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Cancer survivors' experience of telehealth: A Systematic Review and Thematic Synthesis

Cox, AC, Lucas, G, Marcu, A, Piano, M, Grosvenor, W, Mold, F, Maguire, R and Ream, E (2017) Cancer survivors' experience of telehealth: A Systematic Review and Thematic Synthesis Journal of Medical Internet Research, 19 (1), e11.

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Abstract

Background: Net survival rates for cancer are increasing worldwide, placing a strain on health service provision. There is a drive to transfer care of cancer survivors - individuals living with and beyond cancer - to the community and encourage them to play an active role in their own care. Telehealth, the use of technology in remote exchange of data and communication between patients and healthcare professionals, is an important contributor to this evolving model of care and may offer additional benefits to cancer survivors. Telehealth is a complex intervention and understanding patient experiences of it is important in evaluating its impact. However, a wider view of patient experience is lacking as qualitative studies detailing cancer survivor engagement with telehealth have yet to be synthesised. Objective: Systematically identify, appraise and synthesise qualitative research evidence on the experiences of adult cancer survivors participating in telehealth intervention(s), to characterise the patient experience of telehealth interventions for this group. Methods: Medline (PubMed), PsychINFO, CINAHL (Cumulative Index for Nursing and Allied Health Professionals), Embase and Cochrane Central Register of Controlled Trial were searched on 14th August 2015 and 8th March 2016 for English-language papers published between 2006 and 2016. Inclusion criteria were: adult cancer survivors aged 18 and over; cancer diagnosis; experience of participating in a telehealth intervention (defined as remote communication and/or remote monitoring with a healthcare professional(s) delivered by telephone, internet, or hand-held/mobile technology); reporting qualitative data including verbatim quotes. An adapted Critical Appraisal Skill Programme (CASP) Checklist for Qualitative Research was used to assess paper quality. The results section of each included article was coded line by line and all papers underwent inductive analysis, involving comparison, re-examination and grouping of codes to develop descriptive themes. Analytical themes were developed through an iterative process of reflection on, and interpretation of, the descriptive themes within and across studies. Results: 22 papers were included. Three analytical themes emerged, each with three descriptive subthemes: 1. Influence of telehealth on the disrupted lives of cancer survivors a. Convenience b. Independence c. Burden 2. Personalised care in a virtual world a. Time b. Space c. The human factor 3. Remote reassurance – a safety net of healthcare professional connection a. Active connection b. Passive connection c. Slipping through the net Telehealth interventions represent a convenient approach which can potentially minimise treatment burden and disruption to cancer survivors’ lives. Telehealth interventions can facilitate an experience of personalised care and reassurance for those living with and beyond cancer, but it is important to consider individual factors when tailoring interventions to ensure engagement promotes benefit rather than burden. Conclusions: Telehealth interventions can provide cancer survivors with both independence and reassurance; both important for everyday life or wellbeing. Future telehealth interventions need to be developed iteratively and in collaboration with a broad range of cancer survivors to maximise engagement and benefit.

Item Type: Article
Subjects : Health Care
Divisions : Faculty of Health and Medical Sciences > School of Health Sciences
Authors :
AuthorsEmailORCID
Cox, ACUNSPECIFIEDUNSPECIFIED
Lucas, GUNSPECIFIEDUNSPECIFIED
Marcu, AUNSPECIFIEDUNSPECIFIED
Piano, MUNSPECIFIEDUNSPECIFIED
Grosvenor, WUNSPECIFIEDUNSPECIFIED
Mold, FUNSPECIFIEDUNSPECIFIED
Maguire, RUNSPECIFIEDUNSPECIFIED
Ream, EUNSPECIFIEDUNSPECIFIED
Date : 9 January 2017
Identification Number : https://doi.org/10.2196/jmir.6575
Copyright Disclaimer : ©Anna Cox, Grace Lucas, Afrodita Marcu, Marianne Piano, Wendy Grosvenor, Freda Mold, Roma Maguire, Emma Ream. Originally published in the Journal of Medical Internet Research (http://www.jmir.org). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.
Uncontrolled Keywords : Neoplasms, Telemedicine, systematic review, survivorship, patient experience
Related URLs :
Depositing User : Symplectic Elements
Date Deposited : 29 Nov 2016 11:48
Last Modified : 09 Feb 2017 09:28
URI: http://epubs.surrey.ac.uk/id/eprint/812976

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