Thesis (Ph. D.)--University of Missouri-Columbia, 2002. / Typescript. Vita. Includes bibliographical references (leaves 189-194). Also available on the Internet.

Not available

This research aimed to investigate the socio-demographic characteristics alongside the psycho-social factors that impact on the uptake of telephone based healthcare using a socio-cognitive approach. The first study analysed four ‘one month’ periods of national NHS Direct call data (July 2010, October 2010, January 2011 and April 2011) for all 0845 4647 calls in England. Expected and actual usage of NHS Direct was determined for each ethnic group of the population and compared using Chi-square analysis. Results confirmed that White British used NHS Direct more than expected, alongside Mixed (Caribbean/African) and Asian Pakistani groups, with lower representation found for Asian Indian\Bangladeshi, Black African\Caribbean, alongside Chinese ethnic groups. No gender differences were noted. Calls were then analysed for age, gender and deprivation (IMD health, income, employment & education) using negative binominal regression. Results suggest that deprivation increases call rates for adult calls but reduced in calls about children (<15 years). This study also highlights that NHS Direct call rates (all ages combined) are highest in areas with deprivation levels at, or just above, the national average, which remains consistent when accounting for employment, income and education deprivation. The second study, adopted a qualitative approach to explore the psycho-social factors that impact on the uptake of telephone based healthcare. Focus groups were conducted with low user groups (Manchester (N=3) and Mendip (N=4)), alongside high service users (N=2) and service providers (N=2). Five themes emerged: attitudes, structural and perceived barriers, knowledge and awareness of NHS Direct alongside improving access. Findings highlight a preference for instant face-to-face reassurance in low user groups, whereby low users appear to have lower perceived confidence in self-management of symptoms and engaging with telephone based health services. In conclusion the findings suggest there is variation in usage of NHS Direct, influenced by ethnicity, gender, age and deprivation. This research has explored some of the barriers, and has provided a theoretical framework that can be applied to understand uptake of telephone based healthcare. This research can help enable the development of future promotional campaigns that can target particular sections of the population to encourage use of telephone based healthcare services.

published_or_final_version / abstract / toc / Social Sciences / Master / Master of Philosophy

BACKGROUND: A telephone nurse is a nurse that during most of its working time is engaged in healthcare advice via the telephone. The advent of the telephone healthcare advice has probably meant that individuals, who initially wouldn’t have sought help, if they needed to meet healthcare providers face to face, now actually have the confidence to turn to healthcare. For telephone healthcare advice is professional care to identify, assess and advise on individuals’ reactions to actual or potential health problems. AIM: The aim of this literature review was to illuminate how the nurses´ assessment was affected during giving telephone advice. METHOD: This literature review has a qualitative approach and was conducted through twelve analyzed articles which were from the nurses’ point of view. FINDINGS: Two categories emerged from analyzing the articles. These were ethical dilemmas and assessment tools. The first category deals with the ethical dilemmas the telenurses’ are facing while giving advice via the telephone. The second category present which tools the telephone nurses have available or needs for assessment. DISCUSSION: It seems like the telenurses’ are drawn between the limited accesses to healthcare, the care seekers’ agenda and the demands of how them as nurses’ are expected to act.  CONCLUSION:   Possessing coping strategies related to stress and responsibility are valuable factors for the telenurses’ assessment process. Future research is felt to be needed on the subject of how the nurse deals with stress and the feeling of responsibility. / BAKGRUND: En telefonsjuksköterska är en sjuksköterska som till största del under sitt arbete ägnar sig åt hälso- och sjukvårdsrådgivning via telefon. Framväxten av telefonrådgivning har troligtvis gjort att individer som inte skulle ha sökt vård om de behövt möta vårdgivaren ansikte mot ansikte, nu faktiskt vågar vända sig till sjukvården. När det gäller telefonrådgivning är professionell omvårdnad att identifiera, bedöma och ge råd kring individens aktuella eller potentiella hälsoproblem. SYFTE: Syftet med studien var att belysa vad som påverkar sjuksköterskors bedömning vid telefonrådgivning. METOD: Denna litteraturöversikt har en kvalitativ ansats och bygger på tolv analyserade artiklar som har ett sjuksköterskeperspektiv. RESULTAT: Två kategorier framkom från analysen. Dessa var etiska dilemman och redskap för bedömning. Den första kategorin tar upp de etiska dilemman som telefonsjuksköterskor möter under telefonrådgivning. Den andra kategorin presenterar vilka redskap telefonsjuksköterskor har att tillgå eller behöver för sin bedömning. DISKUSSION: Det verkar som telefonsjuksköterskor dras mellan den limiterade tillgängligheten till hälso- och sjukvård, de vårdsökandes agenda och kraven på hur de i sin sjuksköterskeprofession förväntas agera. KONKLUSION: Stresshantering och känslan av ansvar anses som viktiga faktorer som kan påverka sjuksköterskors bedömning. Framtida forskning önskas om hur telefonsjuksköterskor kan hantera dessa faktorer.

