Home telehealth and paediatric palliative care: clinician perceptions of what is stopping us?

BMC Palliative Care

Research Article

Natalie K Bradford¹  Anthony C Smith¹  Nigel R Armfield¹  Anthony Herbert²  Jeanine Young³ 

[1]Centre for Online Health, University of Queensland, Level 3 Foundation Building Royal, Children’s Hospital, Herston Rd, 4029, Herston, Queensland, Australia

[2]Queensland Children’s Medical Research Institute, University of Queensland, Royal Children’s Hospital, Herston Rd, 4029, Herston, Queensland, Australia

[3]Paediatric Palliative Care Service, Royal Children’s Hospital, 4029, Brisbane, Queensland, Australia

[4]School of Nursing and Midwifery, University of the Sunshine Coast, 4556, Sippy Downs, Queensland, Australia

关键词: Palliative care;    Paediatric;    Home care;    Telehealth;    Telehospice;    Health service;   

DOI  :  10.1186/1472-684X-13-29

 received in 2014-04-10, accepted in 2014-06-10,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundAdvances in technology have made the use of telehealth in the home setting a feasible option for palliative care clinicians to provide clinical care and support. However, despite being widely available and accessible, telehealth has still not been widely adopted either in Australia or internationally. The study aim was to investigate the barriers, enablers and perceived usefulness for an established home telehealth program in paediatric palliative care from the perspective of clinicians.MethodsSemi-structured interviews (n = 10) were undertaken with palliative care clinicians in a tertiary paediatric hospital to identify attitudes to, satisfaction with, and perceived benefits and limitations of, home telehealth in palliative care. Iterative analysis was used to thematically analyse data and identify themes and core concepts from interviews.ResultsFour themes are reported: managing relationships; expectations of clinicians; co-ordination, and the telehealth compromise. Core concepts that emerged from the data were the perceived ability to control clinical encounters in a virtual environment and the need to trust technology. These concepts help explain the telehealth compromise and low utilisation of the home telehealth program.ConclusionsEffective communication between caregivers and clinicians is recognised as a core value of palliative care. Home telehealth has the potential to provide a solution to inequity of access to care, facilitate peer support and maintain continuity of care with families. However, significant limitations and challenges may impede its use. The virtual space creates additional challenges for communication, which clinicians and families may not intuitively understand. For home telehealth to be integrated into routine care, greater understanding of the nature of communication in the virtual space is required.

【 授权许可】

CC BY   
© Bradford et al.; licensee BioMed Central Ltd. 2014