Journal article
“It Took Away and Stripped a Part of Myself”: Clinician Distress and Recommendations for Future Telepalliative Care Delivery in the Cancer Context
American journal of hospice & palliative medicine, Vol.40(2), pp.235-243
02/2023
DOI: 10.1177/10499091221101883
PMCID: PMC9663759
PMID: 35574961
Abstract
Background
The COVID-19 pandemic has led to the rapid expansion of telehealth service delivery. We explored the experiences of a multidisciplinary palliative care team delivering telepalliative care for oncology inpatients during a 10-weeks COVID-19 surge in New York City.
Methods/Participants
We conducted semi-structured qualitative interviews with a targeted sample, employing a phenomenological approach with applied thematic text analysis. An interdisciplinary coding team iteratively coded data using a mix of a priori and inductive codes. Team members first independently reviewed each category, then met to reach consensus on recurring themes. The sample (n = 11) included a chaplain (n = 1), social worker (n = 1), pharmacist (n = 1), physicians (n = 3), physician assistant (n = 1), and nurse practitioners (n = 4).
Results
Participants described multidimensional clinician distress as a primary experience in delivering telepalliative care during the COVD-19 surge, characterized by competing loyalties (e.g., institutional obligations, ethical obligations to patients, resentment and distrust of leadership) and feelings of disempowerment (e.g., guilt in providing subpar support, decisional regret, loss of identity as a provider). Participants provided explicit recommendations to improve telepalliative care delivery for acute oncology inpatients in the future.
Conclusion
Palliative care clinicians experienced personal and professional distress providing inpatient telepalliative care during this COVID-19 surge. Clinician strain providing telehealth services must be explored further as the pandemic and utilization of telehealth evolves. Telepalliative care planning must include attention to clinician wellbeing to sustain the workforce and promote team cohesion, and a focus on infrastructure needed to deliver high-quality, holistic care for oncology patients and their families when in-person consultation is impossible.
Details
- Title: Subtitle
- “It Took Away and Stripped a Part of Myself”: Clinician Distress and Recommendations for Future Telepalliative Care Delivery in the Cancer Context
- Creators
- William E. Rosa - Memorial Sloan Kettering Cancer CenterKathleen A. Lynch - Memorial Sloan Kettering Cancer CenterRachel A. Hadler - University of IowaCassidy Mahoney - Memorial Sloan Kettering Cancer CenterPatricia A. Parker - Memorial Sloan Kettering Cancer Center
- Resource Type
- Journal article
- Publication Details
- American journal of hospice & palliative medicine, Vol.40(2), pp.235-243
- DOI
- 10.1177/10499091221101883
- PMID
- 35574961
- PMCID
- PMC9663759
- NLM abbreviation
- Am J Hosp Palliat Care
- ISSN
- 1049-9091
- eISSN
- 1938-2715
- Grant note
- DOI: 10.13039/100000054, name: National Cancer Institute, award: P30 CA008748, T32 CA009461; name: Fellows of the American Association of Nurse Practitioners
- Language
- English
- Electronic publication date
- 05/15/2022
- Date published
- 02/2023
- Academic Unit
- Anesthesia
- Record Identifier
- 9984296136602771
Metrics
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