Sanderson Christine R, Cahill Philippa J, Phillips Jane L, Johnson Anne, Lobb Elizabeth A
Calvary Health Care Kogarah, Kogarah, New South Wales, Australia; The School of Medicine, The University of Notre Dame Australia, Darlinghurst, New South Wales, Australia.
The School of Medicine, The University of Notre Dame Australia, Darlinghurst, New South Wales, Australia.
Ann Palliat Med. 2017 Dec;6(Suppl 2):S195-S205. doi: 10.21037/apm.2017.08.11. Epub 2017 Sep 29.
Family meetings in palliative care can enhance communication with family members and identify unmet needs. However, the patient's voice may not be heard.
This pre and post-test quality improvement project was conducted from 2013-2014 and investigated a patient-centered family meeting, which is a different approach to palliative care family meetings, to determine its feasibility and acceptability for patients, family and the palliative care team. Newly admitted patients to an Australian in-patient specialist palliative care unit were invited to ask anyone they wished to join them in a meeting with the palliative care team and to identify issues they wished to discuss. Consenting inpatients were interviewed shortly after admission; participated in a family meeting and re-interviewed 2-3 days after the meeting. Family members provided feedback at the end of the meeting. A focus group was held with staff for feedback on this new approach for family meetings. Meetings were observed, documented and thematically analyzed.
Thirty-one newly admitted patients were approached to participate in a family meeting. Eighty-four percent had family meetings and the majority (96%) was attended by the patient. Thematic analysis revealed 69% of patient-centered meetings raised end-of-life concerns and 54% were "family-focused".
Patient-centered family meetings in palliative care were shown to be feasible and acceptable for staff, patients and family members. Many patients and families spontaneously shared end-of-life concerns. A patient-centered approach to family meetings that includes active patient involvement may provide additional and valued opportunities for patients and families to: express mutual concerns, deliver messages of comfort and appreciation, and prepare for death. Further investigation of this approach, including families' bereavement outcomes, is warranted.
姑息治疗中的家庭会议可以加强与家庭成员的沟通，并识别未满足的需求。然而，患者的声音可能未被倾听。
这项前后测试的质量改进项目于2013年至2014年开展，研究了以患者为中心的家庭会议，这是一种与姑息治疗家庭会议不同的方法，以确定其对患者、家庭和姑息治疗团队的可行性和可接受性。邀请澳大利亚一家住院专科姑息治疗病房的新入院患者邀请任何他们希望与之一起与姑息治疗团队开会的人，并确定他们希望讨论的问题。同意参与的住院患者在入院后不久接受访谈；参加家庭会议，并在会议后2至3天再次接受访谈。家庭成员在会议结束时提供反馈。与工作人员举行了焦点小组会议，以获取他们对这种新的家庭会议方法的反馈。对会议进行观察、记录并进行主题分析。
31名新入院患者被邀请参加家庭会议。84%的患者召开了家庭会议，大多数（96%）有患者出席。主题分析显示，69%以患者为中心的会议提出了临终关怀问题，54%的会议“以家庭为重点”。
姑息治疗中以患者为中心的家庭会议对工作人员、患者和家庭成员来说是可行且可接受的。许多患者和家庭自发地分享了临终关怀问题。一种以患者为中心的家庭会议方法，包括患者的积极参与，可能为患者和家庭提供额外且有价值的机会，以：表达相互关心、传递安慰和感激之情以及为死亡做准备。有必要对这种方法进行进一步研究，包括家庭的丧亲结果。
