Telepalliation Facilitates a Sense of Security for Patients With Terminal Illnesses
Bibliographic record
Abstract
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.
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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 | 0.004 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.003 | 0.003 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.001 | 0.007 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
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".