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An Electronically Delivered Person-Centered Narrative Intervention for Persons Receiving Palliative Care: Protocol

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This study explored an all-electronic person-centered narrative intervention (PCNI) in outpatient settings. Findings suggest PCNI can enhance patient-clinician communication and integrate patient perspectives into electronic health records (EHRs).

Keywords:
electronic health recordmixed methodsnarrativepalliative careperson-centered care

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Area of Science:

  • Health Informatics
  • Patient-Centered Care
  • Qualitative Research Methods

Background:

  • Electronic health records (EHRs) primarily reflect clinician-centered data.
  • Integrating patient narratives into EHRs can improve communication by including cultural values and beliefs.
  • This study adapted a person-centered narrative intervention (PCNI) for all-electronic delivery in an outpatient setting.

Purpose of the Study:

  • Evaluate the feasibility, usability, and effects of an all-electronic PCNI on patient-reported outcomes.
  • Identify barriers and facilitators to internet-based PCNI from patient and clinician perspectives.
  • Assess acceptability, usability, and fidelity for EHR integration of internet-based PCNI.

Main Methods:

  • A mixed-method, single-arm feasibility study conducted over 3-4 weeks.
  • Patient recruitment via screening outpatient palliative care clinic schedules.
  • PCNI delivered via email and Zoom; patient-reported outcomes collected at baseline, 24-48 hours post-intervention, and 1 month post-baseline.

Main Results:

  • 189 potential patient participants were approached, with 20 enrolled.
  • 7 clinician participants were enrolled, with exit interviews and a focus group conducted.
  • Data collection occurred from May 2021 to September 2022; analysis was expected by June 2023.

Conclusions:

  • Findings from this study and acute care settings can inform clinical practices and policies.
  • The study offers innovative approaches to integrate person-centered care delivery.
  • The all-electronic PCNI shows potential for enhancing patient-clinician communication in outpatient settings.