Experiences With Video Consultations in Specialized Palliative Home-Care: Qualitative Study of Patient and Relative Perspectives

Abstract

Background The work of specialized palliative care (SPC) teams is often challenged by substantial amounts of time spent driving to and from patients’ homes and long distances between the patients and the hospitals. Objective Video consultations may be a solution for real-time SPC at home. The aim of this study was to explore the use of video consultations, experienced by patients and their relatives, as part of SPC at home. Methods This explorative and qualitative study included palliative care patients in different stages and relatives to use video consultations as a part of their SPC between October 2016 and March 2017. Data collection took place in the patients’ homes and consisted of participant observations followed by semistructured interviews. Inclusion criteria consisted of patients with the need for SPC, aged more than 18 years, who agreed to participate, and relatives wanting to participate in the video consultations. Data were analyzed with Giorgi’s descriptive phenomenological methodology. Results A number of patients (n=11) and relatives (n=3) were included and, in total, 86 video consultations were conducted. Patients participating varied in time from 1 month to 6 months, and the number of video consultations per patient varied from 3 to 18. The use of video consultations led to a situation where patients, despite life-threatening illnesses and technical difficulties, took an active role. In addition, relatives were able to join on equal terms, which increased active involvement. The patients had different opinions on when to initiate the use of video consultations in SPC; it was experienced as optional at the initiating stage as well as the final stage of illness. If the video consultations included multiple participants from the SPC team, the use of video consultations could be difficult to complete without interruptions. Conclusions Video consultations in SPC for home-based patients are feasible and facilitate a strengthened involvement and communication between patients, relatives, and SPC team members.

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

“…The bene ts of eHealth can be increased access to care, increased convenience, reduced travel time and reduced risk of infections (47,48). These aspects are re ected in the results of this review, and in line with previous ndings from Pinto et al (19).…”

“…Communication between patient, close relatives and team members was facilitated through eHealth, and patients' experienced increased access to care since physical distance was not an issue. Patients found that the use of video consultation, strengthened communication since visual features are included, also described in other studies (48,49). Another bene t found in our review was that despite life-threatening illness and being close to the end of life, patients could take an active role and govern their own care if they want to, thus promoting individualized care.…”

Palliative Patients’ and Relatives’ Views on Using Telemedicine in Palliative Care – A Pilot Study from Southern Denmark

“…All the participants had the first contact with the SPCT face-to-face. This is in accordance with other studies that assume, that the first contact has to be face-to-face to ensure the trust of the patients and their relatives and obtain informed consent for using telemedicine [8,20]. This is in line with standard practical and ethical conduct in palliative care and the need for an initial assessment of the patient and his needs including a physical examination.…”

“…Findings from Scotland have shown that both patients and carers appreciate telehealth as an addition to clinical care [21]. Telemedicine is applicable and feasible in a Danish context [9,10,20]. Current reviews from Denmark conclude that telemedicine is useful in palliative care for communication between the SPCT and patients and relatives and that telemedicine is useful in teaching district nurses [9,10].…”

Telemedicine in specialised palliative care: Healthcare professionals' and their perspectives on video consultations—A qualitative study

“…The study is a part of a larger qualitative study exploring patients, their relatives and healthcare professionals' experiences of using video consultations in SPC. A publication of the patients and their relatives' experiences in video consultations in SPC has been published in JMIR Journal of Medical Internet Research (Funderskov et al, ).…”