JMIR Publications

ABSTRACT

Background:

In cancer settings, relatives are often seen as a resource as they are able to support the patient and remember information during hospitalization. However, geographic distance to hospitals, work and family obligations are reasons that may cause difficulties for relatives’ physical participation during hospitalization. This provided inspiration to uncover the possibility of telehealth care in connection with enabling participation by relatives during patient rounds. Telehealth is used advantageously in health care systems but is also at risk of failing during the implementation process because of, for instance, health care professionals’ resistance to change. Research of the implications for healthcare professionals by involving relatives through virtual presence is limited.

Objective:

This study aimed to investigate healthcare professionals’ experiences using and implementing technology to involve relatives during video consulted patient rounds.

Methods:

The design was a qualitative approach. Methods used were focus group interviews, short open interviews and field observations of health care professionals working at a cancer department. The text material was analyzed using Interpretative Phenomenological Analysis.

Results:

Field observational studies were conducted for 15 days, yielding 75 hours of observation. Fourteen sessions of video consulted patient rounds were observed, and 15 pages of field notes written, along with 8 short open interviews with physicians, nurses and staff from management. Moreover, 2 focus group interviews with health care professionals (n=9) were conducted. Health care professionals experienced using the technology as a way to facilitate involvement of the patient’s relatives, without them being physically present. Moreover, it raised questions of whether this way of conducting patient rounds could address the needs of both the patients and the relatives. Time, culture and change of work routines were found to be major barriers when implementing new technology involving relatives.

Conclusions:

This study identifies a double change by introducing both new technology and virtual participation by relatives at the same time. The change had consequences for health care professionals’ work routines with regards to work load, culture and organization because of the complexity in health care systems.