“It's hard to talk to a computer, I get it”: An exploratory analysis of clinician connection-building communication practices in rural telepalliative care encounters
Context/Objectives: Establishing human connection is critical during serious illness conversations, however the sensory and relational environment of telehealth may require innovative communication practices for clinicians, patients, and families to do so effectively. We sought to explore if and how...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-06-01
|
| Series: | PEC Innovation |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772628225000068 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832573032243134464 |
|---|---|
| author | Elise C. Tarbi Natalie Ambrose Eric C. Anderson Rebecca N. Hutchinson Paul K.J. Han Maija Reblin Robert Gramling |
| author_facet | Elise C. Tarbi Natalie Ambrose Eric C. Anderson Rebecca N. Hutchinson Paul K.J. Han Maija Reblin Robert Gramling |
| author_sort | Elise C. Tarbi |
| collection | DOAJ |
| description | Context/Objectives: Establishing human connection is critical during serious illness conversations, however the sensory and relational environment of telehealth may require innovative communication practices for clinicians, patients, and families to do so effectively. We sought to explore if and how recommended in-person best practices for establishing human connection are adapted to the telehealth palliative care (telePC) setting, to enable discovery and description of practice innovations in this new care environment. Methods: We analyzed data from the Northern New England Palliative Care TeleConsult Research Study – a formative mixed-methods pilot study at two academic medical centers in rural US states with patients with serious illness (2019–2020). We used a qualitative descriptive approach paired with directed content analysis to analyze video-recorded telePC consultations. Results: Nine video-recorded telePC consultations were analyzed including 9 patients and 6 palliative care clinicians. Patient-participants had a mean age of 68 years, 56 % were women, and 38 % did not complete high school. Mean consultation duration was 52 min (standard deviation 10, range 40–70 min). Our qualitative analysis of visits resulted in three key themes describing clinician communication: 1) Practices for fostering human connection; 2) Practices for overcoming technical problems/difficulties; and 3) Practices for engaging in multi-participant tele-conversations. Conclusion: Our study findings help to provide proof-of-concept evidence that clinicians can use recommended in-person connection-building communication practices in telePC. As palliative care clinicians naturally adapt to telehealth environments, more empirical research is needed to understand which innovative approaches most effectively foster human connection. Innovation: TelePC represents an expanding, yet understudied, mode of palliative care delivery. This study is among the first to describe how the telePC context is catalyzing naturally-occurring communication innovations. |
| format | Article |
| id | doaj-art-b6c327dbc58c493aa18b2a6ade39e6f7 |
| institution | Kabale University |
| issn | 2772-6282 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | PEC Innovation |
| spelling | doaj-art-b6c327dbc58c493aa18b2a6ade39e6f72025-02-02T05:29:32ZengElsevierPEC Innovation2772-62822025-06-016100377“It's hard to talk to a computer, I get it”: An exploratory analysis of clinician connection-building communication practices in rural telepalliative care encountersElise C. Tarbi0Natalie Ambrose1Eric C. Anderson2Rebecca N. Hutchinson3Paul K.J. Han4Maija Reblin5Robert Gramling6Department of Nursing, University of Vermont, Burlington, VT, USA; Department of Family Medicine, Vermont Conversation Lab, University of Vermont, Burlington, VT, USA; Corresponding author at: 106 Carrigan Drive, Burlington, VT 05405, USA.Department of Nursing, University of Vermont, Burlington, VT, USACenter for Interdisciplinary Population and Health Research, MaineHealth Institute for Research, Westbrook, ME, USA; Tufts University School of Medicine, Boston, MA, USACenter for Interdisciplinary Population and Health Research, MaineHealth Institute for Research, Westbrook, ME, USADivision of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USADepartment of Family Medicine, Vermont Conversation Lab, University of Vermont, Burlington, VT, USADepartment of Family Medicine, Vermont Conversation Lab, University of Vermont, Burlington, VT, USAContext/Objectives: Establishing human connection is critical during serious illness conversations, however the sensory and relational environment of telehealth may require innovative communication