Aim
The COVID-19 pandemic triggered rapid implementation of telehealth (telephone and videoconference) in Australia. Psycho-oncology clinicians report a need for greater guidance on adapting in person psycho-oncology therapies to telehealth. We aimed to establish consensus on elements of psycho-oncology therapy that can be adapted for telehealth for inclusion in an educational resource incorporating clinical practice recommendations.
Methods
Draft recommendations were developed based on existing literature, reviews and guidelines. These were refined using a co-design process involving expert consultation (n=13) with psycho-oncology clinicians and researchers. This process identified some uncertainty around key recommendations. A two round Delphi consensus process was conducted to confirm the relative importance and therapeutic appropriateness of content for inclusion in clinical practice recommendations. Participants included psycho-oncology clinicians with telehealth experience. Respondents rated their level of agreement with each statement on a 5-point Likert scale. Consensus was defined as >80 % of respondents scoring within 2 points on the Likert scale.
Results
The co-design approach identified key topics for inclusion in the recommendations: (1) preparation for telehealth (e.g., privacy, security, technical considerations); (2) clinical and cultural considerations (e.g., safety considerations, therapeutic alliance, vulnerable/underserved communities); (3) adaptations to therapeutic assessment and intervention; (4) specific client considerations (e.g., clients in palliative care). 32 clinicians participated in Delphi Round 1, where thirteen recommendations were presented and consensus reached for nine. Recommendations where consensus was not reached were re-presented in Round 2. We will present the consensus recommendations based on the Delphi.
Conclusion and clinical implication
The clinical practice recommendations will provide a robust expert-endorsed educational resource to guide psycho-oncology clinicians tailoring their practice to telehealth. This will support delivery of evidence-based treatments to people living with cancer, increasing the sustainability of, and confidence in, psycho-oncology telehealth.