Telephone Consultation Service Research Articles

Social movements to ban asbestos in Japan: influence of trade unions and the late development of grassroots mobilization

ABSTRACT This article explores the social movements in Japan that aimed to ban asbestos and help those afflicted with asbestos-related diseases (ARDs) and their families. Trade unions representing dock and construction workers, whose members were occupationally exposed to asbestos, played significant roles in the early stages of the anti-asbestos movement, from the mid-1970s to the mid-1980s. These unions were crucial members of the first national anti-asbestos organization, the Ban Asbestos Network Japan (BANJAN), founded in 1987. Initially, BANJAN focused on policy and legislative efforts to ban asbestos. Later, in collaboration with regional occupational safety and health (OSH) centers, BANJAN strove to identify ARD victims across different areas using telephone hotlines and consultation services. They also facilitated meetings for the ARD victims and their families, which led to the formation of the ARD victims’ organization. Thus, grassroots activities organized by ARD victims and their families emerged later, with the first national ARD victims’ organization being established in 2004. This article shows that the grassroots social movement led by ARD victims and their families in Japan depended largely on the resources mobilized by trade unions and related organizations.

Perspectives of Physicians in Taipei on the Home Healthcare Programs

<p>目的：高齡社會時代的來臨，居家醫療照護服務需求增加，然而目前醫師參與居家醫療照護比例仍偏低，因此本研究希望能透過問卷調查，協助瞭解台北市醫師對於推動居家照護相關計畫的實務運作與障礙。</p> <p>方法：本研究為無記名結構式問卷調查，於2022年8月至2022年10月之間進行，針對執業登記會籍為臺北市醫師之意見調查，內容包括：基本資料、參加居家醫療照護整合計畫與居家失能個案家庭醫師照護方案現況與障礙誘因等，問卷經專家效度檢視修正後以電子式表單請醫師回答。針對醫師參與居家照護相關計畫（居家醫療照護整合計畫、居家失能個案家庭醫師照護方案）進行單變量分析與多元邏輯斯迴歸分析。</p> <p>結果：本研究共計回收410份，發現到門診數較少的醫師，較願意參與居家醫療照護整合計畫，女性醫師較願意參與居家失能個案家庭醫師照護方案；而越瞭解計畫/方案內容的醫師，越願意參與居家醫療照護整合計畫、居家失能個案家庭醫師照護方案。醫師對於推動居家醫療照護整合計畫之障礙前三名依序為提供24小時電話諮詢服務有困難(76%)、往返案家交通耗時(75%)、給付不足(74%)；而居家失能個案家庭醫師照護方案前三名影響的因素為往返案家交通耗時(71%)、給付不足(69%)、個管師人力不易安排(69%)。</p> <p>結論：對台北市醫師參與居家醫療照護整合計畫、居家失能個案家庭醫師照護方案之政策建議，包括給付需考量向上調整並納入交通成本與提供24小時緊急電話諮詢服務，以及建立更有效率之個案媒合溝通機制。</p> <p> </p><p>Purpose: With the advent of an aging society, the demand for home medical care services in Taiwan has increased. However, the current participation rate of physicians in home medical care remains low. The study accordingly conducted a questionnaire survey to help understand the operational challenges and barriers facing physicians in Taipei regarding the promotion of home healthcare programs. </p> <p> Methods: This study as an anonymous structured questionnaire survey was conducted between August 2022 and October 2022 to solicit the opinions of physicians registered for practice in Taipei City. The questionnaire covers basic information, participation in home medical care integration programs, the current status, and challenges and incentives of home care for disabled cases by family physicians. After expert validity review and revisions, the questionnaire was administered to physicians through in an electronic form. Univariate and linear regression analyses were performed on the results obtained from physicians participating in home healthcare programs (home medical care integration program, home care for disabled cases by family doctors). </p> <p> Results: According to the 410 responses collected, physicians with less clinic sessions are more willing to participate in home medical care integration programs, and female physicians tend to be more willing to participate in home care for disabled cases by family physicians. Physicians equipped with a better understanding of the programs are also more willing to participate. The top three obstacles for physicians to promote home medical care integration programs were respectively difficulty in providing 24-hour telephone consultation services, time-consuming transportation, and insufficient reimbursement. For home care for disabled cases by family physicians, the top three challenges were time-consuming travel to patients at home, insufficient reimbursement, and difficulty in arranging case managers. </p> <p>Conclusion: To promote the participation of Taipei physicians in home medical care integration program and home care for disabled cases by family physicians, the study recommends the following three measures: increasing the reimbursement considering transportation costs, providing 24-hour emergency telephone consultation services, and establishing a more efficient communication mechanism for case matching.</p> <p> </p>

