Skip to main navigation menu Skip to main content Skip to site footer
##common.pageHeaderLogo.altText##

Original article

Vol. 154 No. 1 (2024)

Perceptions and needs of an outpatient palliative care team regarding digital care conferences in palliative care: a mixed-method online survey

  • Andreas Samuel Ebneter
  • Maud Maessen
  • Thomas C. Sauter
  • Georgette Jenelten
  • Steffen Eychmueller
DOI
https://doi.org/10.57187/s.3487
Cite this as:
Swiss Med Wkly. 2024;154:3487
Published
03.01.2024

Summary

BACKGROUND: Telemedicine in palliative care (PC) is increasingly being used, especially in outpatient settings with large geographic distances. Its proven benefits include improved communication, coordination quality and time savings. However, the effect on symptom control is less evident. Whether these benefits apply to the Swiss setting and the needs of healthcare professionals (HCPs) is unknown.

OBJECTIVES: To identify the perceptions and needs of healthcare professionals (nurses and physicians) regarding telemedicine (generally and specifically for care conferences) in a Swiss outpatient palliative care network.

METHODS: We conducted a cross-sectional, mixed-method online survey with purposefully sampled healthcare professionals from an outpatient palliative care team as baseline data during the planning phase of a quality improvement project (digital care conferences).

FINDINGS/RESULTS: Of the 251 HCPs approached, 66 responded, including nurses (n = 37) and physicians (n = 29), with an overall response rate of 26.6%. These were distributed into two groups: general palliative care HCPs (n = 48, return rate 21.3%) and specialised palliative care HCPs (n = 18, return rate 69.2%). Generally, telemedicine was perceived as useful. Potential easy access to other HCPs and hence improved communication and coordination were perceived as advantages. Barriers included a lack of acceptance and physical contact, unsolved questions about potential data breaches and technical obstacles. Regarding digital care conferences, the perceived acceptance and feasibility were good; preferred participants were the specialised palliative care HCPs (nurses and physicians), primary physicians and home care nurses, as well as the leadership of a nurse. The needs of the HCPs were as follows: (a) clear and efficient planning, (b) usability and security and (c) visual contact with the patient.

CONCLUSION: Digital care conferences are perceived as a feasible and useful tool by healthcare professionals in a local palliative care network in Switzerland. A pilot phase will be the next step towards systematic integration of this telemedicine modality into outpatient palliative care.

