A Formative Mixed-Methods Study of Emotional Responsiveness in Telepalliative Care
Rebecca Hutchinson, Eric Anderson, Mollie A. Ruben, Noah Manning, Liam John, Ava Daruvala, Donna M. Rizzo, Margaret J. Eppstein, Robert Gramling, Paul K. J. Han
Abstract
Background: It is unknown whether telemedicine-delivered palliative care (tele-PC) supports emotionally responsive patient–clinician interactions. Objectives: We conducted a mixed-methods formative study at two academic medical centers in rural U.S. states to explore the acceptability, feasibility, and emotional responsiveness of tele-PC. Design: We assessed clinicians' emotional responsiveness through questionnaires, qualitative interviews, and video coding. Results: We completed 11 tele-PC consultations. Mean age was 71 years, 30% did not complete high school, 55% experienced at least moderate financial insecurity, and 2/3 rated their overall health poorly. All patients rated tele-PC as equal to, or better than, in-person PC at providing emotional support. There was a tendency toward higher positive and lower negative emotions following the consultation. Video coding identified 114 instances of patients expressing emotions, and clinicians detected and responded to 98% of these events. Conclusion: Tele-PC appears to support emotionally responsive patient–clinician interactions. A mixed-methods approach to evaluating tele-PC yields useful, complementary insights.