Perspectives on telehealth implementation in Australia: An exploratory qualitative study with practice managers and general practitioners

BackgroundThere is a lack of understanding regarding the impact of telehealth on clinical delivery and the feasibility of sustained implementation by health services. The COVID-19 pandemic provided an ideal opportunity to identify factors related to the implementation of telehealth. This study assessed factors that influenced telehealth implementation during COVID-19 in the Western region of Victoria, Australia, from the perspectives of practice managers and general practitioners (GPs). MethodsEmploying a qualitative approach, we conducted semi-structured interviews with 14 GPs and 11 practice managers across metropolitan and rural settings in the Western region of Victoria, Australia. Interviews were conducted between December 2021 to June 2022, which included periods during and beyond the peak of the COVID-19 pandemic. Themes were synthesised using the Consolidated Framework for Implementation Research, which comprised five domains: innovation, inner setting, outer setting, individuals and implementation process. An additional domain related to billing and finances was added. ResultsThe innovation domain revealed that telehealth was identified by both stakeholder groups as a critical tool for improving healthcare access for vulnerable patients. GPs highlighted the role of telehealth in follow-up care and the need for extended telephone consultation services. For the implementation process, both stakeholder groups identified a shift in attitudes among GPs from reluctance to acceptance of telehealth. In terms of outer setting, constant changes in regulations posed challenges to administrative staff. Practice managers faced difficulties in acquiring information on changes, but those with robust professional networks were well supported. Initial loss of incentive funding and government-imposed billing methods posed hurdles for clinics. Both stakeholder groups highlighted the need for education around videoconference and a standardised telehealth platform. ConclusionEvolving telehealth regulations during the emergence of COVID-19 posed financial, operational and administrative challenges to primary care clinics. To ensure sustainability, policymakers should improve stakeholder communication, set interoperability standards, and ensure sustainable funding for telehealth.

시각장애인의 TV홈쇼핑 사용 환경에 관한 연구

Due to the importance of corporate social responsibility and sustainable management, ESG (Environmental, Social, and Governance) management is becoming an essential condition for modern companies. In order to find out how the TV home shopping industry is responding to this social consensus, this study identified the current situation of the TV home shopping experience of the visually impaired. As a research method, this study examined the problems pointed out in previous studies and related media articles on the use of home shopping by the visually impaired, and conducted interviews with officials from seven domestic TV home shopping companies and 10 data home shopping companies to find out how the industry is responding to these problems. Through these interviews, we identified what improvements are needed for TV home shopping platforms that rely on visual elements as the main way to deliver information. Specifically, we found that the use of voice recognition technology, screen reader compatibility, in-broadcast service voice descriptions, expansion of telephone consultation services, and provision of information through alternative text and screen readers should be strengthened. In addition, physical factors such as customized TVs and Relumino assistive devices should be introduced, and real-time communication platforms such as live commerce should be expanded to enhance user engagement. The findings of this study can be utilized as ideas for rethinking the accessibility of TV home shopping experiences for the visually impaired as well as digital services in general.

Fukushima Outpatient Pharmacotherapy Model for Breast Cancer.

The Fukushima Model of Outpatient Pharmacotherapy for Breast Cancer was developed to improve the pharmacological treatment of patients with breast cancer in the vast region of Fukushima Prefecture. This model addresses the challenges posed by the area's lower-than-average density of breast cancer specialists. In the core medical institutions of the prefecture's most populous municipalities, we introduced a telephone consultation service managed by pharmacists at local dispensing pharmacies. The novelty of the Fukushima model lies in two distinct elements: a structured checklist-style tracking report and comprehensive patient information sheets. This innovative tool streamlines a range of processes, including patient self-assessment of symptomatology associated with treatment-related side effects, subsequent medical interventions, and a standardized protocol for reporting severe side effects to healthcare practitioners. This approach facilitates the safe administration of breast cancer pharmacotherapy in home settings. In the future, this model could be used beyond Japan to underserved regions globally, thereby increasing the standard of breast cancer care on a wider scale.

