Healthcare professionals' experiences of the change to telephone consultations in cancer care during the COVID-19 pandemic: An explorative qualitative study

Abstract

Objective: During the COVID-19 pandemic, changes were made in cancer care including increased use of teleconsultations (TCs) and restrictions for relatives to attend in-person appointments at the outpatient clinics. This study aimed to provide in-depth information on healthcare professionals' experiences of TC and the limited access for relatives during the COVID-19 pandemic in 2020.

Methods: This qualitative study was conducted at an oncological department responsible for oncological care of all patients with cancer in one of five health regions in Denmark. Fourteen healthcare professionals participated in three semi-structured focus group interviews with either secretaries and nurses or physicians, and one semi-structured individual interview with a secretary. Data were analyzed by thematic analysis.

Results: Four overall themes emerged in the thematic analysis: "Possibilities and limitations in relation to TC," "Information load and timing," "Insecurity" and "Lessons learned for the future." Healthcare professionals missed face-to-face interactions, feared to overlook patients' symptoms and relapse during TC, agreed that TC were not suitable for all types of consultations, and experienced improved work environment due to fewer patients and relatives at the department. Furthermore, patients should be involved in the decision of changing to TC, relatives must be recommended to participate in TC, physicians must meet the patient in-person before TC, and video consultations should be considered.

Conclusion: TC may be a valuable supplement to in-person consultations for patients with cancer in the future, and guidelines must be implemented to ensure suitable consultation types for TC, include patients' preferences, and involve relatives.

Keywords: COVID-19; cancer care; healthcare professionals; qualitative study; teleconsultation.