Wadih Rhondali1, Rony Dev2, Cécile Barbaret3, Anne Chirac4, Celine Font-Truchet5, Fabienne Vallet6, Eduardo Bruera2, Marilene Filbet3. 1. Department of Palliative Care and Rehabilitation Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA; Department of Palliative Care, Centre Hospitalier de Lyon-Sud, Pierre Bénite, France; Laboratoire EA, Santé-Individu-Société, Université Lyon, Lyon, France. Electronic address: wadihrhondali@me.com. 2. Department of Palliative Care and Rehabilitation Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA. 3. Department of Palliative Care, Centre Hospitalier de Lyon-Sud, Pierre Bénite, France. 4. Psychology Institute, Université Lyon 2, Bron, France. 5. Department of Medicine, Centre Hospitalier de Bourg-Saint-Maurice, Bourg-Saint-Maurice, France. 6. Department of Palliative Care, Centre Hospitalier William-Morey, Chalon-sur-Saône, France.
Abstract
CONTEXT: Family conferences are conducted to assist with end-of-life discussions and discharge planning. OBJECTIVES: This study describes the current practices of family conferences in palliative care units (PCUs) in France. METHODS: A cross-sectional descriptive survey was sent to each PCU in France (n = 113). Members of the interdisciplinary health care team (palliative care physician, nurse, psychologist, and social worker) who were active in each PCU at the time of the survey were asked to respond. RESULTS: Two hundred seventy-six of 452 responses (61%) were obtained from members of the health care team in 91 units (81%). Two hundred seventy-two of 276 health care providers (HCPs) (99%) reported conducting family conferences in their clinical practice. Only 13 participants (5%) reported that they followed a structured protocol. Most respondents completed the questionnaire: palliative care physicians (n = 225; 82%), nurses (n = 219; 79%), and psychologists (n = 181; 66%). The three primary goals of family conferences were to allow family members to express their feelings (n = 240; 87%), identify family caregivers (n = 233; 84%), and discuss the patient's plan of care (n = 219; 79%). The primary reasons for conducting a family conference were: the patient's illness was terminal (n = 216; 78%), family caregivers requested a conference (n = 208; 75%), or terminal sedation was required (n = 189; 69%). One hundred six of 452 HCPs (38%) reported that patients were not invited to participate. The primary indications and goals for a family conference were significantly different among the four health care disciplines. CONCLUSION: Most HCPs in our study conducted family conferences. However, most of the family conferences had no structured protocol, half of the participants preferred no patient participation, and a significant variation was noted in the primary indications and goals among disciplines.
CONTEXT: Family conferences are conducted to assist with end-of-life discussions and discharge planning. OBJECTIVES: This study describes the current practices of family conferences in palliative care units (PCUs) in France. METHODS: A cross-sectional descriptive survey was sent to each PCU in France (n = 113). Members of the interdisciplinary health care team (palliative care physician, nurse, psychologist, and social worker) who were active in each PCU at the time of the survey were asked to respond. RESULTS: Two hundred seventy-six of 452 responses (61%) were obtained from members of the health care team in 91 units (81%). Two hundred seventy-two of 276 health care providers (HCPs) (99%) reported conducting family conferences in their clinical practice. Only 13 participants (5%) reported that they followed a structured protocol. Most respondents completed the questionnaire: palliative care physicians (n = 225; 82%), nurses (n = 219; 79%), and psychologists (n = 181; 66%). The three primary goals of family conferences were to allow family members to express their feelings (n = 240; 87%), identify family caregivers (n = 233; 84%), and discuss the patient's plan of care (n = 219; 79%). The primary reasons for conducting a family conference were: the patient's illness was terminal (n = 216; 78%), family caregivers requested a conference (n = 208; 75%), or terminal sedation was required (n = 189; 69%). One hundred six of 452 HCPs (38%) reported that patients were not invited to participate. The primary indications and goals for a family conference were significantly different among the four health care disciplines. CONCLUSION: Most HCPs in our study conducted family conferences. However, most of the family conferences had no structured protocol, half of the participants preferred no patient participation, and a significant variation was noted in the primary indications and goals among disciplines.
Authors: Julio A Allo; Deanna Cuello; Yi Zhang; Suresh K Reddy; Ahsan Azhar; Eduardo Bruera Journal: J Palliat Med Date: 2015-12-14 Impact factor: 2.947