6 minute Speed talk Palliative Care Nurses Australia Conference 2020

Palliative care patients’ and families’ experiences of participating in a ‘Patient-Centred Family Meeting’: A qualitative study. (70428)

Philippa J Cahill 1 , Elizabeth A Lobb 1 2 3 , Christine R Sanderson 2 4 , Jane L Phillips 5 6
  1. School of Medicine, University of Notre Dame Australia, Darlinghurst, NSW, Australia
  2. Calvary Palliative and End of Life Care Research Institute, Calvary Health Care Sydney, Kogarah, NSW, Australia
  3. Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
  4. Palliative Medicine, Alice Springs Hospital, Territory Palliative Care Central Australia, Alice Springs, Northern Territory, Australia
  5. IMPACCT – Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
  6. School of Nursing, University of Notre Dame Australia, Darlinghurst, NSW, Australia

Introduction

Family meetings in palliative care facilitate communication between patients, families and the multi-disciplinary team (MDT) about end-of-life issues. Few studies have undertaken qualitative evaluation to assess the impact of family meetings on patients and families.

Objectives

To assess patients’ and families’ experiences of participation in a clinical trial that compared a Patient-Centered Family Meeting with standard practice.  

Methods

A semi-structured interview evaluated the patient and family experience of the Patient-Centered Family Meeting component.  Grounded theory provided theoretical and procedural direction. Thematic content analysis used the constant comparative method.  The setting was a specialist inpatient palliative care inpatient unit in Metropolitan Sydney.  The participants were patients and their family member who had consented to the clinical trial.  Nine patients and nine corresponding family members were interviewed.

Results

Three overarching themes emerged.  A patient-centred family meeting: (i) provides a safe space for patients to speak candidly about their end-of-life concerns in the presence of significant others; (ii) ensures that the family member has a voice, is heard and has their needs addressed; and (iii) helps to ensure that everyone is “on the same page”.

Implications for practice

Patient-Centred Family Meetings are a potentially effective means of supporting patients and their families to articulate and address end-of-life issues in the presence of the MDT and one another.  The strength of family meetings in commencing and promoting a shared conversation and understanding of the patient’s disease, prognosis and end-of-life concerns may lead to ongoing productive discussion between the patients, their families and the MDT as the end-of-life approaches.

Conclusions

The Meeting model provided patients and their families with the forum to discuss psychosocial and relationship issues and concerns related to end-of-life preparation.  The MDT provided the support for some patients to initiate the difficult conversations they wished to have with families prior to their death.  Additional research to identify which patients and families would benefit most from this type of Meeting is imperative.   

Funding acknowledgement

The Australian Government Collaborative Research Networks program funded the PhD scholarship (PJC) to support this work as part of the research project: Healthy People, Healthy Country.