https://scholars.lib.ntu.edu.tw/handle/123456789/522340
標題: | Smartphone-Enabled, Telehealth-Based Family Conferences in Palliative Care During the COVID-19 Pandemic: Pilot Observational Study | 作者: | Wu, Yu-Rui Chou, Tzu-Jung Wang, Yi-Jen JAW-SHIUN TSAI SHAO-YI CHENG CHIEN-AN YAO JEN-KUEI PENG WEN-YU HU TAI-YUAN CHIU HSIEN-LIANG HUANG |
公開日期: | 2020 | 出版社: | NLM (Medline) | 卷: | 8 | 期: | 10 | 來源出版物: | JMIR mHealth and uHealth | 摘要: | Background: In the palliative care setting, infection control measures implemented due to COVID-19 have become barriers to end-of-life care discussions (eg, discharge planning and withdrawal of life-sustaining treatments) between patients, their families, and multidisciplinary medical teams. Strict restrictions in terms of visiting hours and the number of visitors have made it difficult to arrange in-person family conferences. Phone-based telehealth consultations may be a solution, but the lack of nonverbal cues may diminish the clinician-patient relationship. In this context, video-based, smartphone-enabled family conferences have become important. Objective: We aimed to establish a smartphone-enabled telehealth model for palliative care family conferences. Our model integrates principles from the concept of shared decision making (SDM) and the value, acknowledge, listen, understand, and elicit (VALUE) approach. Methods: Family conferences comprised three phases designed according to telehealth implementation guidelines—the previsit, during-visit, and postvisit phases. We incorporated the following SDM elements into the model: “team talk,” “option talk,” and “decision talk.” The model has been implemented at a national cancer treatment center in Taiwan since February 2020. Results: From February to April 2020, 14 telehealth family conferences in the palliative care unit were analyzed. The patients’ mean age was 73 (SD 10.1) years; 6 out of 14 patients (43%) were female and 12 (86%) were married. The primary caregiver joining the conference virtually comprised mostly of spouses and children (n=10, 71%). The majority of participants were terminally ill patients with cancer (n=13, 93%), with the exception of 1 patient with stroke. Consensus on care goals related to discharge planning and withdrawal of life-sustaining treatments was reached in 93% (n=13) of cases during the family conferences. In total, 5 families rated the family conferences as good or very good (36%), whereas 9 were neutral (64%). Conclusions: Smartphone-enabled telehealth for palliative care family conferences with SDM and VALUE integration demonstrated high satisfaction for families. In most cases, it was effective in reaching consensus on care decisions. The model may be applied to other countries to promote quality in end-of-life care in the midst of the COVID-19 pandemic. ? Yu-Rui Wu, Tzu-Jung Chou, Yi-Jen Wang, Jaw-Shiun Tsai, Shao-Yi Cheng, Chien-An Yao, Jen-Kuei Peng, Wen-Yu Hu, Tai-Yuan Chiu, Hsien-Liang Huang. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85094932865&doi=10.2196%2f22069&partnerID=40&md5=bfe6f25bda855463f466db6cf07ec140 https://scholars.lib.ntu.edu.tw/handle/123456789/522340 |
ISSN: | 2291-5222 | DOI: | 10.2196/22069 | SDG/關鍵字: | adult; aged; Coronavirus infection; female; human; human relation; interpersonal communication; male; middle aged; organization and management; palliative therapy; pandemic; pilot study; procedures; smartphone; telemedicine; very elderly; virus pneumonia; Adult; Aged; Aged, 80 and over; Communication; Coronavirus Infections; Female; Humans; Male; Middle Aged; Palliative Care; Pandemics; Pilot Projects; Pneumonia, Viral; Professional-Family Relations; Smartphone; Telemedicine |
顯示於: | 醫學系 |
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