远程医疗
缓和医疗
医学
门诊部
定性研究
门诊护理
大流行
护理部
家庭医学
远程医疗
医疗保健
2019年冠状病毒病(COVID-19)
疾病
社会科学
病理
社会学
传染病(医学专业)
内科学
经济
经济增长
作者
Jacqueline Alcalde-Castro,Shenhab Zaig,Rinat Nissim,Brenda I. O’Connor,Jenny Lau,Ernie Mak,Camilla Zimmermann,Breffni Hannon
出处
期刊:BMJ supportive & palliative care
[BMJ]
日期:2023-02-24
卷期号:14 (e1): e1512-e1520
被引量:2
标识
DOI:10.1136/spcare-2023-004189
摘要
Objectives Outpatient in-person early palliative care improves quality of life for patients with advanced cancer. The COVID-19 pandemic forced a rapid shift to telehealth visits; however, little is known about how telehealth in outpatient palliative care settings should be optimised beyond the pandemic. We aimed to explore, from the perspective of patients attending an outpatient palliative care clinic, the most appropriate model of care for in-person versus telehealth visits. Methods A qualitative study using the grounded theory method. One-on-one, semistructured qualitative interviews were conducted with 26 patients attending an outpatient palliative care clinic at a tertiary cancer centre recruited from two groups: (1) those with >1 in-person appointment prior to 1 March 2020 and >1 telehealth appointment after this date (n=17); and (2) patients who had exclusively telehealth appointments (n=9). Purposive sampling was used to incorporate diverse perspectives. Results Overall, participants endorsed a flexible hybrid approach incorporating both in-person and telehealth visits. Specific categories were: (1) in-person outpatient palliative care supported building interpersonal connections and trust; (2) telehealth palliative care facilitated greater efficiency, comfort and independence and (3) patient-preferred circumstances for in-person visits (preferred for initial consultations, visits where a physical examination may be required and advance care planning discussions), versus telehealth visits (preferred during periods of relative heath stability). Conclusions The elements of in-person and telehealth outpatient palliative care clinic visits described by patients as integral to their care may be used to develop models of hybrid outpatient palliative care delivery beyond the pandemic alongside reimbursement and regulatory guidelines.
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