Descriptive Study to Explore Nurse-Patient Videoconferencing Relationships in Oncology Ambulatory Care

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“Looking at how the movement toward videoconferencing visits during the COVID-19 pandemic affects the nurse-patient relationship and the capacity to maintain high quality, supportive cancer care is essential…”

A new qualitative study will determine what behaviors, communication techniques, and relational practices are vital in the videoconferencing telehealth era. This study will attempt to explore practical guidelines for relationship building and establishing rapport between patients and oncology nurses through screen-to-screen communication.

Data collection is set to begin in the summer of 2021 and the researchers anticipate results by winter of the same year. Researchers well-versed in qualitative methodology will perform a conventional content analysis using the first--and second-level codes extracted from the transcribed text data.

“A strong and supportive nurse-patient relationship is especially important for persons with cancer,” Paula D. Koppel, MS, RN, GNP-BC, AHN-BC, NBC-HWC and Jennie C De Gagne, PhD, DNP, RN, NPD-BC, CNE, both from Duke University School of Nursing, argue. “Looking at how the movement toward videoconferencing visits during the COVID-19 pandemic affects the nurse-patient relationship and the capacity to maintain high quality, supportive cancer care is essential, given the likelihood that telehealth videoconferencing visits will become an enduring component of cancer care.”

Researchers will conduct a series of semi-structured narrative interviews with both patients with cancer and oncology nurses to facilitate an understanding of rapport building via telehealth videoconferencing. Interviews themselves will be conducted on videoconferencing platforms to abide by COVID-19 safety protocols and restrictions. Nurses and patients will be interviewed separately in order to ensure that insight gained is honest and to allow for comparative analysis of the different perspectives.

Recruiting will be conducted at the oncology clinics at the ambulatory care center through a combination of efforts including, but not limited to, nursing staff meeting announcements, web-based postings on message boards, and study brochure distribution. Informal caregivers will be allowed to be included in this process in an effort to reduce the recruitment process burden on patients with cancer.

The study will not discriminate on the basis of age, self-reported gender, identity, race or ethnicity, except for in cases where it is necessary to meet the inclusion and exclusion criteria. While there certainly is legitimate concern regarding the question of laying further burden upon the patients, literature suggests that patients with cancer are often able to find meaning in the disease by participating in such research.

By concentrating exclusively on nurse-patient rapport in oncology-ambulatory settings, this study aims to not only accurately describe but better understand the challenges, barriers and experiences that one faces in these computer-mediated encounters. Such unique barriers might include nurses’ uncertainty regarding patient privacy, a lack of sensory input due to the limited view of peripheral spaces, and full visualization of body language, as well as a lost sense of physical connectedness. One unsurprising challenge reported to have a negative impact on rapport is technological difficulties.

“The nurse’s technological competency is seen as another way of caring. From this vantage point, videoconferencing visits can be a way to maintain human connectedness during the pandemic or even beyond,” the researchers wrote.

This study hopes to create a foundation for developing such interventions and guidelines so as to facilitate smoother screen-conference experiences. Learning to successfully navigate the world of telehealth videoconferences will most likely continue to be vital to nurses as the potential benefits to patients, providers and health care systems indicate that the use of virtual communication will continue to exist even after the pandemic subsides.

Reference

Koppel P, De Gange J, Exploring nurse and patient experiences of developing rapport during oncology ambulatory care videoconferencing videos; protocol for a qualitative study. JMIR Research Protocols. 2021;10(6):1-11 doi:10.2196/27940.

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