Telephone Support and Telemonitoring for Low-Income Older Adults

Abstract

The objective of the current pilot study was to determine whether nurse-led telephone counseling improves health behavior, self-care, and physiological indices for low-income older adults using a telemonitoring system. The control group (n = 15) was provided with weekly health education only, and the intervention group (n = 20) was given additional telephone support by nurses. At baseline and 8 weeks, data on health and self-care behaviors were collected using a self-reported questionnaire, and blood pressure and fasting blood glucose levels were assessed. Nurse-led telephone support had a medium effect on improving health behavior (Cohen's d = 0.58, 95% confidence interval [CI] [-0.10, 1.27]), reducing systolic blood pressure (Cohen's d = -0.61, 95% CI [-1.29, 0.08]), and improving self-care behavior for hypertension (Cohen's d = 1.16, 95% CI [0.05, 2.27]). Findings support that nurse-led telephone support may be effective for improvements in health behavior, systolic blood pressure, and hypertension self-care in disadvantaged older adults under remote monitoring. Further studies are needed to obtain a powered sample size and investigate the long-term effects of personalized elements surrounding telehealth in community-based settings. [Res Gerontol Nurs. 2018; 11(4):198-206.].

Exploring the role of nurses in after-hours telephone services in regional areas; A scoping review

“…As shown in the data summary table, this included four literature reviews [19][20][21][22], and one Cochrane review [23]. The quantitative studies ranged from randomised controlled trials and interventions [24,25] to, pre and post-test interventions [26][27][28] to cross sectional and longitudinal studies [29][30][31][32][33][34][35][36] to studies that employed surveys and questionnaires [37,38] and analysis of case records [39,40]. There were three mixed method studies [41][42][43] that drew on existing call centre data and interviews, as well as six qualitative studies.…”

“…Supporting the need for a protocol, Derkx et al [35] found that some nurses made decisions about the patient's condition before all the relevant clinical information was gathered, highlighting the need for appropriately prepared nurses and reinforcing that both the use of protocols and the clinical experience of the services provider (usually a registered nurse) are essential elements for phone-based triage/support. The research reported by Jeong et al [25] includes a description of the development of an algorithm developed for the specific needs of their target population.…”

“…Age and generational factors may also influence how consumers engage with telephone triage/support services. Predictably, Jeong et al [25] noted that engagement with older adults depended on their health and digital literacy.…”

“…The type of advice provided can be divided into three categories; health promotion [19,25,31,42,43]; assistance in accessing appropriate services and the related symptom triage [43,48]; or reporting, such as reporting back on out-reach work completed or the outbreak of an infectious disease [23,26,33,34,37,43]. Frequency of contact varied in that the telephone service may supplement home visits [28,38,57] or simply be a one-off call.…”

“…A number of authors support the notion that mobile phones provide a low-cost, flexible tool for health care in rural areas [47] with Jeong et al [25] extending this to older adults. These authors also noted that health literacy was an important aspect in relation to the effectiveness of telephone support, and that in the cases of chronic conditions, regular contact by nurses should be planned to improve outcomes.…”