Telephone consultancy in adolescent psychiatry: an audit
01 Mar 1994-Irish Journal of Psychological Medicine (Cambridge University Press (CUP))-Vol. 11, Iss: 1, pp 15-20
TL;DR: Findings appear to indicate that a telephone consultancy service can provide a counselling service and highlight community resources that may be overlooked by other agencies – therefore it is important to bolster awareness of the service itself on a periodic basis amongst potential users.
Abstract: Objective: An audit was carried out to evaluate the performance of a telephone consultancy service in adolescent psychiatry. Its objective was to answer the following questions: What does a telephone consultancy service actually do? Is it worth having? If so, how can we improve it? Method: Proforma data sheets on 69 consecutive calls to the Telephone Consultancy Service over a 16-month period were analysed. Results: Seventy-seven percent of enquirers used the service to request a referral or to ask about the appropriateness of referral but only 46% of enquiries were responded to in this way. Twenty-two percent of enquiries were given counselling or advice on how to proceed with the cases themselves. Almost 50% of calls came from the social work department and they enquired principally about conduct problems (27% of their calls) and sexual abuse victims (18% of their calls). General practitioners infrequently used the service (7 calls over a 16-month period). Conclusions: These findings appear to indicate that a telephone consultancy service can provide a counselling service and highlight community resources that may be overlooked by other agencies. However, infrequent use of the service by general practitioners suggests that there has been poor dissemination of information about the service – therefore it is important to bolster awareness of the service itself on a periodic basis amongst potential users.
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TL;DR: Clinical use of videoconferencing in the programmes described by the reviewed papers was modest, with an average of 16 consultations per month, and three of the telephone-based services had large numbers of clients.
Abstract: Telepsychiatry is well established in many countries, but there is still little information about its use in routine health care. We reviewed the literature for information on the use of telepsychiatry in mental health services. From 1033 publications identified in the literature search and through references from a separate project, 16 studies or descriptions of the routine use of telepsychiatry services were selected for further review. Eleven of these articles dealt primarily with videoconferencing and five with telephone- based services. Clinical use of videoconferencing in the programmes described by the reviewed papers was modest, with an average of 16 consultations per month. Three of the telephone-based services had large numbers of clients. The papers we reviewed gave limited consideration to the healthcare systems in which telepsychiatry was provided and to the use of conventional mental health services. Telepsychiatry appears to still be a niche technology in many health systems. A lack of champions for the technology and reimbursement problems may contribute to the limited use of this area of telemedicine.
28 citations
References
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TL;DR: While exposure to parental discord during middle and early childhood led to increased risks of early offending, exposure to family change in the absence of parental discord did not lead to increased risk of offending.
Abstract: The relationship between exposure to family change, exposure to parental discord during the period from birth to 10 years and risks of offending by the age of 13 years was studied in a birth cohort of New Zealand children. This analysis showed that while exposure to parental discord during middle and early childhood led to increased risks of early offending, exposure to family change in the absence of parental discord did not lead to increased risks of offending. The results also suggested that children with a history of early conduct problems were particularly susceptible to parental discord but that the effects of discord did not vary with the child's gender. These results persisted when errors of measurement in the reporting of offending were taken into account using latent class methods.
171 citations
TL;DR: Findings justify the widespread promotion of self-help materials as a means of assisting the natural recovery process among problem drinkers.
Abstract: One hundred and seven problem drinkers responding to a newspaper advertisement were randomly assigned to groups receiving: (1) a general advice and information booklet; (2) a behaviourally-based self-help manual; (3) in addition to the manual, an opportunity to make progress reports to a telephone answering service; and (4) in addition to the manual, an opportunity to make telephoned progress reports to an interviewer. Eighty-seven (81.3%) respondents were successfully followed-up and collateral information was available for 54 (61.1%) of these. Results showed a higher proportion drinking above recommended limits at six months follow-up in the control group (78%) than in the groups receiving the manual (53%). There were no significant differences due to presence or type of telephone contact and poor use was made of the opportunity for telephone contact. Findings justify the widespread promotion of self-help materials as a means of assisting the natural recovery process among problem drinkers.
90 citations
TL;DR: The role of the telephone in delivering primary health care in the UK is reviewed, highlighting the wide differences between the UK and other countries, notably the USA, in knowledge of and experience with telephone care.
Abstract: This paper reviews the role of the telephone in delivering primary health care It highlights the wide differences between the UK and other countries, notably the USA, in knowledge of and experience with telephone care The volume and nature of telephone contacts in family medicine are explored before focusing on calls which may be described as consultations, both in and out of office hours Aspects of telephone consultations examined include the quality of care, the effectiveness of training programmes and the role of other health professionals Important gaps in the literature are identified, including the lack of comparisons between telephone and face-to-face care in terms of the quality of process and outcomes and the lack of data on costs and benefits
45 citations
TL;DR: Transtelephonic monitoring of a single-lead electrocardiogram and on-demand 2-way voice communication were accomplished at 1,865 exercise sessions for 67 cardiac patients, appearing safe and attractive because not all patients have access to supervised exercise programs.
Abstract: Transtelephonic monitoring of a single-lead electrocardiogram and on-demand 2-way voice communication were accomplished at 1,865 exercise sessions for 67 cardiac patients. Exercise sessions occurred either at the patients' homes or at remote hospital sites and began an average of 25 or 14 weeks, respectively, after hospital dismissal. Monitoring centers provided experienced nurses to direct all exercise sessions. The transtelephonic monitoring equipment was reliable with only one instance of system failure observed. A broad spectrum of patients with coronary artery disease, including some classified at higher risk, participated in the program. Patients exercised with a variety of equipment (cycle ergometer, treadmill, arm ergometer, cross-country ski simulator, combination arm-leg cycle ergometer, rowing machine), for 30 to 50 minutes, 1 to 3 times each week. No medical emergencies occurred, although 18 specific problems were discovered that led to further evaluation or change in the medical program of specific patients. Transtelephonic monitoring of cardiac rehabilitation exercise sessions at home and at remote hospitals appears safe and is attractive because not all patients have access to supervised exercise programs; this exercise assessment helps to maximally use highly trained cardiac rehabilitation personnel.
43 citations
TL;DR: Analysis of the data showed no significant differences between groups in anxiety, severity of side effects, helpfulness of self-care strategies, and coping strategies, but the survey indicated that the telephone calls were clinically significant and provided a mechanism for demonstrating that the health care professionals cared about their patients and provided an opportunity for patients to talk about their concerns.
Abstract: This study examined the effects of telephone call interventions by a collaborative team on patients' well-being. Fifty-five subjects undergoing radiation therapy for cure and who were able to communicate by telephone comprised the sample. Subjects were randomly assigned to a control group, who received the usual care or to an experimental group, who received a weekly telephone call intervention in addition to the usual care. Speilberger's State Trait Inventory, the Side Effects Profile, and the Coping Strategies Profile were used along with a telephone survey to collect data. Analysis of the data showed no significant differences between groups in anxiety, severity of side effects, helpfulness of self-care strategies, and coping strategies. However, the survey indicated that the telephone calls were clinically significant and provided a mechanism for demonstrating that the health care professionals cared about their patients and provided an opportunity for patients to talk about their concerns. The investigators believe that collaboration, caring, and communication are the essence of exemplary health care.
38 citations