References

  1. Allen Watts K, Malone E, Dionne-Odom JN, McCammon S, Currie E, Hicks J, et al. Can you hear me now?: improving palliative care access through telehealth. Res Nurs Health. 2021 Feb;44(1):226–37. 10.1002/nur.22105 DOI: https://doi.org/10.1002/nur.22105
  2. Finucane AM, O’Donnell H, Lugton J, Gibson-Watt T, Swenson C, Pagliari C. Digital health interventions in palliative care: a systematic meta-review. NPJ Digit Med. 2021 Apr;4(1):64. 10.1038/s41746-021-00430-7 DOI: https://doi.org/10.1038/s41746-021-00430-7
  3. WHO. WHO | Classification of digital health interventions v1.0. WHO.
  4. Cherny N, Portenoy RK. Core concepts in palliative care. In: Cherny N, Fallon M, Kaasa S, editors. Oxford Textbook of Palliative Medicine. Oxford university press; 2021. 10.1093/med/9780198821328.003.0006 DOI: https://doi.org/10.1093/med/9780198821328.001.0001
  5. Ebneter AS, Sauter TC, Christen A, Eychmueller S. Feasibility, acceptability and needs in telemedicine for palliative care. Swiss Med Wkly. 2022 Mar;152(9-10):Swiss Med Wkly. 2022;152:w30148. 10.4414/SMW.2022.w30148 DOI: https://doi.org/10.4414/SMW.2022.w30148
  6. Laver KE, Adey-Wakeling Z, Crotty M, Lannin NA, George S, Sherrington C. Telerehabilitation services for stroke. Cochrane Database Syst Rev. 2020 Jan;1(1):CD010255. DOI: https://doi.org/10.1002/14651858.CD010255.pub3
  7. Lomenick AF, Kuhlman SJ, Barnes JL, Gurley-Calvez T, Spaulding AO, Krebill HM, et al. Economics of Using Telemedicine to Supplement Hospice Care in Rural Areas. J Palliat Med. 2021 Sep;24(10):1461–6. 10.1089/jpm.2020.0117 DOI: https://doi.org/10.1089/jpm.2020.0117
  8. AlDossary S, Martin-Khan MG, Bradford NK, Armfield NR, Smith AC. The Development of a Telemedicine Planning Framework Based on Needs Assessment. J Med Syst. 2017 May;41(5):74. 10.1007/s10916-017-0709-4 DOI: https://doi.org/10.1007/s10916-017-0709-4
  9. AlDossary S, Armfield NR, Smith AC, Martin-Khan MG. A Needs-based Planning Framework for Telemedicine Services: A Practical Guide. Faculty of Medicine The University of Queensland, Australia.: National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Telehealth; 2019.
  10. Ebneter AS, Fliedner M, Trapp D, Ramseier F, Sauter TC, Eychmuller S. [Telemedicine in Palliative Care: Digital Communication in a Relationship-Based Speciality - Does It Make Sense?]. Prax Bern 1994. 2021 Nov;110(15):845–50. DOI: https://doi.org/10.1024/1661-8157/a003781
  11. Ebneter AS, Sauter T, Achter A, Eychmller S. Einsatz von Telemedizin in der Palliative Care. Schweiz Arzteztg. 2022. 10.4414/saez.2022.20419 DOI: https://doi.org/10.4414/saez.2022.20419
  12. Ebneter AS, Eychmueller S. Digital Hilfsmittel in der Palliative Care: Quo vadis? Infoonco-Suisse. 2022 Aug;12(5).
  13. Institute of Medicine Committee on Quality of Health Care in A. In. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington (DC): National Academies Press (US) Copyright 2001 by the National Academy of Sciences. All rights reserved.; 2001.
  14. Langbecker D, Caffery LJ, Gillespie N, Smith AC. Using survey methods in telehealth research: A practical guide. J Telemed Telecare. 2017 Oct;23(9):770–9. 10.1177/1357633X17721814 DOI: https://doi.org/10.1177/1357633X17721814
  15. Weaver MS, Neumann ML, Navaneethan H, Robinson JE, Hinds PS. Human Touch via Touchscreen: Rural Nurses’ Experiential Perspectives on Telehealth Use in Pediatric Hospice Care. J Pain Symptom Manage. 2020 Nov;60(5):1027–33. 10.1016/j.jpainsymman.2020.06.003 DOI: https://doi.org/10.1016/j.jpainsymman.2020.06.003
  16. Boynton PM. Administering, analysing, and reporting your questionnaire. BMJ. 2004 Jun;328(7452):1372–5. 10.1136/bmj.328.7452.1372 DOI: https://doi.org/10.1136/bmj.328.7452.1372
