Nurse hotline helps patients follow self-care advice

( Seven of every eight people who sought advice from a telephone helpline staffed by nurses followed the self-care advice they received, ranging from providing treatment at home to calling an ambulance, according to a study in Canada.

Two factors had a significant impact on people’s decision to engage in self-care for themselves or the person for whom they were calling. Callers who were more satisfied with the nurse interaction were nearly four times more likely to engage in self-care than those who were less satisfied, and callers were 11% more likely to engage in self-care if the nurse made them feel confident about doing so.

Callers were also much more likely to engage in self-care if the nurse stressed the importance of following the professional advice they received, and if they agreed with the advice that had been provided.

The authors said the research, led by investigators with the University of Alberta, confirms nurse triage helplines can be a cost-effective method of addressing the self-care needs of individuals who would otherwise visit an ED.

Researchers spoke to 312 people who called the LINK telephone health advice line, which was established in Alberta in 2000 and is a telephone triage service provided by qualified nurses 24 hours a day, seven days a week, said lead author Bev Williams, RN, PhD, associate professor in the Faculty of Nursing at the University of Alberta.

“Nurses use computer-assisted guidelines and their own nursing experience to assess a caller’s health concerns before suggesting the most appropriate type of care,” Williams said in a news release. “Their advice is in accordance with evidence-based treatment protocols that are regularly reviewed in line with the latest medical and nursing literature.

“At the end of the call, the nurse recommends that the patient either engage in self-care at home, pay a routine visit to their practitioner, visit an ED immediately or call an ambulance.”

Methodology and findings

People who had called the service and received advice over a one-year period were chosen using a random number generator, with the final sample reflecting the general pattern of calls during different times of the day. The researchers made contact with the callers, and 312 agreed to take part in 20-minute interviews.

Women made up 92% of the final sample, with 85% of callers younger than 40 and 53% between ages 18 and 29. Two-thirds had attended college, and 85% lived in urban areas.

The most common calls were about colds and the flu (18%), pregnancy/post-pregnancy and diarrhea/vomiting (both 9%) and infections/diseases (8%). Nearly two-thirds of callers were calling for someone else, specifically a child in 94% of such cases.

Those who engaged in self-care had called the service an average of 11.5 times before. The average for those who did not follow the advice was slightly higher, 13.5 times. More than a third (38%) of callers had considered other sources of information before calling, including family and friends (26%), the Internet (22%) and their physician (12%).

Almost all who were surveyed (99%) said the clarity of the nurse’s advice was an important or very important factor in their decision to engage in self-care. Other key factors included how comfortable the nurse was to talk to (93%), how confident they were in the nurse’s advice (92%) and how easy the nurse’s advice was to follow (89%).

The findings were similar for those who did or did not engage in self-care, with two notable exceptions: Callers who engaged in self-care were more likely to rate how strongly the nurse emphasized the importance of following the advice (85% vs. 67%) and how much they agreed with what the nurse advised them to do (82% vs. 74%).

“These findings underline the importance of the caller having a positive experience and feeling reassured about their ability to provide care for themselves or the person they are calling for,” Williams said. “We are now carrying out further research to find out whether people who presented to emergency departments with minor illnesses were aware of the LINK service or had tried self-care before their visit.”