Rapid Conversion of a Palliative Care Outpatient Clinic to Telehealth

Lally, Kate; Kematick, Benjamin; Gorman, Daniel; Tulsky, James A.

doi:10.1200/op.20.00557

Cited by 52 publications

(55 citation statements)

References 5 publications

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“…The rapid integration of telemedicine into palliative care during the Covid-19 pandemic provides further insight into the use of telemedicine in palliative care and anticipates the important role of telemedicine in post-pandemic palliative care [ 24 , 37 , 38 ]. Therefore, it is worthwhile considering palliative patients’ and relatives’ preferences and concerns in relation to the use of telemedicine in palliative care.…”

Section: Discussionmentioning

confidence: 99%

Patients’ and Relatives’ Preferences for a Palliative/Oncology Day Ward and Out-of-Hours Telemedicine—An Interpretive Description

et al. 2021

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Demographical challenges require adaptation and tailoring of services to suit palliative patients’ and relatives’ needs. Therefore, an interpretive descriptive study was performed to explore patients’ and relatives’ preferences for the establishment of a day ward and out-of-hours telemedicine. Semi-structured interviews were performed, and data were analysed using thematic analysis. Participants included patients (n = 12) and relatives (n = 5). Three themes emerged: (1) ‘Transport burden’ relates to transition from home-to-hospital-to-home and acknowledges the strain placed on patients and relatives. (2) ‘Role of relatives’ contemplates how the role of families in patient care influences patient preferences. (3) ‘Telemedicine—preferences and concerns’ covers preferences and concerns related to telemedicine in palliative care. The burden of transport and living alone play substantial roles in preferences for place of treatment. Relatives of palliative patients who avail of a day ward and telemedicine may experience an increase in the burden of care. Recognition of concerns pertinent to palliative patients and relatives is an important step in planning new services in palliative care. Concerns may be mitigated by rethinking referral guidelines, incorporating voluntary services, early integration of telemedicine into palliative care and examining patients and relatives’ expectations to care, but requires further research.

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Section: Discussionmentioning

confidence: 99%

Patients’ and Relatives’ Preferences for a Palliative/Oncology Day Ward and Out-of-Hours Telemedicine—An Interpretive Description

et al. 2021

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“…The growth of palliative telemedicine, which has been bolstered by the COVID-19 pandemic, might further improve access to these services while decreasing logistical burdens on patients and providers. For example, COVID-19 necessitated an expedient transition to telehealth palliative care at a major US cancer centre and showed an increase in goals of care discussions 82 .…”

Section: Delivery Of Palliative Carementioning

confidence: 99%

Incorporating palliative care principles to improve patient care and quality of life in urologic oncology

et al. 2021

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Palliative care -specialized healthcare focused on improving quality of life for patients with serious illnesses -can help urologists to care for patients with unmet symptom, coping and communication needs. Society guidelines from the American Society of Clinical Oncology and the National Comprehensive Cancer Network recommend incorporating palliative care into standard oncological care, based on multiple randomized trials demonstrating that it significantly improves physical well-being, patient satisfaction and goal concordant care. Misconceptions regarding the objective and ideal timing of palliative care are common; a key concept is that palliative care and treatments seeking to cure or prolong life are not mutually exclusive. Urologists are well positioned to champion the integration of palliative care into surgical urologic oncology and should be aware of palliative care guidelines, indications for palliative care use and how the field of urologic oncology can adopt best practices. PERSPECTIVESNature reviews | Urology 0123456789();:services alone were insufficient to meet patients' needs. The 1960s were a time of intense research interest in oncology and increasing concern over medical neglect of patients dying with cancer 16 . In 1964, Dame Cicely Saunders emerged as a transformative figure who revolutionized end-of-life care, when she introduced the concept of "total pain" and, 3 years later, established the Table 1 | randomized trials of early incorporation of palliative care into standard oncological care Study (country, year) Design and comparison Cohort Intervention and outcomes Key finding Zimmermann et al. 110 (Canada, 2014

