Survey results
| Hospice professionals | Patients/carers | |
| Preparedness for VC | “Concerns about missing something—non-verbal communication, physical signs.” (physiotherapist) “…if the patient or relative would find this a stressful process and if they could cope with the technology.” (nurse) “not always easy to find an undisturbed place at home, concern neighbours may hear through open window.” (nurse) “Concerns about the technology and the internet cutting out and therefore making conversations quite fragmented.” (doctor) | “…had never heard of Zoom or how to use it, but it is so easy.” (patient) |
| Inclusion of family and other HCPs in VC | “…it ensured the GP and I were both aware of the patient’s concerns, what the plan is and encouraged collaborative working…” (doctor) “Doctor and clinical nurse specialist present so could have a multiprofessional team discussion with the patient and family.” (physiotherapist) “Patients/carers often tell us that they enjoy being in the sessions with their loved ones as they feel less isolated, and more relaxed.” (member of the well-being team) “Supported…patient to use technology…able to see all supporting members, as well as patient, and help(ed) to also understand their needs as would in home visit.” (nurse) “…we were able to have ACP conversations together and the patient’s husband was able to help with the tablet for the zoom, whereas the patient may not have had the strength/capability to do this on her own as she was fatigued in bed…” (doctor) | “My wife attended the first Zoom session which was good because we both met the nurse for the first time and understood the objectives of the sessions and the palliative role as a whole.” (patient—new referral to hospice during pandemic) “I am unable to speak so my husband was my voice.” (patient) “I just wanted them to participate in case they wanted to ask something.” (patient) |
| Barriers to VC | “…lack of right equipment, fear of using video, prefer to talk on telephone…” (nurse) “Preferred face-to-face as felt his voice was too weak on the phone or video call.” (doctor) “The perception for some has been that it would be too technically difficult. Some patients/carers were open to us helping them set it up over the phone and have subsequently been delighted that they are now able to access this technology…” (member of well-being team) “I have had several consultations that have been quite disjointed due to the patient’s Wi-Fi dropping out and this can be quite disruptive, especially when you are in the middle of a sensitive conversation.” (doctor) “It is not appropriate for all our patient population for example, those with communication difficulties such as MND, very deaf patients, elderly patients who are not familiar or do not have access to devices…” (doctor) | “There may be times when the complexity of the subject is such that a face-to-face is strongly advantageous to a virtual consultation.” (patient) “It helps significantly if the patient is comfortable with the technology and has the equipment.” (patient) “In times of serious issues being shared. In times of serious upset.” (patient) “…will always be second best to face-to-face but a close second and a lot better than telephone.” (patient) “Sometimes I think an examination would also work.” (carer) |
| Future use of VC in hospice care | “I feel that there needs to be a mixture of video calls and visits/face-to face interaction as a video call would be sufficient in some cases.” (nurse) “We can use the technology to talk to people who are scared of visiting the hospice and give them an idea of what this is really about.” (member of well-being staff) “I have found it possible to contact more patients and offer advice and assess whether a face-to-face visit is necessary.” (physiotherapist) “Very beneficial for patients who are at home and can’t leave the house for variety of reasons—seeing a face can be more reassuring than a voice at the end of the phone.” (speech and language therapist) “It gives professionals and patients a choice especially if they are hard to reach due to travel problems and mobility issues.” (social worker) “We need to ensure all staff have the correct equipment and have an SOP in place to ensure safety and consistency across the team.” (nurse) | “I think you should maintain it as an option and offer it to patients when face-to-face is not warranted or difficult to schedule.” (patient) “Video is great when you can do things easily as it’s a long drive there. Nice to have been to the hospice at least once to be introduced and see facilities and people.” (patient) |
ACP, advance care planning; GP, general practitioner; HCPs, healthcare professionals; MND, motor neuron disease; SOP, standard operating procedure; VC, video consultation.