Patients’ experiences of eHealth in palliative care: an integrative review.

Abstract

Background: With a growing world population, a longer life expectancy, and more deaths due to chronic diseases, the need for palliative care is increasing. E-Health involves the use of information and communication technology to provide care, and also to transmit health information through the Internet and related technologies. E-Health can be an effective way of supporting communication between patient and healthcare providers, but it is unclear to how patients regard information and communication technology (ICT) within palliative careMethods: The aim of this study was to describe patients’ experiences of eHealth in palliative care. An integrative review with a systematic literature search of six databases: Cinahl Complete; MEDLINE with Full Text; PubMed; Psychology and Behavioral Sciences Collection; Nursing and Allied Health; and PsycINFO generated 12 scientific articles. The articles were evaluated, data extracted, analyzed and synthesized, according to the aim.Results: The results are presented in the main theme: E-health applications – promoting communication on patients’ and families’ terms, and three sub- themes: usability and feasibility of eHealth applications; symptom control and individualized care promoted through eHealth applications; and use of eHealth applications increased sense of security and patient safety. Patients described ease of use, usability and feasibility of eHealth applications. Equal and individualized care, security, better symptom management, participation through increased accessibility and increased patient safety were described.Conclusions: E-Health applications promoted equal, individualized care, and may be a tool to promote accessibility and patient participation in palliative care settings. Furthermore, care transparency increased with eHealth communication when patients and families received more information, and experiences were that patient safety and feelings of security also were promoted. At organizational and societal levels, eHealth may contribute to sustainable development and more efficient use of resources in palliative care.

Virtual models of care for people with palliative care needs living in their own home: A systematic meta-review and narrative synthesis

“…The majority ( n = 10) of reviews had a low for risk of bias score, 26,28–30,33,35,58–61 while the highest risk of bias was noted in a recent review. 62 The risk of bias in the remaining reviews was unclear ( n = 4) 31,32,34,63 (Refer Table 3).…”

“…Most reviewers (n = 10) concluded there was insufficient evidence to support the use of integrating digital health technology into existing models of palliative care. [26][27][28][29][30][31][32][33][34][35] The paucity of intervention details was highlighted as a major limitation in many reviews, making it difficult to determine which elements of many virtual care interventions were effective. 27,29,32,34 The overall level of evidence was low.…”

“…Mixed evidence emerged from the nine reviews reporting on the effectiveness of scheduled telephone consultations. 26,31,[33][34][35]58,61,63 Telephone consultations were used for counselling, 34,61 delivery of nursing support, 31,34,60 education 60 and multidisciplinary team communication. 60 Seven Phase III RCTs (Level 1b evidence) [36][37][38][39][40][41][42]44,64,65 tested scheduled telephone consultations and generated mixed results.…”

“…Eight reviews reported on RPM as part of a virtual model of palliative care. 26,[29][30][31]33,35,60,63 These RPM interventions included the monitoring of biometric data (i.e. heart rate, blood pressure, respiration rate) or symptoms such as pain, either actively by nurses or through generated alerts to clinicians when patient scores reported outside of a predetermined acceptable threshold, 35,60 both within hours and after-hours.…”

“…The majority (n = 10) of reviews had a low for risk of bias score, 26,[28][29][30]33,35,[58][59][60][61] while the highest risk of bias was…”