Reassuring and managing patients with concerns about swine flu: Qualitative interviews with callers to NHS Direct

G. James Rubin, Richard Amlot, Holly Carter, Shirley Large, Simon Wessely, Lisa Page

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18 Citations (Scopus)


Background. During the early stages of the 2009 swine flu (influenza H1N1) outbreak, the large majority of patients who contacted the health services about the illness did not have it. In the UK, the NHS Direct telephone service was used by many of these patients. We used qualitative interviews to identify the main reasons why people approached NHS Direct with concerns about swine flu and to identify aspects of their contact which were reassuring, using a framework approach. Methods. 33 patients participated in semi-structured interviews. All patients had telephoned NHS Direct between 11 and 14 May with concerns about swine flu and had been assessed as being unlikely to have the illness. Results. Reasons for seeking advice about swine flu included: the presence of unexpectedly severe flu-like symptoms; uncertainties about how one can catch swine flu; concern about giving it to others; pressure from friends or employers; and seeking 'peace of mind.' Most participants found speaking to NHS Direct reassuring or useful. Helpful aspects included: having swine flu ruled out; receiving an alternative explanation for symptoms; clarification on how swine flu is transmitted; and the perceived credibility of NHS Direct. No-one reported anything that had increased their anxiety and only one participant subsequently sought additional advice about swine flu from elsewhere. Conclusions. Future major incidents involving other forms of chemical, biological or radiological hazards may also cause large numbers of unexposed people to seek health advice. Our data suggest that providing telephone triage and information is helpful in such instances, particularly where advice can be given via a trusted, pre-existing service.

Original languageEnglish
Article number451
JournalBMC Public Health
Publication statusPublished - 2010

Bibliographical note

Funding Information:
We are grateful to the NHS Direct staff who initially informed and sought consent from potential participants, to Kate Hardie who assisted with data coding and analysis, and to the participants themselves. Funding for this survey was provided by the National Institute for Health Research, as part of a Career Development research training Fellowship awarded to GJR. RA and HC are supported as full-time employees of the Health Protection Agency. SW is funded by the NIHR Biomedical Research Centre for Mental Health, the South London and Maudsley NHS Foundation Trust, and the Institute of Psychiatry, King’s College London. The funders played no role in the study design, the collection, analysis or interpretation of the data, the writing of the report, or the decision to submit the manuscript for publication. The views expressed in this publication are those of the authors and not necessarily those of their funders or employers.


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