O-18 Design with us, not for us: motivations and challenges of digital technology use in palliative care from the patient’s perspective

Abstract

Background Digital technologies are increasingly present in palliative care, yet there is limited understanding about how patients experience, value, or avoid them. The voices of patients, who often face physical, emotional, and cognitive challenges, are frequently under-represented in decisions about how these tools are selected, designed and implemented.

Aim To explore the motivations and challenges for digital technology use in palliative care from the perspective of patients, including ideas for innovation, grounded in lived experiences.

Method Semi-structured interviews (n=20) were conducted with multiple stakeholders including patients receiving in-patient and community-based palliative care at a hospice in North West England. A hybrid inductive and deductive thematic analysis was applied, resulting in eleven overarching themes, including ethics, technology implementation and physical needs.

Results Patients described using a range of technologies from Virtual Reality (VR), and WhatsApp to iPads and mobile phones. VR was described by one patient as profoundly meaningful, allowing them to experience a mountain walk from the hospice bed. When technology did not meet their needs, however, it became burdensome, one patient reporting that using an iPad in bed was difficult because of physical constraints. Technology innovation ideas included a desire for a virtual hospice linked to patients’ smart televisions at home, to provide remote care and support. Pain and symptom management remained a priority, with ideas including apps for tracking and communicating symptoms. Findings show that although patients had mixed digital confidence, many saw value in technology when it offered reassurance, reduced isolation, or supported care.

Conclusion Patients did not reject technology, they asked for it to be easy and meaningful. Listening to what matters to patients should inform how we design with them, not just for them. Their experiences are not just stories; they are evidence to guide more usable and inclusive digital technologies in palliative care.