Telehealth-Based Family Conferences with Implementation of Shared Decision Making Concepts and Humanistic Communication Approach: A Mixed-Methods Prospective Cohort Study

被引:7
作者
Chou, Tzu-Jung [1 ]
Wu, Yu-Rui [2 ]
Tsai, Jaw-Shiun [1 ,3 ,4 ]
Cheng, Shao-Yi [1 ,3 ,4 ]
Yao, Chien-An [1 ,3 ]
Peng, Jen-Kuei [1 ,3 ,4 ]
Chiu, Tai-Yuan [1 ,3 ,4 ]
Huang, Hsien-Liang [1 ,3 ,4 ]
机构
[1] Natl Taiwan Univ Hosp, Dept Family Med, Taipei 100, Taiwan
[2] Taitung Christian Hosp, Dept Family Med, Taitung 950, Taiwan
[3] Natl Taiwan Univ, Dept Family Med, Coll Med, Taipei 100, Taiwan
[4] Natl Taiwan Univ Hosp, New Southbound Hlth Ctr, Taipei 100, Taiwan
关键词
COVID-19; clinical encounter; family conference; shared-decision making; telehealth; DOCTOR-PATIENT-RELATIONSHIP; PALLIATIVE MEDICINE; CARE; SATISFACTION; OPPORTUNITIES; TELEMEDICINE; VALIDATION;
D O I
10.3390/ijerph182010801
中图分类号
X [环境科学、安全科学];
学科分类号
08 ; 0830 ;
摘要
Smartphone-enabled, telehealth-based family conferences represent an attractive and safe alternative to deliver communication during the COVID-19 pandemic. However, some may fear that the therapeutic relationship might be filtered due to a lack of direct human contact. The study aims to explore whether shared decision-making model combining VALUE (Value family statements, Acknowledge emotions, Listen, Understand the patient as a person, Elicit questions) and PLACE (Prepare with intention, Listen intently and completely, Agree on what matters most, Connect with the patient's story, Explore emotional cues) framework can help physicians respond empathetically to emotional cues and foster human connectedness in a virtual context. Twenty-five virtual family conferences were conducted in a national medical center in Taiwan. The expression of verbal emotional distress was noted in 20% of patients and 20% of family members, while nonverbal distress was observed in 24% and 28%, respectively. On 10-point Likert scale, the satisfaction score was 8.7 & PLUSMN; 1.5 toward overall communication and 9.0 & PLUSMN; 1.1 on meeting the family's needs. Adopting SDM concepts with VALUE and PLACE approaches helps physicians foster connectedness in telehealth family conferences. The model has high participant satisfaction scores and may improve healthcare quality among the pandemic.</p>
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页数:12
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