  17. Boynton PM, Wood GW, Greenhalgh T, Clinic Q. Reaching beyond the white middle classes. BMJ. 2004 Jun;328(7453):1433–6. 10.1136/bmj.328.7453.1433 DOI: https://doi.org/10.1136/bmj.328.7453.1433
  18. Boynton PM, Greenhalgh T. Selecting, designing, and developing your questionnaire. BMJ. 2004 May;328(7451):1312–5. 10.1136/bmj.328.7451.1312 DOI: https://doi.org/10.1136/bmj.328.7451.1312
  19. Demiris G, Speedie S, Finkelstein S. A questionnaire for the assessment of patients’ impressions of the risks and benefits of home telecare. J Telemed Telecare. 2000;6(5):278–84. 10.1258/1357633001935914 DOI: https://doi.org/10.1258/1357633001935914
  20. Spitallisten [Internet]. Kanton Bern. [cited 2023 Apr 2]. Available from: https://www.gsi.be.ch/de/start/themen/gesundheit/gesundheitsversorger/spitaeler-psychiatrie-rehabilitation/spitallisten.html
  21. Basec. Qualitätssicherung oder bewilligungspflichtige. Forschung. 2020.
  22. Kleinheksel AJ, Rockich-Winston N, Tawfik H, Wyatt TR. Demystifying Content Analysis. Am J Pharm Educ. 2020 Jan;84(1):7113. 10.5688/ajpe7113 DOI: https://doi.org/10.5688/ajpe7113
  23. Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005 Nov;15(9):1277–88. 10.1177/1049732305276687 DOI: https://doi.org/10.1177/1049732305276687
  24. InfoSocietyDays. STUDIENERGEBNISSE 2021 – Swiss eHealth Forum. Gfs.bern; 2021.
  25. Disalvo D, Agar M, Caplan G, Murtagh FE, Luckett T, Heneka N, et al. Virtual models of care for people with palliative care needs living in their own home: A systematic meta-review and narrative synthesis. Palliat Med. 2021 Sep;35(8):1385–406. 10.1177/02692163211024451 DOI: https://doi.org/10.1177/02692163211024451
  26. Hammerton M, Benson T, Sibley A. Readiness for five digital technologies in general practice: perceptions of staff in one part of southern England. BMJ Open Qual. 2022 Jun;11(2):e001865. 10.1136/bmjoq-2022-001865 DOI: https://doi.org/10.1136/bmjoq-2022-001865
  27. Silva MD, Schack EE. Outpatient Palliative Care Practice for Cancer Patients During COVID-19 Pandemic: Benefits and Barriers of Using Telemedicine. Am J Hosp Palliat Care. 2021 Jul;38(7):842–4. 10.1177/1049909121997358 DOI: https://doi.org/10.1177/1049909121997358
  28. Kalicki AV, Moody KA, Franzosa E, Gliatto PM, Ornstein KA. Barriers to telehealth access among homebound older adults. J Am Geriatr Soc. 2021 Sep;69(9):2404–11. 10.1111/jgs.17163 DOI: https://doi.org/10.1111/jgs.17163
  29. Tang M, Reddy A. Telemedicine and Its Past, Present, and Future Roles in Providing Palliative Care to Advanced Cancer Patients. Cancers (Basel). 2022 Apr;14(8):1884. 10.3390/cancers14081884 DOI: https://doi.org/10.3390/cancers14081884
  30. Hollander J, Sharma R. Telemedicine Is Mainstream Care Delivery. NEJM Catal. 2022;3(7):CAT.22.0176. 10.1056/CAT.22.0176 DOI: https://doi.org/10.1056/CAT.22.0176
  31. Tieman JJ, Swetenham K, Morgan DD, To TH, Currow DC. Using telehealth to support end of life care in the community: a feasibility study. BMC Palliat Care. 2016 Nov;15(1):94. 10.1186/s12904-016-0167-7 DOI: https://doi.org/10.1186/s12904-016-0167-7
  32. Salvador Vergès À, Cusí Sánchez MV, Bossio Grigera P, Fàbrega Agulló C, Gomes da Costa F, Serra Trullas A, et al. Determinants in Stakeholder Opinions About Telemedicine in Palliative Care: A Scoping Review. Telemed J E Health. 2022 Jul;28(7):932–41. 10.1089/tmj.2021.0441 DOI: https://doi.org/10.1089/tmj.2021.0441
  33. Snoswell CL, Smith AC, Page M, Scuffham P, Caffery LJ. Quantifying the Societal Benefits From Telehealth: Productivity and Reduced Travel. Value Health Reg Issues. 2022 Mar;28:61–6. 10.1016/j.vhri.2021.07.007 DOI: https://doi.org/10.1016/j.vhri.2021.07.007
  34. Andrade C. The Limitations of Online Surveys. Indian J Psychol Med. 2020 Oct;42(6):575–6. 10.1177/0253717620957496 DOI: https://doi.org/10.1177/0253717620957496

Most read articles by the same author(s)