false positive and 15 percent by false negative) and kappa is 0.45. Characteristics such as living alone (adjusted OR 5 2.5), calls relating to psychological problems (OR 5 2.8), perceived seriousness (OR 5 B2.6), as well as others, were associated with inaccurate reports. Conclusions. Telephone health-line providers should be aware that many callers appear to interpret advice to seek additional health care differently than intended. Our findings suggest the need for continuing quality control interventions to reduce miscommunication, insure better understanding of advice by callers, and contribute to more effective service.

Understanding of and adherence to advice after telephone counselling by nurse: a survey among callers to a primary emergency out-of-hours service in Norway

“…This corresponds to the studies from Dale et al, and Leclerc et al [17,19]. One way to ensure that the information is understood is to ask the caller to repeat the advices given by the nurse at the end of the telephone call, but this intervention has received little attention in studies in which nurse advice has been discussed.…”

Decision aid software programs in telenursing: not used as intended? Experiences of Swedish telenurses

“…When the dimension of urgency is established, the nurses’ task will be focused more on information, support, and teaching. To achieve a positive outcome from a telephone consultation, good communication is essential (Leclerc et al ., 2003). Good communication gives the caller a feeling of being heard and understood and thus motivated to follow the nurse’s advice.…”

An Audit of the Appropriateness of Teletriage Nursing Advice

“…Patient understanding and willingness or ability to comply are crucial to the process. [22][23][24] In over 80% of the audits, the auditors rated the teletriage nurse's ability to establish a relationship with the caller and extract pertinent information as "good to excellent" or "good." The caller's ability or willingness to describe the problem and the caller's level of literacy or understanding was also rated as "good to excellent" or as "good" in approximately 80% of the audits.…”