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

Bradford, Natalie K., Young, Jeanine, Armfield, Nigel R., Herbert, Anthony and Smith, Anthony C. (2014) Home telehealth and paediatric palliative care: clinician perceptions of what is stopping us?. BMC Palliative Care, 13 1: 29.1-29.10. doi:10.1186/1472-684X-13-29

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Author Bradford, Natalie K.
Young, Jeanine
Armfield, Nigel R.
Herbert, Anthony
Smith, Anthony C.
Title Home telehealth and paediatric palliative care: clinician perceptions of what is stopping us?
Journal name BMC Palliative Care   Check publisher's open access policy
ISSN 1472-684X
Publication date 2014-06-16
Year available 2014
Sub-type Article (original research)
DOI 10.1186/1472-684X-13-29
Open Access Status DOI
Volume 13
Issue 1
Start page 29.1
End page 29.10
Total pages 10
Place of publication London, United Kingdom
Publisher BioMed Central
Language eng
Formatted abstract
Background: Advances 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.

Methods: Semi-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.

Results: Four 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.

Conclusions: Effective 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.
Keyword Palliative care
Home care
Health service
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

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Created: Tue, 24 Jun 2014, 20:54:36 EST by Burke, Eliza on behalf of Centre for On-Line Health