Use of home telehealth in palliative cancer care: a case study.
We conducted a mixed-methods case study to explore the perceptions of family caregivers and palliative cancer patients of home telehealth, and their experience with it. The intervention in the randomized controlled trial from which study participants were selected consisted of specialist nurses available 24 hours per day who communicated with patients and families using videophones, with optional remote monitoring. Qualitative data were collected from interviews with five patient/caregiver dyads and seven bereaved family caregivers, direct observation and nursing documentation. Quantitative data were collected from computerized nursing documentation and analyzed for patterns of use. During the study there were 255 contacts, including videophone, telephone or face-to-face visits, between tele-nurses and families. Overall the patients, family caregivers and tele-nurses felt that home telehealth enabled family caregiving, citing increased access to care, and patient and family caregiver reassurance. Pain management was the most common reason for initiating contact with the nurse, followed by emotional support. Concerns included lack of integration of services, inappropriate timing of the intervention and technical problems. The case study confirmed the importance of timely and accessible care for a group of clinically vulnerable, dying cancer patients and their family caregivers.
Toronto Health Economics and Technology Assessment Collaborative, Leslie Dan Pharmacy Building, University of Toronto, 6th Floor, Room 651, 144 College Street, Toronto, Ontario M5S 3M2, Canada. anita.stern@theta.utoronto.ca
Anita
A
Stern
Ruta
R
Valaitis
Robin
R
Weir
Alejandro R
AR
Jadad
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology; D003258:Consumer Behavior; D005260:Female; D006297:Health Services Accessibility; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000451:nursing*; D010166:Palliative Care / Q000379:methods*; D017060:Patient Satisfaction; D036301:Qualitative Research; D017216:Telemedicine / Q000592:standards* / Q000706:statistics & numerical data