Exploring rural palliative care patients’ experiences of accessing psychosocial support through telehealth: A longitudinal approach
In this research, we explore the experiences of rural palliative care patients receiving psychosocial support through telehealth. A longitudinal approach considered how experiences vary over time. Three patients with a terminal cancer diagnosis were given a laptop to access psychosocial support via telehealth over three months. Semi-structured interviews were conducted at monthly intervals. Interpretative phenomenological analysis identified four themes: Deepening understanding through unburdened and continuous connections; the ever-present paradox of visible and invisible telehealth; insight into the holistic self: from barrier to facilitator; and, the immediate change from unnecessary distraction to mindful engagement. Findings challenge previous conclusions regarding the inability of telehealth to support meaningful relationships, and instead provide novel insights to explain why enabling rural palliative care patients to access support from home is supportive for their wellbeing and the quality of healthcare relationships. Our conclusions question whether the indirect benefits of telehealth could also offer a valuable way of accessing health services beyond a palliative care setting.
National Institute for Clinical Excellence (2004). Guidance on Cancer Services Improving Supportive and Palliative Care for Adults with Cancer. The Manual. . (pg 20.) ISBN:1-84257-579-1
Marie Curie. Dying at home: The role of social housing providers in supporting terminally ill people in Wales. Policy and Public Affairs Team, Wales July 2014.
National Council for Palliative Care. National survey of patient activity data for specialist palliative care services 2014-15. Available from: https://www.hospiceuk.org/docs/default-source/What-We-Offer/publications-documents-and-files/minimum-data-set-hospital-support-report-2014-15.pdf?sfvrsn=0 Accessed January 2020.
Deaville JA. Health-care challenges in rural areas: physical and sociocultural barriers. Prof Nurs 2003; 18:262-4.
Strasser R. Rural health around the world: challenges and solutions. Fam Prac 2003; 20:457- 63. Doi: 10.1093/fampra/cmg422
Welsh Assembly Government. Rural health plan; Improving integrated service delivery across Wales. Welsh Assembly government report 11:19: 2009.
Hughes PH, Ingleton MC, Noble B, Clark D. Providing cancer and palliative care in rural areas: a review of patient and carer needs. J Palliat Care 2004; 20:44-9.
Johnston B, Kidd L, Wengstrom Y, Kearney N. An evaluation of the use of telehealth within palliative care settings across Scotland. Palliative Med 2011; 26:152-61.
Kidd L, Wengstrom Y, Johnston BM. Telehealth in palliative care in the UK: A review of the evidence. Journal of Telemed Telecare 2010; 16:394-402. Doi 10.1258/jtt.2010.091108
Demiris G, Oliver DP, Wittenberg-Lyles E, Washington K. Use of videophones to deliver cognitive-behavioural therapy to hospice caregivers. J Telemed Telecare, 2011;17:142-5.
Zheng Y, Head BA, Schapmire TJ. A systematic review of telehealth in palliative care: Caregiver outcomes. Telemed e-health, 2016;22:1-7.
Hennemann-Krause L. Lopes AJ, Araύjo JA, et al. The assessment of telemedicine to support outpatient palliative care in advanced cancer. Palliat support Care 2015;13: 1025-1030.
Watanabe SM, Fairchild A, Pituskin E, et al. Improving access to specialist multidisciplinary palliative care consultation for rural cancer patients by videoconferencing: report of pilot project. Support care cancer, 2013; 21:1201-7.
Olver I, Brooksbank M, Champion N, Keeley J. The use of videophones to enhance palliative care outreach nursing in remote areas. Prog Palliat Care; 2005; 13:263-7. Doi: 10.1179/096992605X57679.
Larson J, Rosen AB, & Wilson FA. The effect of telehealth interventions on quality of life in cancer patients: A systematic review and meta-analysis. Telemed e-health 2018;24:397-405. DOI: 10.1089/tmj.2017.0112.
Shepherd L, Goldstein D, Whitford et al. The utility of videoconferencing to provide innovative delivery of psychological treatment for rural cancer patients: results of a pilot study. J Pain Symptom Manage 2006; 32:453-461.
Stern A, Valaitis R, Weir R, Jadad AR. Use of home telehealth in palliative cancer care: a case study. J telemed telecare 2012;18:297-300.
Roberts D, Taylor C, MacCormack D, Barwich D. Telenursing in hospice palliative care. Can nurse; 2007:103;24-7.
Venkatesh V, Thong JYL, Xu X. Unified theory of acceptance and use of technology: A synthesis and the road ahead. J Assoc Inf Syst 2016;17:328-376.
Smith, JA. Qualitative Psychology, a practical guide to researchers (2nd ed). London, Sage: 2008.
Davies A., & Newman S. Evaluating telecare and telehealth interventions. London: The King’s Fund, Department of Health, UK: 2011.
Jones G, Rahman R, & Robson, M. Group art therapy using telemedicine technology for immunosuppressed patients undergoing chemotherapy. In M Wood, B Jacobson & H Cridford (eds), The International Handbook of Art Therapy in Palliative and Bereavement Care. Routledge International Handbooks, Taylor & Francis: 2019. doi.org/9781138087330:
Jones, G, Rahman, R & Robson, M. Group art therapy and telemedicine. In CA Malchiodi (ed.), The Handbook of Art Therapy and Digital Technology. Jessica Kingsley Publishers: 2018.
Brocki JM, Wearden AJ. A critical evaluation of the use of interpretative phenomenological analysis (IPA) in health psychology. Psychol Health 2006; 21:87-108.
Farr J & Nizza IE. Longitudinal interpretative phenomenological analysis (LIPA) a review of studies and methodological considerations. Qual Res Psychol (online) 2019;16:199-217.
Smith J, Osborn M, Interpretative Phenomenological Analysis. In: Smith, J. Qualitative psychology: A practical guide to research methods. London, UK: Sage; 2008. pp53-80.
Shaw RL, West K, Hagger B, Holland CA. Living well to the end: A phenomenological analysis of life in extra care housing. Int J Qual Stud Heal 2016; 11:1-12. Doi: 10.3402/ghw.v11.31100
Ley P. Improving patients’ understanding, recall, satisfaction and compliance. In: Broome AK ed.. Health Psychology. Boston, MA: Springer Sciences; 1989. pp74-102.
Deci, EL, Ryan RM. Self-determination theory: A macrotheory of human motivation, development and health. Can Psychol 2008; 49:182-5.
Reiss H, Kraft-Todd G. A tool to enhance nonverbal communication between clinicians and their patients. Acad Med 2014; 89:1108-12.
Shepherd L, Goldstein D, Olver I, Parle M. Enhancing psychosocial care for people with cancer in rural communities: what can remote counselling offer? Rehabil Disabil Ageing 2008; 32: 423-438.
Maher D, Hemming L. Understanding patient and family: holistic assessment in palliative care. Br J Community Nurs 2013;10.
- Abstract views: 605
- PDF: 252
Copyright (c) 2020 The Authors
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.