Understanding palliative medicine physicians’ perceptions and experiences with palliative medicine during COVID-19

logo showing palm of a hand holding 3 stylized people, center figure shows a heartCommunication in palliative care plays a very important role since it ensures that patients and families have a clear understanding of the disease, leads to well-informed decisions, and influences patient and family satisfaction with care (Gabbard & Smith, 2015). Communication also increases the likelihood of agreement between patient-goals and medical records, have a positive impact in form of reduced hospitalizations and life-sustaining treatment, and guarantee a better compliance with patients’ wishes (Brighton & Bristowe, 2016).

The COVID-19 pandemic has brought changes to the traditional way in which medical care is provided, especially for palliative care. Restricted visitation policies, while functional from a public health perspective, increase the sense of isolation and distress for patients and their families, and limit in-person interactions and open communication (Ersek et al., 2020). To facilitate communication in healthcare settings, the use of telehealth has increased to facilitate opportunities to discuss advance care planning on time, patient monitoring, and conduct follow-up visits to adjust medications and offer multidisciplinary management (Grewal et al., 2020; Mackey et al., 2020), in addition to allowing hospitalized patients the opportunity to connect with their families (Rivera et al., 2020).

This project is designed to explore the effects of isolation and restricted visitation policies in palliative care communication during the COVID-19 pandemic and understand the role of technology in the patient-provider relationship in conditions of isolation and social distancing from a healthcare provider’s perspective. The results of this study aim to inform the design of a doctoral thesis project that will contribute to the understanding of communication practices in palliative and end-of-life care in conditions of social distancing and isolation, especially for minorities and vulnerable populations.

References:

Brighton, L. J., & Bristowe, K. (2016). Communication in palliative care: talking about the end of life, before the end of life. Postgraduate Medical Journal, 92(1090), 466–470. https://doi.org/10.1136/postgradmedj-2015-133368

Gabbard, J., & Smith, T. (2015). Communication in Palliative Medicine. In E. Wittenberg, B. R. Ferrel, J. Goldsmith, T. Smith, M. Glajchen, & G. F. Handzo (Eds.), Textbook of Palliative Care Communication (pp. 44-52). Oxford University Press. DOI: 10.1093/med/9780190201708.003.0007

Grewal, U. S., Terauchi, S., & Beg, M. S. (2020). Telehealth and Palliative Care for Patients with Cancer: Implications of the COVID-19 Pandemic. JMIR Cancer, 6(2), e20288. https://doi.org/10.2196/20288

Mackey, R. M., Yeow, M. E., Christensen, A. R., Ingram, C., Carey, E. C., & Lapid, M. I. (2020). Reconnecting: Strategies for Supporting Isolated Older Adults during COVID-19 through Tele-palliative Care. Clinical Gerontologist, 1–8. Advance online publication. https://doi.org/10.1080/07317115.2020.1830905
 
Rivera, V., Aldridge, M. D., Ornstein, K., Moody, K. A., & Chun, A. (2021). RESEARCH Racial and Socioeconomic Disparities in Access to Telehealth. Journal of the American Geriatrics Society, 69(1), 44–45. https://doi.org/10.1111/jgs.16904