R3 (Resident Advocacy Project) Evaluation of a Novel COVID-19 Vaccine Consult Service

Abstract Rationale and Objectives Strengthening confidence in COVID-19 vaccination in the paediatric population promotes more children getting vaccinated, leading to fewer COVID-19 illnesses, hospitalizations and deaths. Paediatric providers play an important role in promoting dialogue on the risks and benefits of the COVID-19 vaccines for children. Caregivers who experience hesitancy toward the vaccines may lack access to quality medical information. Developed to close this gap, the SickKids COVID-19 Vaccine Consult Service (VCS) is a nurse-led, telephone consultation service for residents of Ontario with questions/concerns about COVID-19 vaccination for children. The VCS aims to address vaccine hesitancy and enhance vaccine uptake, and ensures that children and caregivers have equitable access to timely and reliable information regarding COVID-19 vaccines in a safe and judgement-free environment. The VCS has escalation pathways in place should further discussion with a physician be required. Appointments can be booked without a referral and discussions are held by telephone. The VCS supports families whose children require specialized accommodation for vaccination with appointments at SickKids and throughout Ontario. Project Description A retrospective review of telephone consults received by the VCS between October 1, 2021- April 1, 2022 was undertaken to evaluate the service utilizing descriptive methodology. Information was extracted from databases stored in RedCap/EPIC and was maintained by staff conducting the calls. Inductive Thematic Analysis was utilized to analyze qualitative data and codes were generated to inform themes. Feedback formation was collected via exit surveys and included details about who was calling, reasons for calling, if concerns had been addressed, and intention to vaccinate. Outcomes Parents were the majority of callers (96%) and 4% were patients themselves, grandparents or other. A total of 99% of the calls included general questions about the vaccine, 36% of calls were questions about children with underlying medical conditions (cardiac conditions being the most common), and 12% were allergy-related questions. 9% of calls required a consult with MD/NP. 83% of questions/concerns were resolved following the call. Further, the majority of those surveyed following the appointment expressed intent for vaccination. Safety and development, side effects, and doses/intervals were the most common reason callers described hesitancy with proceeding with vaccination. Discussion/Future Directions Providing caregivers with timely and reliable information regarding COVID-19 vaccines through the VCS has proven to be effective in reducing vaccine hesitancy and increasing vaccine uptake in the paediatric community. In the future, the VCS model can be utilized to provide education to caregivers on other routine childhood vaccines.

The effect of nurse-led diabetes self-management programmes on glycosylated haemoglobin levels in individuals with type 2 diabetes: A systematic review.

This review aimed to examine the content, frequency, duration, and outcomes of nurse-led diabetes self-management programmes on glycosylated haemoglobin levels in individuals with type 2 diabetes. Diabetes self-management programmes improve glycemic control in individuals with type 2 diabetes to acquire specific behavioural changes and develop effective problem-solving skills. A systematic review was used in this study. PubMed, Science Direct, Cochrane Library, Web of Science, Ovid, CINAHL, Proquest and Scopus databases were searched for studies published in English until February 2022. The risk of bias was assessed using the Cochrane Collaboration tool. This study followed the recommendations of the Cochrane 2022 guidelines and was reported using the Preferred Reporting Items for Systematic Reviews and Meta-analysis. Eight studies with 1747 participants met the inclusion criteria. Interventions included telephone coaching, consultation services and individual and group education. The duration of the intervention ranged from 3 to 15 months. The results showed that nurse-led diabetes self-management programmes had positive and clinically significant effects on glycosylated haemoglobin levels in individuals with type 2 diabetes. These findings highlight the important role of nurses in improving self-management and achieving glycemic control in individuals with type 2 diabetes. The positive outcomes of this review offer suggestions for health care professionals to develop effective self-management programnmes in type 2 diabetes treatment and care.

Collaborative Care Model Gaining Traction in North Carolina

Collaborative Care Model Gaining Traction in North Carolina

A Survey on Patient and Clinician Satisfaction With a Rapidly Implemented Telephone Consultation Service During the COVID-19 Pandemic.

