Enhancing palliative care for advanced cancer patients: evaluating implementation and impact of a virtual nurse-led symptom monitoring and telehealth initiative.
Background: As a result of the COVID-19 pandemic, we implemented a novel nurse-led symptom monitoring and virtual telehealth program for patients with advanced cancer on palliative care. Aims: To evaluate the reach, effectiveness, adoption, implementation, maintenance and acceptability of our progra...
| Publicado en: | BMC Palliative Care Vol. 23; no. 1; pp. 1 - 9 |
|---|---|
| Autores principales: | , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
BioMed Central
10/8/2024
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=180153558&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 180153558 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 1472684X 1CID jtl: BMC Palliative Care issn: 1472684X maglogo: N pubinfo: dt: 10/8/2024 vid: 23 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 180153558 180153558 180153558 10.1186/s12904-024-01541-0 180153558 ppf: 1 ppct: 8 formats: tig: atl: Enhancing palliative care for advanced cancer patients: evaluating implementation and impact of a virtual nurse-led symptom monitoring and telehealth initiative. aug: au: Neo, Shirlyn Hui-Shan Mok, Natalie Ng, Xin-Hui Zhu, Xia affil: https://ror.org/03bqk3e80 Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, S169610, Singapore, Singapore sug: subj: Palliative Care Methods Neoplasm Staging Cancer Patients Telemedicine Methods Nurse-Patient Relations COVID-19 Nursing Neoplasms Complications Neoplasms Therapy Signs and Symptoms Nursing Program Evaluation Program Implementation Program Development Human Male Female Middle Age Aged Aged, 80 and Over Funding Source Prospective Studies Patient-Reported Outcomes Health Services Accessibility Quality of Health Care Process Assessment (Health Care) Outcome Assessment Functional Status Scales Financial Management Questionnaires Health Services Research Implementation Science Patient Attitudes Descriptive Statistics Patient Satisfaction Referral and Consultation Self Report Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: Background: As a result of the COVID-19 pandemic, we implemented a novel nurse-led symptom monitoring and virtual telehealth program for patients with advanced cancer on palliative care. Aims: To evaluate the reach, effectiveness, adoption, implementation, maintenance and acceptability of our program. Methods: This was a prospective study carried out in a cohort of patients with advanced cancer over the period of 3rd June 2020 to 22nd October 2021. Demographic characteristics, cancer diagnosis, and functional status of patients were collected upon recruitment. Patients were asked to complete a patient-reported outcome measure (the Integrated Palliative Care Outcome Scale, IPOS) prior to the first palliative care consult and subsequently every week for the duration of their participation in the program (12 weeks). The IPOS measures the severity of physical symptoms, emotional concerns, information, and financial needs. Participants' utilization of healthcare services by participants 3 months before, during and 3 months after the telemedicine program was reviewed. At the end of the program, a client satisfaction questionnaire (CSQ-4) to survey participants' experience with the telehealth program and their willingness to pay for this program was administered. Results: Reach: The recruitment to adoption ratio of the program was 0.71. Acceptability:: Participants expressed satisfactory experience. Effectiveness: We noted that the severity of patients' symptoms and number of emergency department visits decreased over time with nurse support. Adoption: we received referrals from 23 oncologists, yielding an adoption rate of 70%. Implementation: Of the 99 patients recruited for the program, 88.9% of them managed to complete their initial video consults as planned. 16% of them failed to complete the program due to factors such as patient demising. Maintenance: The declining rate of IPOS completion throughout the study period (98.9% at week 1 to 60.8% at week 12) demonstrated the difficulties in sustaining regular administration of self-reported patient outcome measures. Conclusion: The telemedicine program was effective and acceptable. We noted challenges in sustaining the administration of patient reported outcome measures over time. Further studies on how we can improve the sustainability of symptom monitoring in a telehealth program for patients with advanced illnesses, under palliative care, should be conducted. Contributions to the literature: • A virtual, nurse-led telehealth symptom monitoring service for patients with advanced cancer under palliative care, has acceptable reach, adoption from oncologists, is effective and could be implemented satisfactorily in the Asian population. • However, there are challenges in sustaining the regular reporting of patient reported outcome measures over time. • The use of the REAIM framework in this study has helped guide the evaluation of programs and helped generate areas for future studies. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|