Communication Skills Training Program and Research Laboratory, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Patient-Reported Outcomes, Community-Engagement, and Language Core, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Transl Behav Med. 2022 Jul 18;12(7):816-824. doi: 10.1093/tbm/ibac044.
New York City was a "global COVID-19 hotspot" in spring 2020. Many health teams rapidly transitioned to telehealth platforms. Little is known about the experiences of inpatient palliative care services who delivered telehealth services during the pandemic. This study was aimed to explore the experiences of an interdisciplinary palliative care team in meeting the holistic needs of oncology inpatients via telehealth over a 10-week period during the first COVID-19 surge. A targeted sample of interdisciplinary palliative specialists at an urban comprehensive cancer center participated in in-depth interviews that explored participants' experiences delivering physical, psychosocial, and spiritual care via telehealth. An interdisciplinary coding team followed a rigorous thematic text analysis approach and met regularly to reach consensus on emerging themes. Eleven palliative specialists from six disciplines (chaplaincy, medicine, nursing, pharmacy, physician assistant, and social work) participated. Seventy-three percent reported not receiving telehealth training prior to COVID-19 and 64% were "not at all" or "somewhat comfortable" delivering telepalliative care. Several themes were identified, including the barriers related to telehealth, the impact of telehealth on the quality of relationships with patients, their families, and coworkers, and the changes in perceived self-efficacy of fulfilling job responsibilities. Telehealth use has increased significantly during COVID-19, requiring further evaluation of its utility. Participants reported both positive and negative inpatient telepalliative care experiences associated with various domains of professional functioning, such as communication, relationships with key stakeholders, and self-efficacy. Enhanced telehealth training and support must be improved to sustain the palliative workforce and promote high-quality patient and family care in the future.
2020 年春季，纽约市是“全球 COVID-19 热点地区”。许多医疗团队迅速转向远程医疗平台。鲜为人知的是，在大流行期间，提供远程医疗服务的住院姑息治疗服务的经验。本研究旨在探讨在 COVID-19 首次激增的 10 周期间，跨学科姑息治疗团队通过远程医疗满足肿瘤住院患者整体需求的经验。在一家城市综合癌症中心，一组跨学科姑息治疗专家参与了深入访谈，探讨了参与者通过远程医疗提供身体、心理社会和精神关怀的经验。一个跨学科的编码团队遵循严格的主题文本分析方法，并定期开会就新出现的主题达成共识。来自六个学科（牧师、医学、护理、药学、医师助理和社会工作）的 11 名姑息治疗专家参与了研究。73%的人报告在 COVID-19 之前没有接受过远程医疗培训，64%的人“一点也不”或“有点”舒适地提供远程姑息治疗。确定了几个主题，包括与远程医疗相关的障碍、远程医疗对与患者、他们的家人和同事关系质量的影响，以及履行工作职责的自我效能感的变化。在 COVID-19 期间，远程医疗的使用显著增加，需要进一步评估其效用。参与者报告了与沟通、与关键利益相关者的关系以及自我效能等各种专业功能领域相关的积极和消极的住院姑息治疗经验。必须加强远程医疗培训和支持，以维持姑息治疗人员队伍，并在未来促进高质量的患者和家庭护理。