Aim: The novel coronavirus pandemic presented unique challenges to healthcare organisations on an unprecedented scale. Due to the cessation of routine care, the Humberside Oral and Maxillofacial Surgery department implemented a telephone review service to maintain access to care. This survey study was conducted to gain feedback from patients and staff regarding the recently implemented remote telephone consultation service within the Humberside Oral and Maxillofacial Surgery unit.Methods: A paper questionnaire comprising 16 questions was posted to 199 patients who underwent telephone review. A further questionnaire was sent via SurveyMonkey (Momentive Inc., San Mateo) to the clinicians involved.Results: From 199 patients, 93 surveys returned were suitable for inclusion; 7 out of 12 staff replied to the survey. The results showed a high level of satisfaction with the service from both groups. There were also suggestions for future additions to the service, including use for new patient consultations, addition of webcam facilities and further streamlining of suitable cases for remote consultation.Conclusion: Our study demonstrated high patient and staff satisfaction with telephone consultations. It showed that over one third (37%) of patients were able to be discharged via telephone consultation, helping to maintain access, free up clinical resources and reduce the need for face-to-face clinical attendance, which has been vital throughout the coronavirus disease 2019 (COVID-19) pandemic. We now have suggestions for how this service can be implemented in the longer term within our department, including developing clearer guidelines for inclusion in the service and the possible benefit of video consultation.

Nurse-led telephone follow-up for early palliative care patients with advanced cancer.

To present our experience of a nursing telephone consultation service, describing patient and caregiver requests, and outlining ensuing nursing or medical interventions. Recently, there has been an increase in the use of telephone consultation for cancer patients. However, there is still limited data on the characteristics of this type of service and on the nature of the interventions carried out. In this observational retrospective study, we evaluated the phone calls made over a 6-month period by patients or caregivers to the early palliative care team of a cancer institute. Information regarding telephone calls (frequency, reason and management) was systematically collected by a nursing case manager. The study complies with the STROBE checklist File S1. 171 patients used the service, for a total of 323 phone calls. The majority (80.8%) were from patients followed at the outpatient clinic and the most common requests were for pain management (38.4%) and for updates on the clinical situation (23.8%). Other frequent requests were for medication management (18.9%) and scheduling (18.3%). 210 of the 323 phone calls were handled by the nurse, while 22 were managed in collaboration with a physician. An 87.6% effectiveness in telephone management was observed. The overall use of the phone service was higher for early palliative care patients. The majority of phone calls were effectively handled by the nursing case manager. An effective and feasible nurse-led telephone follow-up of early palliative care patients with advanced cancer could improve their care experience. Specifically, it could impact on patients and families improving quality of life and symptom control securing access to timely care without travel or additional cost.It can also improve continuity of care, adherence to oncological treatments and minimise acute care visits.

Exploring the Taiwanese Anticipatory Experience of Grief Among Primary Caregivers in Palliative Home Care.

Aims and Objectives: The goal of the present study was to explore anticipatory grief experiences among primary caregivers in home-based palliative care. We placed a special emphasis on coping methods adopted by individuals from Eastern cultures when facing death. Background: Most patients prefer spending their last days at home, which often exerts considerable physical and mental stress on their primary caregivers. Design: This study adopted a qualitative exploratory research design and used open-ended in-depth interviews to explore anticipatory grief experiences among primary caregivers of patients receiving palliative home care. Methods: In the study of the factors that Anticipatory Experience of Grief among Primary Caregivers in Palliative Home Care, we used the phenomenological approach and methods to glean answers. Posters and snowball sampling were used to individually recruit participants. In total, 16 primary hospice home caregivers participated. We used semi-structured interviews to collect data. The interviews were audio-recorded in a quiet location. Each interview was divided into two to three sessions, and each session lasted 60-90minutes. For data analysis, field notes and audio recordings are transcribed into protocols. A thematic analysis method was used to analyze the context of the interviews. Sampling and analysis processes were repeated until theoretical saturation was achieved. Results: Four major themes emerged from the categorized interview data: meaning and manifestation as to the essence of life, the art of coping with death, realization and the gift of death, and adapting, coping with, and controlling emotions. Additionally, we observed, as with many Eastern cultures, a lunar calendar death in July and crying at the death of a relative is considered taboo. Conclusions: The coping methods adopted by individuals in Eastern cultures when facing death were summarized accordingly. These findings could serve as a reference to better understand the coping mechanisms these individuals use to address anticipatory grief when facing a family member's impending death. Relevance to Clinical Practice: Potential relevance for the present findings include acceptance of Eastern cultural grief customs, early hospice and palliative care interventions for helping individuals adjust to their grief, case management and resource consolidation, providing 24-hour telephone consultation services, regular assessment visits, and developing localized teaching materials for life-and-death education.

