Koppel Paula D, De Gagne Jennie C
Duke University School of Nursing, Durham, NC, United States.
JMIR Res Protoc. 2021 Jun 14;10(6):e27940. doi: 10.2196/27940.
Telehealth videoconferencing has largely been embraced by health care providers and patients during the COVID-19 pandemic; however, little is known about specific techniques for building rapport and provider-patient relationships in this care environment. Although research suggests that videoconferencing is feasible and can be effective for some types of care, concerns about the impact of technology on provider-patient relationships exist across health disciplines. Suggestions for adapting some in-person rapport techniques, such as the use of small talk, eye contact, and body language to facilitate trust, personal connection, and communication during videoconferencing encounters, have been discussed in the popular press and clinical commentaries. Notably, evidence regarding the effects of these strategies on rapport and clinical care outcomes is lacking. Understanding how to establish rapport in videoconferencing visits is especially important in oncology nursing, where rapport with patients enables nurses to become a source of emotional support, helping patients adapt and navigate the cancer journey.
This study aims to investigate the nature of nurse-patient rapport in ambulatory cancer care videoconferencing visits. The objectives include exploring how patients with cancer and nurses describe experiences of rapport and strategies for cultivating rapport in videoconferencing visits and similarities and differences identified by patients with cancer and nurses between experiences of rapport in videoconferencing and in-person visits.
Semistructured narrative interviews of patients with cancer and nurses will be conducted to understand the experience of rapport building in videoconferencing visits. Nurses and patients will be interviewed separately to facilitate an understanding of the perspectives of both types of participants. Interviews will be conducted on a secure videoconferencing platform. This qualitative descriptive study will describe participant experiences in a manner that, although not without interpretation, is as close to the data as possible. The research team will meet regularly to discuss, define, and document codes, categories, and themes, and the team will maintain a detailed audit trail of analytical decisions. In addition, member checking will enhance the rigor of the study. Nurse and patient interviews will be analyzed separately using identical procedures and may be explored side by side in the final analysis to provide a comparative analysis. Data management and analysis will be performed using NVivo 12.
Data collection will begin during summer 2021, with results from the data analysis anticipated by winter 2021. A research team trained in qualitative methodology will use conventional content analysis to analyze the data using first- and second-level codes derived directly from the transcribed text data.
This study aims to determine what behaviors, communication techniques, and relational practices need to be adapted in videoconferencing telehealth visits, setting the foundation for future development of interventions and evidence-based practice guidelines for relationship building during videoconferencing telehealth visits.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/27940.
在新冠疫情期间,远程医疗视频会议在很大程度上受到了医疗服务提供者和患者的欢迎;然而,对于在这种护理环境中建立融洽关系及医患关系的具体技巧,我们知之甚少。尽管研究表明视频会议是可行的,并且对某些类型的护理可能有效,但各健康学科都存在对技术对医患关系影响的担忧。大众媒体和临床评论中已经讨论了一些调整面对面融洽关系技巧的建议,例如在视频会议交流中使用闲聊、眼神交流和肢体语言来促进信任、建立个人联系和沟通。值得注意的是,缺乏关于这些策略对融洽关系和临床护理结果影响的证据。在肿瘤护理中,了解如何在视频会议就诊中建立融洽关系尤为重要,因为与患者建立融洽关系能使护士成为情感支持的来源,帮助患者适应并度过癌症治疗过程。
本研究旨在调查门诊癌症护理视频会议就诊中医患融洽关系的本质。目标包括探索癌症患者和护士如何描述融洽关系的体验以及在视频会议就诊中培养融洽关系的策略,以及癌症患者和护士所确定的视频会议就诊与面对面就诊中融洽关系体验的异同。
将对癌症患者和护士进行半结构化叙事访谈,以了解视频会议就诊中建立融洽关系的体验。护士和患者将分别接受访谈,以促进对两类参与者观点的理解。访谈将在安全的视频会议平台上进行。这项定性描述性研究将以一种虽非没有解释但尽可能贴近数据的方式描述参与者的体验。研究团队将定期开会讨论、定义和记录代码、类别和主题,并且团队将保留分析决策的详细审核记录。此外,成员核对将提高研究的严谨性。护士和患者的访谈将使用相同的程序分别进行分析,并且在最终分析中可能会并列探讨,以提供比较分析。数据管理和分析将使用NVivo 12进行。
数据收集将于2021年夏季开始,预计2021年冬季得出数据分析结果。一个接受过定性方法培训的研究团队将使用传统内容分析法,通过直接从转录文本数据中得出的一级和二级代码来分析数据。
本研究旨在确定在视频会议远程医疗就诊中需要调整哪些行为、沟通技巧和关系实践,为未来开发视频会议远程医疗就诊期间建立关系的干预措施和循证实践指南奠定基础。
国际注册报告识别号(IRRID):PRR1-10.2196/27940。