Death in the Digital Age: A Systematic Review of Information and Communication Technologies in End-of-Life Care

Abstract

Background: End-of-life (EOL) communication plays a critical role in ensuring that patients receive care concordant with their wishes and experience high quality of life. As the baby boomer population ages, scalable models of end-of-life communication will be needed to ensure that patients receive appropriate care. Information and communication technologies (ICTs) may help address the needs of this generation; however, few resources exist to guide the use of ICTs in EOL care.Objective: The primary objective was to identify the ICTs being used in EOL communication. The secondary objective was to compare the effectiveness of different ICTs in EOL communication.Methods: The study was a systematic review, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We systematically searched seven databases for experimental and observational studies on EOL communication between doctors and patients using ICTs, published in 1997–2013.Results: The review identified 38 relevant articles. Eleven types of technology were identified: video, website, telephone, videoconferencing, e-mail, telemonitoring, Internet search, compact disc, fax, PalmPilot, and short message service (SMS) text messaging. ICTs were most commonly used to provide information or education, serve as decision aids, promote advance care planning (ACP), and relieve physical symptom distress.Conclusions: The use of ICTs in EOL care is a small but growing field of research. Additional research is needed to adapt older, analog technologies for use in the digital age. Many of the interventions discussed in this review do not take full advantage of the affordances of mobile, connected health ICTs. The growing evidence base for e-health applications in related fields should guide future interventions in EOL care.

Construção e validação de vídeo educativo para orientação de pais de crianças em cateterismo intermitente limpo

“…In view of this, health education technologies, including educational video, are an attractive form of communication, since audio and video are capable of holding the attention of the viewer. The validation of expert content judges and technicians make these technologies effective and appropriate to the public, and may favor the modification of the health habits of a population, as it correctly informs, bringing it closer to its reality, in order to make it more adapted to the environment in which it is included (26) . Roy's Adaptation model states that the person adapts holistically, interacting with internal and external environments.…”

No Exit: Identifying Avoidable Terminal Oncology Intensive Care Unit Hospitalizations

“…33 These care models will depend on innovation in how ACP is provided. In their recent review of information and communication technologies in end-of-life care, Ostherr et al 34 concluded that scalable new technologies are "sorely needed to improve quality of life at the end-of-life while reducing costs of care." 34(p417) The risk factors associated with potentially avoidable terminal oncology ICU hospitalizations could potentially be used as a starting point to structure a precision algorithm to identify patients with cancer at high risk for avoidable aggressive end-of-life care.…”

Pursuing a Good Death in the Time of COVID-19

“…Depending on prevailing isolation/social distancing policies and resources, the NOK can conduct videoconferencing sessions in the hospital. 3 However, briefing must be done beforehand to prepare the NOK regarding the patient's condition and possibly how they appear visually. Additionally, the meeting must be supported by professional staff, with anticipation of psychoemotional outbursts.…”

“…Alternatively, a call-in option may be considered. 3 Other options include prerecorded messages in the form of letters or audio recordings in conjunction with comfort objects, for example the patient's or NOK's treasured items can serve as a linking object for the patient and NOK. These items can be kept in the casket to signify a continuing bond between the patient and NOK.…”