Telephone assessment of new breast clinic referrals: Reviewing its clinical effectiveness

Introduction: The COVID-19 pandemic has accelerated the use of telemedicine. Since March 2020, our breast unit has offered telephone consultation to new breast clinic referrals, following careful breast clinic triage. This study aimed to review the clinical effectiveness and safety of our telephone consultation service.

Satisfaction of primary care physicians towards initiation of phone consultations during the COVID-19 pandemic management in Qatar: a cross-sectional study

ObjectivesTo assess primary care physicians’ satisfaction towards initiation of phone consultation during COVID-19 pandemic management in Qatar and to identify the factors associated with dis/satisfaction.DesignA cross-sectional web-based survey was conducted from 1 June to 30 July 2020.SettingAll the available 27 public primary healthcare centers in Qatar at the time of the study.ParticipantsTwo hundred ninety-four primary care physicians working in the publicly run primary healthcare corporation in Qatar.Primary outcome measuresOverall satisfaction of primary care physicians with the initiation of phone consultation during the COVID-19 pandemic in Qatar and their satisfaction towards each aspect of this management.ResultsTwo hundred thirty-nine primary care physicians participated in the survey with a response rate of 53.1%. Overall, about 45% and 21% of respondents agreed that COVID-19 disease management has highly impacted and very highly impacted their daily practice, respectively. More than half of the physicians (59.9%) indicated being satisfied/highly satisfied with the initiation of telephone consultation service. On the other hand, few physicians were satisfied (14.3%) or highly satisfied (3.4%) with conducting telephone consultations with patients who lack previous electronic medical records. Also, only 20.3% and 3.8% of physicians were satisfied and highly satisfied with the lack of physical examination in telephone consultations, respectively. On bivariate analysis, primary care physicians’ age was significantly associated with the perceived level of impact of COVID-19 management on daily practice (P = 0.03). There was no significant association between participants’ characteristics and the level of satisfaction toward telephone consultations. On the other hand, there was a statistically significant association between physicians’ age (p = 0.048) and gender (p = 0.014) and their level of satisfaction toward communication and support.

THE RELATIONSHIP BETWEEN CORONAVIRUS FEAR AND ANXIETY IN PREGNANT WOMEN DURING COVID-19 OUTBREAK

The aim of this research is to determine the relationship between coronavirus (COVID-19) fears and anxiety levels of pregnant women. The research was conducted in descriptive and cross-sectional design with 461 pregnant women between 15.10.2020-15.11.2020. Data were collected using personal information form, COVID-19 Fear Scale, and Beck Anxiety Scale. There was no statistically significant difference between the women's occupation, number of pregnancies, family structure, and income status, and the total mean scores of COVID-19 fear (p>0.05). While the coronavirus fear average score of pregnant women (21.29±6.08) was above the medium level, it was found to be at a moderate level for anxiety (15.85±9.80). It was determined that there was a significant positive difference between the COVID-19 fear and anxiety in pregnant women (r=.399, p<0.01). It can be recommended to provide telephone consultation service to pregnant women during the pandemic to reduce their fear and anxiety levels and inform them using mass communication methods.

The Relationship between Spiritual Well-Being and Fear of COVID-19 in Individuals with Chronic Disease during COVID-19 Outbreak

