Kent School of Social Work, University of Louisville, Louisville, Kentucky 40292, USA.
J Palliat Med. 2013 Jan;16(1):60-6. doi: 10.1089/jpm.2012.0229. Epub 2012 Oct 4.
The ACTIVE (Assessing Caregivers for Team Intervention through Video Encounters) intervention uses technology to enable family caregivers to participate in hospice interdisciplinary team (IDT) meetings from geographically remote locations. Previous research has suggested that effective communication is critical to the success of these meetings. The purpose of this study was to explore communication in ACTIVE IDT meetings involving family caregivers and to assess the degree to which hospice teams use specific communication principles (summarized in the mnemonic VALUE: value, acknowledge, listen, understand, and elicit), which have been supported in previous research in intensive care settings.
Researchers analyzed team-family communication during 84 video- and/or audio-recorded care plan discussions that took place during ACTIVE team meetings, using a template approach to text analysis to determine the extent and quality of VALUE principles. The total content analyzed was 9 hours, 28 minutes in length.
Hospice clinicians routinely employed the VALUE communication principles in communication during ACTIVE IDT meetings with family caregivers, but the quality of this communication was frequently rated moderate or poor. The majority of such communication was task-focused. Less often, communication centered on emotional concerns and efforts to gain a more holistic understanding of patients and families.
This analysis suggests an opportunity for improving support for family members during ACTIVE IDT meetings. Members of hospice IDTs should remain aware of the opportunity for additional attention to the emotional realities of the hospice experience for family caregivers and could improve support for family caregivers during IDT meetings by ensuring that messages used to exemplify VALUE principles during team-family communication are of a high quality.
ACTIVE（通过视频交流评估护理人员团队干预）干预措施利用技术使家庭护理人员能够从地理上偏远的地方参与临终关怀跨学科团队（IDT）会议。先前的研究表明，有效的沟通对于这些会议的成功至关重要。本研究旨在探讨 ACTIVE IDT 会议中涉及家庭护理人员的沟通情况，并评估临终关怀团队在多大程度上使用了特定的沟通原则（概括为记忆术 VALUE：重视、承认、倾听、理解和引出），这些原则在重症监护环境中的先前研究中得到了支持。
研究人员使用模板分析方法对 84 次视频和/或音频记录的护理计划讨论中的团队-家庭沟通进行了分析，以确定 VALUE 原则的程度和质量。分析的总内容为 9 小时 28 分钟。
临终关怀临床医生在 ACTIVE IDT 会议期间与家庭护理人员的沟通中经常采用 VALUE 沟通原则，但这种沟通的质量经常被评为中等或较差。这种沟通大多数是任务型的。较少的情况下，沟通集中在情感问题上，并努力更全面地了解患者和家庭。
这项分析表明，有机会在 ACTIVE IDT 会议期间为家庭提供更好的支持。临终关怀 IDT 的成员应该始终意识到为家庭护理人员提供更多关注临终关怀体验的情感现实的机会，并通过确保在团队-家庭沟通中用于举例说明 VALUE 原则的信息具有高质量，来改善 IDT 会议期间对家庭护理人员的支持。
