title: How outpatient palliative care teleconsultation facilitates empathic patient-professional relationships: a qualitative study.
abstract: OBJECTIVE
  The problems and needs of advanced cancer patients and proxies normally increase as the disease progresses. Home-based advanced cancer patients and their proxies benefit from collaborations between primary care physicians and hospital-based palliative care specialists when confronted with complex problems in the last phase of life. Telemedicine might facilitate direct, patient-centered communication between patients and proxies, primary care physicians, and specialist palliative care teams (SPCTs). This study focuses on the impact of teleconsultation technologies on the relationships between home-based palliative care patients and hospital-based palliative care specialists.
  
  
  METHODS
  This work consists of a qualitative study among patients, family members, and caregivers that utilizes long-term direct observations, semi-structured interviews, and open interviews following the observations.
  
  
  RESULTS
  The analysis of the empirical data resulted in three key concepts that describe the impact of teleconsultation on the patient-professional relationship in palliative homecare: transcending the institutional walls of home and hospital; transparency of teleconsultation technology; and technologized, intimate patient-professional relationships. Teleconsultation offers (1) condensed encounters between home-based palliative care patients and distant professionals, (2) a unique insight into the patients' daily lives for palliative care specialists, and (3) long-term interaction that results in trustful relationships and experiences of intimacy and relief.
  
  
  CONCLUSIONS
  Teleconsultation fits the practice of home-based palliative care. Teleconsultation can, if well applied, facilitate computer-mediated but empathic patient-palliative care specialist relationships, which enable professional care attuned to the patient's context as well as patient involvement. This article proposes a teleconsultation implementation guide for optimal use of teleconsultation in daily palliative care practice.
authors.affiliation: Department of Anesthesiology, Pain, and Palliative Medicine, Radboud University Medical Center, Nijmegen, Netherlands.
authors.forename: Jelle
authors.initials: J
authors.lastname: van Gurp
authors.affiliation: Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, Netherlands.
authors.forename: Martine
authors.initials: M
authors.lastname: van Selm
authors.affiliation: Department of Anesthesiology, Pain, and Palliative Medicine, Radboud University Medical Center, Nijmegen, Netherlands.
authors.forename: Kris
authors.initials: K
authors.lastname: Vissers
authors.affiliation: Department of IQ Healthcare Ethics Section, Radboud University Medical Center, Nijmegen, Netherlands.
authors.forename: Evert
authors.initials: E
authors.lastname: van Leeuwen
authors.affiliation: Department of Anesthesiology, Pain, and Palliative Medicine, Radboud University Medical Center, Nijmegen, Netherlands.
authors.forename: Jeroen
authors.initials: J
authors.lastname: Hasselaar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004645:Empathy; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D010166:Palliative Care; D011369:Professional-Patient Relations; D036301:Qualitative Research; D019114:Remote Consultation; D013672:Technology; D055815:Young Adult