Connection, comfort and COVID-19 in palliative care

Kirby, Emma; McLaughlan, Rebecca; Wallworth, Lynette; Chappell, Louise; Bellemore, Frances; Chye, Richard

doi:10.1177/26323524211001389

Cited by 7 publications

(7 citation statements)

References 14 publications

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“…11,35,36 Unfortunately, due to the Covid pandemic, many health professionals were not provided with a training opportunity to develop skills to navigate rapport in the telehealth environment. [37][38][39] As in other studies, our findings suggest that there is a gap in professional preparation for telehealth. 40 In this study, participants were not asked explicitly how much telehealth training they had, but most indicated telehealth was approached by trial and error, while recognising a need for interpersonal skills training.…”

Section: Discussionsupporting

confidence: 85%

Health professionals’ experiences of rapport during telehealth encounters in community palliative care: An interpretive description study

2023

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Background: Despite the reported importance of rapport, there are knowledge gaps in the ways rapport is developed and experienced by health professionals during telehealth calls in palliative care. Aim: To gain an understanding about developing rapport during telehealth calls by exploring the experiences of health professionals in community palliative care. Design: A qualitative Interpretive Description study was conducted with semi-structured interviews and focus groups between November 2020 and May 2021. Data was audio recorded, transcribed, and analysed using Reflexive thematic analysis. A COREQ checklist was completed. Setting/Participants: Thirty-one palliative care professionals who had participated in telehealth calls were recruited from four hospice locations in Aotearoa, New Zealand. Results: There were two themes identified: (1) ‘Getting on together’, which included how rapport shows up in telehealth, with examples of calls with rapport and without rapport, and (2) ‘Rapport is a soft skill’, which identified health professionals using body language and listening in specific ways in telehealth, while being aware of the privacy of calls, and lack of training concerns. Conclusion: Based on health professionals experiences of rapport it was determined that rapport is vitally important in telehealth calls, as it is in-person interactions. Rapport is a soft skill that can potentially be learned, practiced and mastery developed, although rapport in each interaction is not guaranteed. Patient and family experiences of rapport in the palliative telehealth area warrants further research and there is some urgency for health professional training in telehealth interpersonal skills.

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Section: Discussionsupporting

confidence: 85%

Health professionals’ experiences of rapport during telehealth encounters in community palliative care: An interpretive description study

2023

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“…Design provisions related to this included comfortable chairs and sufficient space for family around the beside; alongside provisions for family members to sleep over, including larger beds for co-sleeping, foldout beds within patient rooms, or boarding spaces elsewhere within the palliative care unit or hospital campus. Where in-person family visits aren’t possible, support for internet-based communications (e.g., telehealth, Skype) was said to enable “those family [members] who can’t be there [to] easily link to the patient/family in the room.” While geographical distance or work commitments often prevent friends and family from being physically present, visitor restrictions related to COVID-19 have heightened the perceived necessity of communicating with loved ones via technology (Kirby et al, 2021).…”

Section: Resultsmentioning

confidence: 99%

“…Where in-person family visits aren't possible, support for internet-based communications (e.g., telehealth, Skype) was said to enable "those family [members] who can't be there [to] easily link to the patient/family in the room." While geographical distance or work commitments often prevent friends and family from being physically present, visitor restrictions related to COVID-19 have heightened the perceived necessity of communicating with loved ones via technology (Kirby et al, 2021).…”

Section: Spaces and Spatial Qualitiesmentioning

confidence: 99%

Designing Palliative Care Facilities to Better Support Patient and Family Care: A Staff Perspective

McLaughlan

Richards

Lipson-Smith

et al. 2022

HERD

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Objective: To contribute staff perspectives on the design of palliative care facilities to better align with the philosophy of palliative care, in support of patient, family, and staff well-being. Background: The receipt of palliative care differs from other inpatient experiences owing to its distinct philosophy of care, longer lengths of stay, a greater presence of family members, and more frequent end-of-life events. While research regarding the optimal design of palliative care environments recognizes these differences, this knowledge has been slow to exert change on the guidelines and procurement processes that determine the design solutions possible within these settings. Sustained research attention is required. Methods: An online survey, comprising a series of open-ended questions, elicited the perceptions of palliative care staff regarding the relationship between the physical environment and the distinct philosophy of palliative care. Results: Responses from 89 Australian-based palliative care professionals confirmed the high value that staff place on environments that offer privacy, homeliness, safety, and access to gardens to assist the delivery of optimum care. Conclusions: Our findings illustrate that the implications of privacy and homeliness extend far beyond the patient room and that homeliness is about more than an aesthetic of comfort. This highlights a broader capacity for design to better support the philosophy of palliative care. Importantly, the data reveal a key relationship between staff well-being and the environments in which they work; environments that are unable to match the quality of care that staff aspire to deliver can engender frustration and distress.

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“…Here we suggest more than the simple addition of a desk or reading chair to a patient room, but rather, providing spaces that can support a sense of temporary escape, or reconnection with self; a window seat, a reading alcove, a small, intimate spot within a larger garden space, for example, could all contribute tangible benefits to the experience of patients. Spaces designed to support family interaction also critically supports homeliness, and where the physical presence is not possible, electronic communication is vital 42…”

Section: Discussionmentioning

confidence: 99%

Designing the physical environment for inpatient palliative care: a narrative review

Wong

McLaughlan

Collins

et al. 2021

BMJ Support Palliat Care

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BackgroundIt is essential that the physical environments in which inpatient palliative care is provided support the needs of patients and the facilitate the multidimensional delivery of palliative care. This review aims to identify the features and characteristics of inpatient palliative care environments that enhance or detract from the patient experience; and identify opportunities for progress within this field.MethodThree databases were searched: MEDLINE (1946–2020), PsycINFO (1806–2020) and CINAHL (1937–2020). Articles were screened by title and abstract with included studies read in full for data extraction. Data synthesis involved thematic analysis informed by the findings of the included literature. Inclusion criteria were studies with empirical methodology examining adult palliative care in the hospital, hospice or nursing home environment. Studies that examined palliative care delivered within the emergency department, ICU or within the home were excluded, as were those related to paediatric palliative care.ResultsFour main themes were identified: the provision of privacy, facilitating interactions with family, facilitating comfort through homeliness and connections to nature.ConclusionsThe board acceptance of single rooms as the preeminent design solution for supporting privacy, dignity and family interaction, alongside current conceptions of homeliness that typically focus on matters of interior design, are limiting possibilities for further design innovation within palliative care settings. Research that investigates a broader set of design strategies through which the built environment can support care, alongside enhanced interdisciplinary collaboration, could positively contribute to patient and family experiences of inpatient palliative care.

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Connection, comfort and COVID-19 in palliative care

Cited by 7 publications

References 14 publications

Health professionals’ experiences of rapport during telehealth encounters in community palliative care: An interpretive description study

Health professionals’ experiences of rapport during telehealth encounters in community palliative care: An interpretive description study

Designing Palliative Care Facilities to Better Support Patient and Family Care: A Staff Perspective

Designing the physical environment for inpatient palliative care: a narrative review

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