Liz Forbat1, Karemah François2, Lynne O'Callaghan3, Julie Kulikowski3. 1. Calvary Centre for Palliative Care Research, Calvary Public Hospital, Canberra, Australia; School of Health Sciences, Australian Catholic University, Canberra, Australia. Electronic address: elizabeth.forbat@acu.edu.au. 2. Calvary Centre for Palliative Care Research, Calvary Public Hospital, Canberra, Australia; School of Health Sciences, Australian Catholic University, Canberra, Australia. 3. Calvary Centre for Palliative Care Research, Calvary Public Hospital, Canberra, Australia.
Abstract
CONTEXT: Family meetings are increasingly used in palliative care, yet have little empirical evidence of their impact in inpatient settings. OBJECTIVES: To examine whether relatives report more empathy after a family meeting in a specialist palliative care inpatient ward. METHODS: Pre/post self-complete questionnaires measuring relational empathy and information needs were administered. Qualitative interviews were also conducted. Data were collected during nine months from one inpatient specialist palliative care unit. Participants from 52 family meetings completed pre/post questionnaires, and 13 relatives participated in an interview that was analyzed thematically. RESULTS: Families reported more empathy from staff after a family meeting (Wilcoxon test: n = 47; P > 0.001; Z score -4.17). Some families with relatives who do not speak with each other reported that meeting facilitators were unable to manage the pre-existing dynamics. CONCLUSION: Family meetings improve reported empathy. It would be beneficial to have more specific preparation and planning by the clinical team for meetings with people who have a history of familial conflict, and those where the staff's agenda is around discharge planning. Published guidelines could be adapted to better support staff to run meetings where there are complex family dynamics. Adoption of family meetings in outpatient settings has the potential to improve perceptions of empathy with a larger patient group.
CONTEXT: Family meetings are increasingly used in palliative care, yet have little empirical evidence of their impact in inpatient settings. OBJECTIVES: To examine whether relatives report more empathy after a family meeting in a specialist palliative care inpatient ward. METHODS: Pre/post self-complete questionnaires measuring relational empathy and information needs were administered. Qualitative interviews were also conducted. Data were collected during nine months from one inpatient specialist palliative care unit. Participants from 52 family meetings completed pre/post questionnaires, and 13 relatives participated in an interview that was analyzed thematically. RESULTS: Families reported more empathy from staff after a family meeting (Wilcoxon test: n = 47; P > 0.001; Z score -4.17). Some families with relatives who do not speak with each other reported that meeting facilitators were unable to manage the pre-existing dynamics. CONCLUSION: Family meetings improve reported empathy. It would be beneficial to have more specific preparation and planning by the clinical team for meetings with people who have a history of familial conflict, and those where the staff's agenda is around discharge planning. Published guidelines could be adapted to better support staff to run meetings where there are complex family dynamics. Adoption of family meetings in outpatient settings has the potential to improve perceptions of empathy with a larger patient group.