The aim of this research is to determine the relationship between the spiritual well-being levels of individuals with chronic diseases and their fear levels of COVID-19 during the COVID-19 pandemic. The study was designed and conducted as cross-sectional and correlational research. The research was conducted with 323 individuals with chronic diseases living in Iğdır city located in the Eastern Anatolia Region of Turkey between the dates 05th of June of 22nd of June of 2020. Data were collected using a personal information form, Spiritual Well-Being Scale (FACIT-Sp), and Coronavirus Fear Scale (C19P-S). Mean, percentile distributions, and Pearson Correlation Analysis were used to analyze the data. It was determined that total score average of the participants on the FACIT-Sp was 28.94±5.61, and it was 59.43±16.71 for the C19P-S. It was determined that individuals’ spiritual well-being and fear of COVID-19 mean scores were moderate, while meaning, peace, and faith sub-dimension domains were above the moderate level. In addition, it was indicated that the psychological and social fear levels of were above the average, and their somatic and economic fear levels were below the average. A negative significant relationship was found between the levels of meaning, faith and peace in the spirituality sub-dimensions of individuals with chronic diseases and the fear of coronavirus. It was observed that as individuals’ spirituality increased, their fear of coronavirus decreased. It was recommended to provide telephone consultation service to individuals with chronic diseases during the pandemic to reduce their fear levels and inform them using mass communication methods.

Telephone and Video Consultations within Qatar's Primary Health Care Corporation

Background: The COVID-19 pandemic changed the way we deliver primary health care services for good. The need to protect staff and patients from the spread of infection while still providing essential healthcare services to the public was challenging but ignited innovations to facilitate healthcare delivery. International research supports the action of containing the spread of a virus by limiting the number of people co-located, if possible1. The implementation of telephone and video consultations started in March 2020 in Qatar, within 4 weeks of COVID-19 being detected in the community, to support patient safety and provide primary health care services. Methods: Qatar's Primary Health Care Corporation (PHCC) implemented telephone consultations at 27 health care centers across general and specialty services to meet patients’ demands. Video consultations swiftly followed within an inbound community call center and 10 health care centers for general medicine, dental, and ophthalmology services. The latter then expanded to include, dermatology, and physiotherapy services. Results: Patients quickly adapted to attending telephone consultations as they understood the safety aspects of staying home unless a face-to-face consultation was absolutely necessary. The implementation of telephone and video consultations within PHCC has been successful as over 1,000,000 telephone consultations and more than 2,000 video consultations have been completed in one year. At the climax of the pandemic (around June 2020) approximately 50% of consultations were held virtually (Table 1: Telephone consultations versus in-person visits from April to July 2020). Conclusion: The implementation of telephone and video consultation services within PHCC, imposed by the pandemic, changed the way to connect and deliver services to patients. As the pandemic continues, this offers an alternative to face-to-face visits and is widely accepted by the public as a model of care delivery. The use of telephone and video consultations are widely implemented across the globe and both patients and clinicians have adapted well to such new ways of working2,3.

GP perceptions of telehealth services in Australia: a qualitative study.

BackgroundPrimary care providers have been rapidly transitioning from in-person to telehealth care during the 2019 coronavirus (COVID-19) pandemic. There is an opportunity for new research in a rapidly evolving area, where evidence for telehealth services in primary care in the Australian setting remains limited.AimTo explore general practitioner (GP) perceptions on providing telehealth (telephone and video consultation) services in primary care in Australia.Design & settingA qualitative study using semi-structured interviews to gain an understanding of GP perceptions on telehealth use in Australia.MethodGPs across Australia were purposively sampled. Semi-structured interviews were conducted, recorded, and transcribed verbatim for analysis. Transcripts were analysed using inductive thematic analysis to identify initial codes, which were then organised into themes.ResultsFourteen GPs were interviewed. Two major themes that described GP perceptions of telehealth were: (1) existence of business and financial pressures in general practice; and (2) providing quality of care in Australia. These two themes interacted with four minor themes: (3) consumer-led care; (4) COVID-19 as a driver for telehealth reimbursement and adoption; (5) refining logistical processes; and (6) GP experiences shape telehealth use.ConclusionThis study found that multiple considerations influenced GP choice of in-person, videoconference, or telephone consultation mode. For telehealth to be used routinely within primary care settings, evidence that supports the delivery of higher quality care to patients through telehealth and sustainable funding models will be required.

Content Analysis of the Free COVID-19 Telephone Consultations Available during the First Wave of the Pandemic in Japan.