practices for clinicians, patients, and families to do so effectively. We sought to explore if and how recommended in-person best practices for establishing human connection are adapted to the telehealth palliative care (telePC) setting, to enable discovery and description of practice innovations in this new care environment. Methods: We analyzed data from the Northern New England Palliative Care TeleConsult Research Study – a formative mixed-methods pilot study at two academic medical centers in rural US states with patients with serious illness (2019–2020). We used a qualitative descriptive approach paired with directed content analysis to analyze video-recorded telePC consultations. Results: Nine video-recorded telePC consultations were analyzed including 9 patients and 6 palliative care clinicians. Patient-participants had a mean age of 68 years, 56 % were women, and 38 % did not complete high school. Mean consultation duration was 52 min (standard deviation 10, range 40–70 min). Our qualitative analysis of visits resulted in three key themes describing clinician communication: 1) Practices for fostering human connection; 2) Practices for overcoming technical problems/difficulties; and 3) Practices for engaging in multi-participant tele-conversations. Conclusion: Our study findings help to provide proof-of-concept evidence that clinicians can use recommended in-person connection-building communication practices in telePC. As palliative care clinicians naturally adapt to telehealth environments, more empirical research is needed to understand which innovative approaches most effectively foster human connection. Innovation: TelePC represents an expanding, yet understudied, mode of palliative care delivery. This study is among the first to describe how the telePC context is catalyzing naturally-occurring communication innovations.http://www.sciencedirect.com/science/article/pii/S2772628225000068Serious illness communicationTelehealthTelepalliative careRural health |
| spellingShingle | Elise C. Tarbi Natalie Ambrose Eric C. Anderson Rebecca N. Hutchinson Paul K.J. Han Maija Reblin Robert Gramling “It's hard to talk to a computer, I get it”: An exploratory analysis of clinician connection-building communication practices in rural telepalliative care encounters PEC Innovation Serious illness communication Telehealth Telepalliative care Rural health |
| title | “It's hard to talk to a computer, I get it”: An exploratory analysis of clinician connection-building communication practices in rural telepalliative care encounters |
| title_full | “It's hard to talk to a computer, I get it”: An exploratory analysis of clinician connection-building communication practices in rural telepalliative care encounters |
| title_fullStr | “It's hard to talk to a computer, I get it”: An exploratory analysis of clinician connection-building communication practices in rural telepalliative care encounters |
| title_full_unstemmed | “It's hard to talk to a computer, I get it”: An exploratory analysis of clinician connection-building communication practices in rural telepalliative care encounters |
| title_short | “It's hard to talk to a computer, I get it”: An exploratory analysis of clinician connection-building communication practices in rural telepalliative care encounters |
| title_sort | it s hard to talk to a computer i get it an exploratory analysis of clinician connection building communication practices in rural telepalliative care encounters |
| topic | Serious illness communication Telehealth Telepalliative care Rural health |
| url | http://www.sciencedirect.com/science/article/pii/S2772628225000068 |
| work_keys_str_mv | AT elisectarbi itshardtotalktoacomputerigetitanexploratoryanalysisofclinicianconnectionbuildingcommunicationpracticesinruraltelepalliativecareencounters AT natalieambrose itshardtotalktoacomputerigetitanexploratoryanalysisofclinicianconnectionbuildingcommunicationpracticesinruraltelepalliativecareencounters AT ericcanderson itshardtotalktoacomputerigetitanexploratoryanalysisofclinicianconnectionbuildingcommunicationpracticesinruraltelepalliativecareencounters AT rebeccanhutchinson itshardtotalktoacomputerigetitanexploratoryanalysisofclinicianconnectionbuildingcommunicationpracticesinruraltelepalliativecareencounters AT paulkjhan itshardtotalktoacomputerigetitanexploratoryanalysisofclinicianconnectionbuildingcommunicationpracticesinruraltelepalliativecareencounters AT maijareblin itshardtotalktoacomputerigetitanexploratoryanalysisofclinicianconnectionbuildingcommunicationpracticesinruraltelepalliativecareencounters AT robertgramling itshardtotalktoacomputerigetitanexploratoryanalysisofclinicianconnectionbuildingcommunicationpracticesinruraltelepalliativecareencounters |