The majority of smokers - regardless of race - wish to quit. Quitting tobacco use is a top national priority to improve the quality of life for all people. There is a wide range of effective tobacco addiction treatment strategies. Telephone counseling services or Tobacco Quit Lines (TQL) is one of the effective smoking cessation aids available to all people in the U.S. free of charge. This is a cross sectional analysis of data from Georgia Tobacco Quit Line (TQL). The study examined the differences in the utilization rates of the Georgia TQL by different smoking population. Analysis revealed that 2.9 per 1000 male smokers in Georgia called the TQL compared to 5.0 per 1000 females. Also, the rate of calling among black was significantly higher than that among white smokers. Television commercials promoting the use of the TQL were successful in reaching the Black smokers.

No description available.

This dissertation addresses the issue of cost subadditivity of two Canadian telecommunications carriers, Bell Canada and Alberta Government Telephones (AGT). Multi-output, multi-input models of the production structure of Bell Canada and AGT are estimated under various alternative hypotheses. Subadditivity tests are conducted for both these companies in order to increase understanding of the issues concerning the deregulation of the Canadian telecommunications network and to assist policy makers in their decisions. / The hypothesis that both Bell Canada and AGT are natural monopolies cannot be rejected. Important cost savings are realized from having each of these firms alone in their respective markets producing the total of toll and local calls. Allowing competition in AGT's market would increase costs by approximately 20%, while costs in Bell Canada's market would increase by twice as much. It is found that Bell Canada's cost savings, though still quite important, are significantly reduced after 1983. Apparently, the high adjustment costs that Bell Canada incurs in installing new capital equipment, its organizational restructuring that followed the liberalization of customer premises equipment in 1982 as well as the recent technological changes may explain this turn-about in Bell Canada's cost structure. / We conclude that the 1985 Canadian Radio-Television and Telecommunications Commission's (CRTC) decision not to deregulate Bell Canada's long distance public voice monopoly market (MTS and WATS) was socially optimal.

Dissertation submitted in compliance with the requirements for the Masters Degree in Technology: Business Administration, 2008. / The aim of the study was to identify causes of churning, to find ways of managing it and to diagnose customers‟ communication needs. Furthermore the research tested the impact of messaging services on customer retention and whether these services could compensate for the declining revenue or become new cash cows for service providers. The units of analyses were young people of ages ranging from 15 to 24. This group was chosen because it was found, during the study, that they used new services more often than any other age group. The initial plan, however, was to interview the entire population of cellphone users. Stratified random sampling was used to randomly select the units of analysis. Interviews were conducted at the homes of respondents, in the streets and at a shopping centre. Causes of customer churning were found to be billing by service providers that confused customers and „better phone deals offered by the competitors‟ resulting in some of the respondents switching providers. Other aspects about which respondents complained and which therefore could cause churning are „poor network quality‟, „confusing pricing structure‟ and „long waiting on customer care line‟. The respondents indicated that their communication needs could be satisfied by services that are easy to use, a helpful customer care agent and being able to retain a number when switching a service provider. Therefore churning could be managed by removing or reducing the causes of it and attracting the customers by meeting their communications needs, which are, improving customer care service and designing services that are easy to use. The research was inconclusive on the messaging services. Of the three new messaging services that were studied, only one was extremely popular, while the other two were hardly used. Instant messaging was the second most used service to voice and SMS and it was also ranked second, in order of importance. The other two messaging services, mobile email and MMS, received low rankings from the respondents. In addition more than a quarter (27%) of the respondents had never used mobile email. The implications of these findings are that service providers should improve their customer care service and design services that are easy to use.

Telefonrådgivning är en vanlig vårdform. I en alltmer medicinskt och tekniskt utvecklad ögonsjukvård efterfrågas ögonsjuksköterskornas omvårdnadskompetens av både patienter, anhöriga och kollegor inom andra delar av sjukvården. Syftet med studien var att undersöka ögonsjuksköterskors upplevelser av att använda sin specifika omvårdnadskunskap vid telefonrådgivning inom ögonsjukvård. Studien genomfördes med en kvalitativ metod och data samlades in genom semistrukturerade intervjuer. Materialet analyserades med kvalitativ innehållsanalys. Resultatet visade att ögonsjuksköterskorna upplevde arbetet som utvecklande och utmanande. De såg sig själva som en lots i vården med en stor rådgivande funktion relaterat till sin specifika kunskap. De beskrev också en del svårigheter med att triagera via telefon. De önskade bättre bedömningsunderlag men var dock trygga med sina bedömningar och någon rädsla för anmälningar till tillsynsmyndighet framkom inte. De uttryckte även ett behov av utbildning inom samtalsmetodik. Ögonsköterskorna saknade tid för kollegiala reflektioner för att utveckla sin professionella hållning i arbetet med telefonrådgivningen / Telephone counseling is a common form of care. In an increasing medical and technical development in ophthalmological care is ophthalmic nurses skills demanded by both patients, relatives and colleagues in other areas of health care. The purpose of this study was to examine the eye nurses experiences of telephone counseling in ophthalmology. The study was conducted using a qualitative approach and data were collected through semi-structured interview. The material was analyzed using qualitative content analysis. The results showed that eye nurses were confident and proud of their professional role. They experienced the work as fun, stimulating and challenging. They saw themselves as a pilot in the care of a large advisory role related to their specific knowledge. They also described some difficulties in triagera by phone. They wanted better assessment documentation but was confident in their assessments and any fear of notifications to the regulator were not revealed. They also expressed a need for training in counseling skills. Ophthalmic nurses lacked the time for collegial reflection to develop their professional attitude in the work of telephone counseling.