Marklund B, Koritz P, Bjorkander E, Bengtsson C
Department of Primary Health Care, Gothenburg University, Sweden.
Br J Gen Pract. 1991 Nov;41(352):462-5.
The telephone consultation service is an important part of Swedish primary health care. However, few studies have compared telephone consultations managed by nurses with surgery consultations managed by both doctors and nurses in terms of information obtained from the patient regarding his or her symptoms, and the management decisions made. In this study, the information obtained from a patient during a telephone consultation with a health centre nurse and the management decisions made, were compared with those obtained at a subsequent surgery consultation with the same nurse, and then with a doctor. Of 200 telephone consultations at a health centre (50 in each of the following four categories as defined by the management decision of the nurse: acute case, semi-acute case, referral case and self-care case), 193 patients were included in the study. The information given to the nurse during the telephone consultation was recorded. The patient was then asked to come for a surgery consultation on the same day, first with the same nurse and then with a general practitioner. A comparison was made between the information obtained and the decisions taken in these three situations. In 185 of the 193 cases (96%) the information led to the same management decision by the nurse, in both the telephone consultation and later in the surgery consultation. In all cases the same history was recorded by the nurse during the telephone and surgery consultations as by the general practitioner. This indicates that in most cases little or no information is missed in a telephone consultation with a nurse as compared with a surgery consultation with a nurse or doctor.(ABSTRACT TRUNCATED AT 250 WORDS)
电话咨询服务是瑞典初级卫生保健的重要组成部分。然而，很少有研究在从患者那里获取的关于其症状的信息以及所做出的管理决策方面，将护士管理的电话咨询与医生和护士共同管理的门诊咨询进行比较。在本研究中，将在与健康中心护士的电话咨询期间从患者那里获得的信息以及所做出的管理决策，与随后在与同一名护士以及之后与一名医生进行的门诊咨询中获得的信息进行了比较。在一个健康中心的200次电话咨询中（根据护士的管理决策分为以下四类，每类50次：急症病例、半急症病例、转诊病例和自我护理病例），193名患者被纳入研究。记录了电话咨询期间患者向护士提供的信息。然后要求患者在同一天前来进行门诊咨询，首先是同一名护士，然后是一名全科医生。对这三种情况下获得的信息和做出的决策进行了比较。在193例中的185例（96%）中，无论是在电话咨询还是后来的门诊咨询中，护士根据信息做出了相同的管理决策。在所有病例中，护士在电话咨询和门诊咨询期间记录的病史与全科医生记录的相同。这表明，与和护士或医生进行的门诊咨询相比，在与护士的电话咨询中，大多数情况下很少或没有信息遗漏。（摘要截选至250词）
