Department of Psychosocial Oncology and Palliative Care, Princess Margaret Hospital, Toronto, Ontario, Canada.
Palliat Support Care. 2012 Mar;10(1):43-9. doi: 10.1017/S1478951511000575.
The World Health Organization (WHO) definition of palliative care as "an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness …" recognizes the importance of family members in this setting. In practice, family meetings account for a significant amount of the weekly workload in a specialist inpatient palliative care unit. Despite this, there is little empirical evidence to support the benefits of family meetings from the perspective of family members.
A prospective study over 6 months, invited a designated family member to complete a self-report instrument (SRI) and the Family Inventory of Needs (FIN) questionnaire prior to, immediately following, and 48 hours after a planned family meeting attended by several members of the multidisciplinary team.
Thirty-one designated family members completed the study. The SRIs completed prior to a family meeting identified particular areas of concern and worry for family members, and also helped to generate an agenda based on the family's particular needs. The pre-meeting FIN identified areas of patient care of greatest importance to each family member, and asked them to rate whether particular care needs were presently met or unmet, in their opinion, by the healthcare team caring for the patient. Following the family meeting, repeat SRIs showed an overall reduction in concerns and increased confidence in dealing with those issues raised. Post-family meeting FIN scores confirmed a greater number of met care needs compared with pre-meeting scores, all of which were sustained over time.
This study confirms the value of planned multidisciplinary family meetings for patients in specialist inpatient palliative care units. It identifies the often unmet needs of family members and the sustained benefits associated with formal family meetings.
世界卫生组织（WHO）将姑息治疗定义为“一种提高面临危及生命的疾病相关问题的患者及其家属生活质量的方法……”，这认识到了家庭成员在这种情况下的重要性。实际上，在专科住院姑息治疗病房中，家庭会议占每周工作量的很大一部分。尽管如此，从家庭成员的角度来看，几乎没有经验证据支持家庭会议的好处。
一项为期 6 个月的前瞻性研究，邀请指定的家庭成员在参加多学科团队成员参加的计划家庭会议之前、之后立即以及 48 小时后，填写自我报告工具（SRI）和家庭需求清单（FIN）问卷。
31 名指定的家庭成员完成了研究。在家庭会议之前填写的 SRI 确定了家庭成员特别关注和担忧的领域，并有助于根据家庭的特殊需求制定议程。会前 FIN 确定了对每个家庭成员而言患者护理最重要的领域，并要求他们根据医疗保健团队对患者的护理，对特定的护理需求是否已经满足或未满足进行评分。家庭会议后，重复 SRI 显示出对关注问题的总体减少以及对处理提出的问题的信心增加。家庭会议后的 FIN 分数证实了与会议前相比，更多的护理需求得到满足，并且所有这些需求都随着时间的推移而持续。
这项研究证实了计划中的多学科家庭会议对专科住院姑息治疗病房患者的价值。它确定了家庭成员经常未满足的需求以及与正式家庭会议相关的持续益处。
