Optimization of complex palliative care at home by making use of expert consultation via telemedicine - a socio-ethical study

Recruitment & Eligibility

Status: Completed

Sex: Not specified

Target Recruitment: 30

Inclusion Criteria

GP's:
• are willing to participate in the study, i.e. willing to make time for the implementation of TM in their daily practice, to make time for interviews with the researcher, and leave room for their patients to participate in this research.
• have to be willing to resolve patient*s issues, caused unintentionally by the interviews.
• have shown some affection with research in the past.;The sample of gp*s will vary on:
• willingness to adopt advanced communication technologies
• the experience with treating and caring for palliative patients. ;PATIENTS:
• Patients are included if they either a) suffer of cancer or b) suffer of COPD .
* The patient finds him-/herself in a progressive palliative phase (Karnofsky-score < 60).
* Estimated life expectancy < 3 months.
* Patients are included if they have received a ZZP10 home care-indication.
* In case of COPD patient trajectories are rather difficult to determine. We will include 6 patients with COPD who seem to be in the last phase of their disease and bear in mind that these patients might live beyond these 8 to 12 weeks.
• Patients are included if they fit one of the three age-subgroups
* age 18-45 (6 patients)
* age 45-65 (12 patients)
* age 65- ... (6 patients);Inclusion criteria designed to guarantee homogeneity within the studied patient-group.;• Patients are included when they are aware of their disease as well as the state of their disease.
• Patients are included if they are surrounded by proxies.
• Patients are included if both the patient and his/her proxies give their informed consent.
• Patients are included if the patient and his/her proxies agree to be assisted by the ZZG home care organization during the palliative trajectory.

Exclusion Criteria

• The patient is incompetent.
• The patient wishes to die in a hospice.
• The patient does not speak and/or understand Dutch.

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
<p>• Participants* experiences of the use of telemedicine in the practice of home<br /><br>based palliative care.<br /><br>• The (moral) acceptability of telemedicine in palliative care. </p><br>

Secondary Outcome Measures

Name	Time	Method
<p>• The absorption of the telemedicine-application into existing palliative care<br /><br>giving and/or social routines, or the creation of new routines for the<br /><br>telemedicine-application.<br /><br>• Communication patterns (in terms of transmission, registration, consultation,<br /><br>and conversation) facilitated by the telemedicine-application.<br /><br>• The consequences of the mediation by the telemedicine-application for<br /><br>communication in existing or new supportive and/or care giving relationships<br /><br>(in terms of maintenance, elaboration, and modification).<br /><br>• (Normative) evaluation of the fit of telemedicine in participants* and<br /><br>bioethicists* conceptions about a good death and good palliative care.<br /><br>• (Normative) evaluation of the effects of telemedicine on the patient*s<br /><br>position in his/her own care process. </p><br>