International Observatory on End of Life Care, School of Health and Medicine, Division of Health Research, Lancaster University, Lancaster, United Kingdom.
J Palliat Med. 2011 Apr;14(4):421-7. doi: 10.1089/jpm.2010.0436. Epub 2011 Mar 8.
Communication is an ongoing challenge for clinicians working with people facing life-threatening illnesses and end of life. Family conferences offer patient-focused, family-oriented care that brings together patients, family members, and health care providers.
The aim of this study was to develop a research-based model for family conferences to help physicians and other health care providers conduct such conferences effectively and improve communication with patients and families.
We prospectively studied family conferences for patients facing life-threatening illness in two inpatient medical centers. We videotape and audiotape recorded real-life conferences and postconference interviews with participants.
Twenty-four family conferences were included in the study. Participants consisted of 24 patients, 10 of whom took part in the family conferences, 49 family members, and 85 health care providers.
A multidisciplinary team conducted a qualitative analysis of the videotaped and audiotaped materials using thematic analysis. The team used a multistage approach to independently and collectively analyze and integrate three data sources.
The resulting theoretical model for family conferences has 4 main components. These include the underlying structural context of conference organization and the key process components of negotiation and personal stance. Emotional engagement by health care providers, emotion work, appears central to the impact of these components on the successful outcome of the conference. In addition to the theoretical model, the authors found that family conference participants place specific value on the "simultaneous presence" of conference attendees that leads to being on the "same page."
Physicians and other health care professionals can use the model as a guide for conducting family conferences and strengthening communication with patients, families and colleagues.
对于面临危及生命的疾病和生命末期的患者的临床医生来说，沟通是一个持续存在的挑战。家庭会议提供以患者为中心、以家庭为导向的护理，将患者、家庭成员和医疗保健提供者聚集在一起。
本研究旨在开发一种基于研究的家庭会议模型，帮助医生和其他医疗保健提供者有效地进行此类会议，并改善与患者和家属的沟通。
我们前瞻性地研究了两家住院医疗中心面临危及生命疾病的患者的家庭会议。我们对真实的会议进行了录像和录音，并对与会者进行了会后采访。
共有 24 场家庭会议纳入研究。参与者包括 24 名患者，其中 10 名患者参加了家庭会议，49 名家属和 85 名医疗保健提供者。
一个多学科团队使用主题分析对录像和录音材料进行了定性分析。该团队采用多阶段方法，对三个数据源进行独立和集体分析和整合。
家庭会议的理论模型有 4 个主要组成部分。这些组成部分包括会议组织的基本结构背景以及谈判和个人立场的关键过程组成部分。医疗保健提供者的情感投入，情感工作，似乎是这些组成部分对会议成功结果的影响的核心。除了理论模型，作者还发现家庭会议参与者特别重视会议参与者的“同时存在”，这导致了“同一页”。
医生和其他医疗保健专业人员可以使用该模型作为指导，进行家庭会议，并加强与患者、家属和同事的沟通。
