Exploring Nurse and Patient Experiences of Developing Rapport During Oncology Ambulatory Care Videoconferencing Visits: A Qualitative Study (Preprint)
Authors: Koppel Paula D , De Gagne Jennie C , Docherty Sharron , Smith Sophia , Prose Neil S , Jabaley Terri 
Published: May 2022

BACKGROUND

Although videoconferencing between oncology patients and nurses became routine during the pandemic, little is known about the development of clinician-patient rapport in this care environment. Evidence that virtual visits may challenge nurses’ ability to form connections with patients, demonstrate empathy, and provide support suggests that videoconferencing may not ensure optimal care for persons with cancer. Establishing rapport during videoconferencing visits is important in oncology nursing, as rapport enables the nurse to provide emotional support and assistance to patients as they navigate their cancer journey.

OBJECTIVE

This study investigated the nature of nurse-patient rapport in ambulatory cancer care videoconferencing telehealth visits. Objectives included exploring (1) how patients with cancer and nurses describe experiences of and strategies for cultivating rapport, and (2) similarities and differences between rapport in videoconferencing and in-person visits.

METHODS

Qualitative descriptive study. Interviews were conducted with 22 participants comprising patients with cancer (n=10) and oncology nurses (n=12) about their experiences of rapport-building during videoconferencing visits. All interviews were analyzed using conventional content analysis. Data from nurses and patients were analyzed separately using identical procedures, with comparative analysis of patient and nurse results performed in the final analysis.

RESULTS

Most patients in the study had experienced 3-5 video visits within the past 12 months (n=7, 70%). Half of the nurse participants (n=6) reported having participated in over 100 videoconferencing visits, and all had experiences with videoconferencing (ranging from 3 to 960 visits) over the previous 12 months. Three themes and 6 categories were derived from the patient data. Four themes and 13 categories were derived from the nurse data. Comparisons of themes derived from participant interviews identified similarities in how nurses and patients described experiences of rapport during videoconferencing visits. Three themes fit the collective data: (1) person-centered and relationship-based care is valued and foundational to nurse-patient rapport in oncology ambulatory care regardless of how care is delivered, (2) adapting a “bedside” manner to facilitate rapport during videoconferencing visits is feasible, and (3) nurses and patients can work together to create person-centered options across the care trajectory to ensure quality care outcomes.

CONCLUSIONS

Person-centered and relationship-based approaches can be adapted to support nurse-patient rapport in telehealth, including forming a personal connection with the patient and using active listening techniques. Barriers to relationship-building in videoconferencing include unexpected interruptions from others, breaks in internet connection, concerns about privacy, and limitations associated with not being physically present. Balancing these challenges and limitations with the benefits of videoconferencing is an essential competency requiring additional research and guidelines.

INTERNATIONAL REGISTERED REPORT

RR2-10.2196/27940