Telepalliation Facilitates a Sense of Security for Patients With Terminal Illnesses

Background: Each year, an estimated 20 million people worldwide are in need of palliative care. The main diagnosis of people needing palliative care is cancer, followed by cardiovascular disease and chronical obstructive lung disease. The web-based telepalliation program and digital platform (offering video consultation, treatment planning, patient-reported outcomes, chat forum, and information on palliation) was developed through a participatory design process involving patients, their relatives, health care professionals, and researchers. Objective: This study aimed to pilot-test the telepalliation program during the COVID-19 pandemic. Methods: The case study is used as the overall method for the study. The theoretical framework is the Antonovsky “Sense of Coherence” theory. A triangulation of data collection techniques was used: documents (home pages and documents on palliative care) were studied; participant observation was carried out in patients’ homes (n=16 hours); and semistructured qualitative interviews were carried out with 3 women (ages 46-73 years) and 3 men (aged 64-80 years). Of the 6 patients, 4 were diagnosed with cancer and 2 with cardiovascular diseases. The interviews were recorded and analyzed. We followed 7 subjects and conducted 6 interviews; 1 patient dropped out due fatigue. Results: Patients participating in the telepalliation program articulated their experiences in terms of the following themes: a sense of security; a sense of coherence; a feeling that the telepalliation platform facilitates continuity and better communication with health care professionals across sectors; a sense of easier access to the palliative team; and a feeling that their spouse and family were more integrated into the care process, because they could participate in difficult dialogues with the palliative team via video link. Conclusions: Preliminary findings indicate that patients participating in a telepalliation program experience a sense of security, coherence in their care process, and integrated care across sectors for the individual patients. Further research is needed on the potential benefits and drawbacks of telepalliation.