OBJECTIVES: To examine the perception of telephone advice-line users as to whether or not a formal recommendation had been made to seek another consultation and to compare users' perception to what the nurse documented. 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 among users of Info-Santé CLSC, a free-of-charge telenursing health-line service (THLS) available throughout the province of Quebec.
STUDY DESIGN/DATA COLLECTION: Self-reported advice from follow-up survey phone interviews, conducted within 48-120 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 call, and satisfaction with the nurses' intervention. Association between these variables and inaccurate reports was identified using multinomial logistic regression analyses.
PRINCIPAL FINDINGS: Advice to consult another health resource was recorded by the nurse in 42% of cases, whereas 39% of callers stated they had received such a recommendation. Overall disagreement between the two sources is 27% (12% by false positive and 15% by false negative) and kappa is 0.45. Characteristics such as living alone (adjusted OR = 2.5), calls relating to psychological problems (OR = 2.8), perceived seriousness (OR = -2.6) 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, ensure better understanding of advice by callers, and contribute to more effective service.