how me the evidence" is the frequent response of skeptics of patient-oriented research, or of those who are not convinced of the merit of this approach without evidence of its positive impact on research or health outcomes. The advance of patient-oriented research is rooted primarily in moral, ethical and political arguments 1-5 and social trends in health care that are breaking down the barriers between health professionals and patients. 6 The moral argument is that patients have a fundamental right to be engaged in research, or that it is an ethical mandate that leads to better transparency and accountability. 1,7-9 Politically, patient-oriented research introduces democratic ideals so that public funding for research is spent responsibly and serves the public interest, 1,6 leading to the democratization of science and the research process. 3,7,10 Patientoriented research is also based on a social imperative of engaging those who are most affected by health care decisions; such studies aim to build on patients' perspectives, needs and priorities. 9 Patient-oriented research is conducted in collaboration with patients (including their families and informal caregivers), clinicians and decision-makers; focuses on priorities and outcomes that matter to patients; and ultimately aims to integrate research into policy and practice to improve health care outcomes. 11 Most importantly, it extends the role of a patient beyond that of a research subject to engage patients as meaningful and active partners of the research team. This approach is reflective of a global movement away from a traditional and often paternalistic model of health care, toward such models as self-management programs, patient-centred care and participatory action research.
We compared conventional palliative homecare visits and a combination of conventional and home telehealth 'video-visits' with respect to symptom management and quality of life. Participants were recruited from 11 rural communities in Alberta and randomized to the treatment or control groups, remaining in the study for 8 weeks. Although we planned to recruit 200 clients over two years, only 44 clients participated. Factors contributing to low recruitment included the introduction of new service delivery models and changes in the home care environment. No significant differences were found between the groups in measures of symptom management and quality of life. Compared to the home care nurses, clients generally indicated a higher level of readiness to use the technology. The study suggested that videophone technology would probably not be adopted for palliative home care in the population that was studied although it might be considered for other applications in the management of chronic illnesses.
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