Table 3:

Selected quotes from participants according to the discussion themes

Major themesQuotes
Access to technology and Internet are barriers“I was speaking with one patient who said that she can’t afford Internet so she gets in her wheelchair and goes to the library and sits outside the library and picks up their Internet. But during the pandemic when they closed the library they also shut down the Internet.” (Group 4, Caregiver 1)
“My husband had 2 strokes and both of them were during the pandemic, so everything was done through Zoom, which we’d never used before. He is not computer literate and he wouldn’t really be there for a lot of the discussions. Physio, how do you do physio over Zoom? That’s pretty tricky. OT and speech were all done by Zoom. But after about 10 minutes we kind of lost his interest, so it was really hard to keep him involved.” (Group 4, Caregiver 2)
“For the first one, income, like I said, I don’t own a computer myself so I can’t afford a computer right now, especially with COVID times and not working so I’m sure I’m not the only one in that boat right now.” (Group 6, Caregiver 1)
“The thing about virtual care would be so great, but you guys are talking about in your room being a place where there’s a dead zone; we’ve got whole roads that are dead zones.” (Group 5, Patient 1)
Language barriers and cultural differences can affect virtual care“English is not my mother tongue and then I just remember one of my appointment with a doctor. It was about my shoulder, so even though I have a degree in physical education, I got to know all the muscles in Latin, I was unable to explain my problem in English.” (Group 5, Patient 2)
“I mean, in my family, my parents don’t speak English very well, so it happens that I often have to call back and just get them clarification on some of the results or anything that’s happened at their appointments or my sibling’s appointments.” (Group 1, Patient 3)
Caregiver and family involvement“My husband can’t use a computer. He has no idea even how to turn it on. All the appointments have to be set up when I’m there. He can’t answer the phone, he has no strength in his hands, so I have to make all the arrangements to get the phone and get it on speaker and it’s really difficult for him to deal with technology.” (Group 4, Caregiver 2)
“It’s impacted my mother because she doesn’t own a cellphone and she doesn’t have Wi-Fi or a computer. […] I feel like I need to be there all the time. I’m only 2 blocks away from my mom, but we speak quite a few times during the day and I just feel like I need to be around all the time, yeah.” (Group 6, Caregiver 1)
“You might not have access to virtual care and it would be up to the doctor to realize that you live separately. The caregiver may have access to a computer and Internet, but the patient may not. Does that mean the caregiver has to go and take all their phone or whatever over to the patient every time?
There’s a lot of moving parts there that you need to think about.” (Group 4, Caregiver 1)
Privacy, consent and confidentiality considerations“I think the issue of privacy comes up to my mind and I put something in the chat about that as well just, if you’re at home and you have other family at home and maybe you want to have a private conversation, your family might listen in and you don’t want them to. That impacts things.” (Group 3, Patient 1)
“But also I was thinking about privacy, what if the person doesn’t want to share some of private … it doesn’t have to be private but your health is part of your privacy. So you may not want to share certain parts of your health issues with whoever the person is next to you. So it’s sort of … I don’t know, creates a sort of tension where privacy is questioned ‘cause if I say I don’t want you to be present, but we are in a partnership, why don’t you want me to hear this, etc.” (Group 1, Caregiver 1)
Patient–physician relationship“There was kind of a little bit of an almost artificial, like you’re talking to somebody but you don’t really get that they’re real and whatever ‘cause you’ve not seen them face-to-face, so there was some of that but the care was, in all but one instance, was very good.” (Group 1, Caregiver 2)
“Lastly, when I need to talk to my GP I email her and that seems to work, although I have a sense that emailing is replacing face-to-face contact and I’m not so happy about the future of that.” (Group 2, Patient 2)
“I don’t know, it’s just an assumption ‘cause you don’t see the person and then another thing, you don’t know if the person is talking to you attentively. They might be doing something on computer and then talking to you on the side, so there’s always this hesitant … I don’t know.” (Group 5, Patient 2)
“I found too that when doctors know that you’re actually online for the kids and for yourself, I found that it’s hard to find yourself sometimes feeling weak and feeling scared in appointments especially online, but still have to advocate. I find it easier to advocate in person and say, you know, this needs to be done, or feeling weak in person, but then you have to find yourself in between to find any support.” (Group 4, Caregiver 3)
Future research directions or calls to action“I think when things are integrated it makes my life a whole lot easier. The service that I mentioned when I have tried video conferencing I really liked that I could see the doctor’s notes and that I could specify the pharmacy of my choice and it would be sent. I think that’s really helpful to have all those components put together and not have all these different parts that you have to follow up on.” (Group 3, Patient 3)
“I think the technical side has to develop so it becomes universally accessible to the physicians and patients in an efficient way.” (Group 2, Patient 1)
  • Note: GP = general practitioner, OT = occupational therapy.