A nurse-led approach to testing and adapting a telehealth guide for e-empathy in goals of care conversations for Black patients with chronic kidney disease.

Abstract

This study aims to explore and enhance the expression of empathy in telehealth visits (e-empathy) with Black American Chronic Kidney Disease (CKD) patients, focusing on goals of care conversations. It seeks to address the intersection of CKD, telehealth advancements, palliative care discussions, and the impact of racism in healthcare for holistic understanding. A qualitative case study design was employed in Washington, DC, involving Black patients with CKD. Data collection included cognitive testing via semi-structured interviews and feedback from a Stakeholder Advisory Group (SAG). Thematic analysis was conducted using NVivo 20 software. Themes emerged regarding empathy definitions, telehealth understanding, factors influencing confidence, importance of patient stories, cultural awareness, handling upsetting conversations, prioritizing treatment preferences, end-of-life decisions, and definitions of mental health professionals. The study highlights the significance of e-empathy in telehealth for Black CKD patients, emphasizing respect, trust, and effective communication. It underscores the need for culturally targeted guidance and acknowledges limitations such as self-selection bias and a small sample size. Future work should address healthcare disparities and improve palliative care discussions, including virtual advance directives. Providers should prioritize e-empathy in telehealth visits with Black CKD patients, fostering trust and communication to improve patient outcomes during goals of care discussions.