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“…Nurses, physicians, and mental health providers have expressed concern that the two-dimensional interactions in video conferencing coupled with the loss of physical proximity, presence, and touch depersonalizes care and inhibits the providers' ability to best understand the patient and demonstrate care [16][17][18][19]. In palliative care studies, providers have indicated a reluctance to initiate emotional topics, feeling a need to be physically present with the patient to provide necessary support [20,21]. Reluctance has also been described because providers cannot be sure that patients have adequate privacy in videoconferencing visits [14].…”

Section: Knowledge Gapsmentioning

confidence: 99%

Exploring Nurse and Patient Experiences of Developing Rapport During Oncology Ambulatory Care Videoconferencing Visits: Protocol for a Qualitative Study

Koppel

Gagné

2021

JMIR Res Protoc

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Background Telehealth videoconferencing has largely been embraced by health care providers and patients during the COVID-19 pandemic; however, little is known about specific techniques for building rapport and provider-patient relationships in this care environment. Although research suggests that videoconferencing is feasible and can be effective for some types of care, concerns about the impact of technology on provider-patient relationships exist across health disciplines. Suggestions for adapting some in-person rapport techniques, such as the use of small talk, eye contact, and body language to facilitate trust, personal connection, and communication during videoconferencing encounters, have been discussed in the popular press and clinical commentaries. Notably, evidence regarding the effects of these strategies on rapport and clinical care outcomes is lacking. Understanding how to establish rapport in videoconferencing visits is especially important in oncology nursing, where rapport with patients enables nurses to become a source of emotional support, helping patients adapt and navigate the cancer journey. Objective This study aims to investigate the nature of nurse-patient rapport in ambulatory cancer care videoconferencing visits. The objectives include exploring how patients with cancer and nurses describe experiences of rapport and strategies for cultivating rapport in videoconferencing visits and similarities and differences identified by patients with cancer and nurses between experiences of rapport in videoconferencing and in-person visits. Methods Semistructured narrative interviews of patients with cancer and nurses will be conducted to understand the experience of rapport building in videoconferencing visits. Nurses and patients will be interviewed separately to facilitate an understanding of the perspectives of both types of participants. Interviews will be conducted on a secure videoconferencing platform. This qualitative descriptive study will describe participant experiences in a manner that, although not without interpretation, is as close to the data as possible. The research team will meet regularly to discuss, define, and document codes, categories, and themes, and the team will maintain a detailed audit trail of analytical decisions. In addition, member checking will enhance the rigor of the study. Nurse and patient interviews will be analyzed separately using identical procedures and may be explored side by side in the final analysis to provide a comparative analysis. Data management and analysis will be performed using NVivo 12. Results Data collection will begin during summer 2021, with results from the data analysis anticipated by winter 2021. A research team trained in qualitative methodology will use conventional content analysis to analyze the data using first- and second-level codes derived directly from the transcribed text data. Conclusions This study aims to determine what behaviors, communication techniques, and relational practices need to be adapted in videoconferencing telehealth visits, setting the foundation for future development of interventions and evidence-based practice guidelines for relationship building during videoconferencing telehealth visits. International Registered Report Identifier (IRRID) PRR1-10.2196/27940

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Rapid Conversion of a Palliative Care Outpatient Clinic to Telehealth

Cited by 52 publications

References 5 publications

Patients’ and Relatives’ Preferences for a Palliative/Oncology Day Ward and Out-of-Hours Telemedicine—An Interpretive Description

Patients’ and Relatives’ Preferences for a Palliative/Oncology Day Ward and Out-of-Hours Telemedicine—An Interpretive Description

Incorporating palliative care principles to improve patient care and quality of life in urologic oncology

Exploring Nurse and Patient Experiences of Developing Rapport During Oncology Ambulatory Care Videoconferencing Visits: Protocol for a Qualitative Study

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