A Pre-Post Evaluation of a Telehomecare Program in Oncology and Palliative Care
Bibliographic record
Abstract
The purpose of this study was to evaluate the effects of a telehomecare intervention implemented in an oncology and palliative care unit in Quebec, Canada. As part of the intervention, nurses working within the oncology and palliative care program were given a tablet PC to use during patients' home visits and capture data related to the patient's encounter. Outcomes of interest were nurses' satisfaction with the software application, perceived quality of care, and individual and group productivity. With regard to productivity, we hypothesized that this system use would increase (1) the number of patients treated by all the nurses involved in the program, (2) the average number of home visits made by a nurse per shift, and (3) the percentage of time nurses spent providing direct care to patients. There was no intention to reduce the number of home visits made to individual patients. In order to assess the effects of the intervention, data collection was performed over three periods, representing the pre-implementation phase and two post-implementation phases, over 8 months. Data were collected using semistructured interviews, questionnaire surveys, and available documents. Findings revealed that nurses showed a positive attitude toward the software application and were satisfied with the quality of the information stored in the system, which appeared to be of great value for recalling patient information during a visit. According to the nurses, the clinical information system increased the completeness and quality of their interventions in the patient's home, mostly in terms of patient assessment, treatment, and education. Finally, in terms of productivity, we observed a significant increase in the number of patients treated by all the nurses (p = 0.04), the average number of home visits made by a nurse per shift (p = 0.02), and the percentage of time spent by nurses providing direct care (p = 0.003). In summary, the telehomecare intervention produced several positive effects that were related to nurses' quality of documentation and productivity.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.015 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".