Nurses' Perspectives on the Integration of Telehealth in Palliative Care: A Qualitative Descriptive Study

This study aimed to explore palliative care nurses' perspectives on integrating telehealth into palliative care in Indonesia.

A qualitative descriptive design was employed. Sixteen palliative care nurses were recruited through purposive sampling based on their involvement in palliative care practice. Data were collected through semi-structured interviews and analysed inductively following a five-phase process of qualitative data analysis. The resulting themes were subsequently interpreted through the Non-Adoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework. Methodological rigour was ensured through structured peer debriefing, an audit trail, and detailed procedural documentation to enhance credibility and trustworthiness.

The analysis generated four major themes: (1) structural and regulatory foundations of palliative care; (2) post-discharge care needs and deficiencies; (3) inter-facility coordination gaps affecting continuity of palliative care; and (4) nurses' perceived benefits, barriers, and functional expectations of telehealth in palliative care. The findings indicate that although foundational structures for palliative care have been established, significant gaps remain in care continuity, coordination, and system integration.

This study underscores the need for a more integrated palliative care system in Indonesia. Nurses perceived telehealth as a potentially valuable complementary modality for supporting continuity of care, although this study did not evaluate its implementation feasibility, clinical effectiveness, or scalability. Strengthening regulatory frameworks, improving healthcare workforce capacity, and increasing public and patient readiness for digital health were identified by participants as prerequisites for the future development of telehealth-based palliative care services.

The findings indicate that nurses require clearer regulatory guidance, structured inter-facility coordination mechanisms, and dedicated workforce capacity before telehealth can be formally and safely integrated into palliative care pathways. Nurse leaders and policymakers can draw on these findings to prioritise the formalisation of referral and communication protocols, the development of telehealth-specific competencies among palliative care nurses, and the preparation of patients and families for digitally supported home-based care.

These findings are relevant to palliative care nurses, nurse leaders, health policymakers, and researchers in Indonesia and other resource-constrained health systems seeking to inform the future regulation, workforce preparation, and system-level integration of telehealth-based palliative care.

This study adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) reporting guideline.

Patients or members of the public were not involved in the design, conduct, analysis, or reporting of this study. Participants were palliative care nurses who contributed their perspectives through semi-structured interviews.