Delivery of telephone-based supportive care to people with cancer: An analysis of cancer helpline operator and cancer nurse communication.

Telephone-based supportive care presents a potentially highly accessible means of addressing unmet supportive care needs for people with cancer. Identification of behaviours that facilitate communication is essential for development of training for telephone-based supportive care. The aim of this study was to describe communication behaviours within supportive care telephone calls in two contexts (1) a telephone outreach intervention and (2) cancer helpline calls, to identify potential areas for further training. 50 recorded calls were analysed using two standardised coding systems: the RIAS and Verona-CoDES-C. Mean call length was 21 min (304 utterances) for nurse-outreach calls and 23 min (355 utterances) for helpline calls. Closed questioning, verbal attentiveness and giving information/counselling were the most common communication behaviours identified. Emotional cues were most commonly responded to through non-explicit back-channelling, exploration of content or provision of reassurance or advice. This study confirmed the need to address the manner in which questions are framed to maximise patient disclosure. Responding to patent emotional cues was highlighted as an area for future training focus. Communication skills training that addresses each of these tasks is likely to improve the effectiveness of telephone-based delivery of supportive care.

Shaw J ，Young J ，Butow P ，Chambers S ，O'Brien L ，Solomon M ... -  《-》

Delivering healthcare at a distance: Exploring the organisation of calls to a health helpline.

Health helplines are integral to contemporary healthcare, offering fast, low-cost, and geographically unrestricted access to health information and advice. Although some health helplines offer support services (e.g., counselling), many function in ways that are similar to physically co-present (i.e., face-to-face) primary care consultations. However, due to the lack of physical presence, there are differences in the way health consultations are routinely managed on the telephone. This article explores some ways in which healthcare is managed at a distance, on a telephone helpline. Data are 196 recorded calls from the helpline, Healthdirect Australia. Using conversation analysis, this paper compares the delivery of healthcare over the telephone with what is known about physically co-present primary care consultations. Through an exploration of the overall structure of these helpline calls, we show how Healthdirect Australia calls are organised in terms of eight distinct phases: call opening, establishment of reason-for-calling, check of caller safety, creation of a confidential patient file, medical information-gathering, health advice, caller survey questions, and call closing. We demonstrate how interactants organise their talk around these phases, with a particular focus on the shift between mandated administrative tasks and traditional medical tasks. Findings from this study suggest that there are systematic differences between the overall structure of health helplines and physically co-present primary care consultations. We demonstrate that the delivery of health information and advice via helplines can be challenging, but that service can be enhanced through continued efforts to inform understanding about how medical encounters routinely unfold in over-the-phone environments.

Lopriore S ，LeCouteur A ，Ekberg S ，Ekberg K ... -  《-》

A survey of rheumatology nurse specialists providing telephone helpline advice within England and Wales.

Thwaites C ，Ryan S ，Hassell A 《-》

"How can I help?" Nurse call openings on a cancer helpline and implications for call progressivity.

Helplines are a key service used for information and support by people affected by cancer. Little is known about the process of delivering and seeking cancer related telephone help. Using conversation analysis 52 calls between callers and specialist nurses on a major UK cancer helpline are analysed; focusing on the openings of helpline calls by specialist nurses. The helpline involves a triage system from a frontline call-taker to a specialist nurse. The triage system introduces challenges to the interactions for nurses and callers. This paper demonstrates how calls commence, and outlines implications for how they progress. Four key elements to the nurse's initial opening of the call were identified, which together contribute to managing an effective transition from the frontline call-taker to the current call with the specialist cancer nurse. The smooth exchange of information and provision of support in a trusted call environment is a critical goal of the cancer helpline; an effective call opening in a triage environment may significantly optimise the possibility of this goal being realised. A simple strategy is recommended to avoid the difficulties identified, a script for how the triaged call openings may be optimally formulated.

Leydon GM ，Ekberg K ，Drew P 《-》

Medication-related calls received by a national telenursing triage and advice service in Australia: a retrospective cohort study.

Li L ，Lake R ，Raban MZ ，Byrne M ，Robinson M ，Westbrook J ，Baysari MT ... -  《BMC HEALTH SERVICES RESEARCH》