Family Meetings in Palliative Care: Are they effective?

Centre for Palliative Care Education and Research, St Vincent's, Victoria, Australia.
Palliative Medicine (Impact Factor: 2.86). 12/2008; 23(2):150-7. DOI: 10.1177/0269216308099960
Source: PubMed


Despite the promotion of family meetings as an essential tool for information sharing and planning in palliative care, minimal evidence exists to show their effectiveness. We sought to rectify this gap in evidence-based practice by evaluating recently developed clinical guidelines for facilitating family meetings. Palliative care nurses were trained to conduct family meetings using the guidelines. To assess the effectiveness of the guidelines, primary family carers who attended a family meeting completed a self-report instrument to measure unmet needs at three time periods: immediately before the meeting (T1), immediately after the meeting (T2) and two days after the meeting (T3). Phone interviews with carers were also conducted at T3. Patients, health professionals and family meeting facilitators were also invited to complete an evaluation form at T2. A focus group was conducted at the end of the project to gain reflections from the family meeting facilitators about their role, re-evaluate the family meeting clinical guidelines and discuss barriers and facilitators for ongoing implementation. Twenty family meetings were conducted at St Vincent's Hospital (Melbourne, Australia). A total of 42 participants were involved, including 20 family carers, 4 patients and 18 health professionals. Family carers reported a statistically significant increase in having their care needs met, from T1 to T2, which was maintained at T3; they also reported that the meetings were useful. Health professionals and patients advised that the meetings were well facilitated. The results from this pilot study indicate that family meetings, conducted using specific clinical practice guidelines, were useful and effective. However, more research is required to confirm these findings. Strategies for implementation and further research are outlined.

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    • "Family meetings have been promoted in palliative care as important tools for information sharing and care planning and have been shown to be effective in meeting the needs of family carers in particular [30]. The need for health professionals to have skills in communication in order to effectively conduct family meetings has been recognised [31,32] and attempts have been made to address this need with the development of training modules [31]. "
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    ABSTRACT: This study explores the experience of palliative patients and their family members of a family meeting model, utilised as an instrument for the provision of spiritual and psychosocial care. In doing so the study embraces a broad understanding of spirituality which may or may not include formal religious practice and a concept of psychosocial care that includes: social and emotional well-being, communication, self esteem, mental health and adaptation to illness. The meeting of spiritual and psychosocial needs is considered to be an important aspect of palliative care. This qualitative study, philosophically underpinned by hermeneutic phenomenology, investigates the participatory experience of palliative care patients and their significant family members of such a family meeting. People registered with two large metropolitan palliative care services, who met selection criteria, were referred by medical staff. Twelve of the 66 referred took part in family meetings which also included significant others invited by the patient. A total of 36 family members participated. The number of participants of individual family meetings ranged from two to eleven. After the family meeting every participant was invited to take part in an individual in-depth interview about their experience of the meeting. Forty seven interviews were conducted. These were audio recorded and transcribed. Data analysis, utilising Ricoeur's theory of interpretation, revealed seven main themes: personal experience of the meeting, personal outcomes, observation of others' experience, observation of experience and outcomes for the family unit, meeting facilitation, how it could have been different and general applicability of the family meeting. Throughout these themes were numerous references to aspects of the web of relationships which describe the concept of spirituality as it is defined for the purpose of this study. The findings indicate the potential of the type of family meeting reported for use in the spiritual and psychosocial care of people receiving palliative care and their families. However further research is needed to explore its application to more culturally diverse groups and its longer term impact on family members.
    BMC Palliative Care 03/2011; 10(1):7. DOI:10.1186/1472-684X-10-7 · 1.78 Impact Factor

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    ABSTRACT: Little attention has been paid to the specific communication training needs of nurses in palliative care. A narrative-based approach to communication, or narrative nursing, is proposed as a framework for developing holistic communication preparation for nurses. Building on clinical and nonclinical research in hospice, palliative care, and medical education settings, the authors present the COMFORT initiative as an outline of the tenets of narrative nursing. COMFORT is an acronym for communication, orientation and opportunity, mindfulness, family, oversight, reiterative and radically adaptive messages, and team. Explication of each concept is provided alongside a case study vignette that details communication properties at work. Integration of the COMFORT initiative into nursing education is proposed.
    Journal of Hospice and Palliative Nursing 08/2010; 12(5):282-292. DOI:10.1097/NJH.0b013e3181ebb45e · 0.44 Impact Factor
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