This cross-sectional study aimed to (1) describe the unclassified contents of telephone consultation services provided by a public health center during the first wave of COVID-19 in Japan and (2) examine whether the contents required assistance from public health nurses (PHNs). We analyzed a total of 207 calls in which the purpose of the call was unclassified into pre-set categories. PHNs transcribed the exact text of the consultation conversations recorded from 25 March to 20 April 2020 in City A. Approximately half of the calls were from residents. Seven categories were extracted through a qualitative content analysis. The most common topic was infection control measures, where the presence of COVID-19 infection was assumed (n = 62); the second most common was extreme anxiety and fear of infection (n = 50). Questions about the COVID-19 response system (n = 30), discrimination and misunderstandings about COVID-19 (n = 24), and response measures for COVID-19 outbreaks within organizations (n = 18) were also included. The unclassified consultations included various topics, several of which required the expertise of a PHN. Each local government should consider sharing and task-shifting telephone consultation services among PHNs and other staff to reduce their burden and allow them to concentrate on conducting infection control more effectively.

Telephone consultation service in orthopedics during COVID-19 pandemic

Background and aimThe current COVID-19 pandemic scenario has driven surgical departments to a transformation.The worldwide spread of the disease has led to a public health quarantine where health care professionals are at high risk of infection. In this context, telemedicine has been promoted and scaled up to reduce the risk of transmission. This study aims to demonstrate that a combined framework based on telematics and in-person clinical encounter not only ensures medical care but the safety of healthcare professionals and patients. Material and methodDescriptive observational study on the follow-up of patients during the COVID19 Pandemic, combining telephone and traditional. ResultsA total of 5031 telephone calls were made, differentiating between medical referrals, specialised primary care visits, and outpatient consultation.They were classified as successful, required an in-person visit, or no successful telephone contact. Furthermore, we divided them into 2 groups: resolved and unresolved.53% of all telematic visits were successful. ConclusionsTelematic medical systems are a feasible option in a orthopedics department and an interesting resource to preserve once the pandemic is resolved. Future lines of research should be opened to improve system success, analyze its cost-effectiveness ratio, and correct any legal conflicts that may exist.

How doctors take initiatives in online healthcare communities

PurposeIn China, healthcare services have historically been expensive and difficult to access, with resources being unfairly distributed, often being centralized in large hospitals in major cities. In rural regions, hospitals often suffer from limited supplies, including human capital and equipment. E-health technologies have received significant attention from governments and citizens, with online healthcare communities (OHCs) providing easier communication between patients and doctors. Although doctors play a pivotal role in the success of OHCs, they are often unsure how to attract patients, with limited research focusing on this. The purpose of this paper is to explore how doctors can take initiatives in OHCs, from the joint perspectives of individual effort (i.e. intrapersonal factor) and identity in medical teams (MTs) (i.e. interpersonal factor), based on attribution theory.Design/methodology/approachHierarchical linear regression was conducted on data from 3,170 doctors participating in 865 online MTs, to examine the effects of individual effort and identity in MTs on individual performance. Individual effort included central effort (log-in frequency to OHC) and peripheral effort (articles published on doctors' homepages). Identity in MTs was represented as the identity of team leader and multiple team membership (MTM).FindingsThis study found that the main variables – central and peripheral effort, and leader and MTM identity – all had significant and positive impacts on the service quantity (SQ) of both written and telephone consultations. Although positive effects could be experienced in most conditions that were congruent with the logic of identity theory, the interaction terms demonstrated complex influences. Specifically, leader identity did not moderate the effect of article effort in written consultation, while MTM identity could not moderate the relationship between frequency effort and SQ in telephone-consultation services. Further, the leader identity negatively moderated the relationship between article effort and SQ in telephone consultations. Thus, for doctors with the leader identity, the impact of article effort on SQ was weaker. In summary, both aspects were proved to play important roles in individual SQ.Practical implicationsThis study provides empirical findings through focusing on the SQ of both written and telephone consultations in OHCs, thereby enabling healthcare providers to take initiatives and ultimately improve the efficiency and provision of delivered healthcare services. It is worth mentioning that doctors possessing the identity of team leader should be cautious that the more articles published by them may not lead to envisaged telephone-consultation performance, according to the negative moderating effect of leader identity on the relationship between article effort and SQ during telephone consultations.Originality/valueThis study contributes to the OHC literature by investigating how doctors' efforts and identity in OHCs affect individual performance, based on attribution theory and identity theory. Further, we provide healthcare practitioners with an improved understanding of these dimensions to improve autonomy regarding service provision in OHCs.