Rebekah Laidsaar-Powell1, Phyllis Butow2, Frances Boyle3, Ilona Juraskova2. 1. Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, The University of Sydney, New South Wales, Australia. Electronic address: rebekah.laidsaar-powell@sydney.edu.au. 2. Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, The University of Sydney, New South Wales, Australia. 3. Patricia Ritchie Centre for Cancer Care and Research, Mater Hospital, North Sydney, New South Wales, Australia.
Abstract
OBJECTIVE: Family caregivers can, at times, add complexity to clinical encounters. Difficult family caregivers and dynamics may: derail consultation communication, reduce patient autonomy, and compromise effective clinical care. A paucity of practical strategies guiding effective clinician-family communication exists. This study aimed to develop and evaluate the first comprehensive, evidence-based guidelines (the TRIO guidelines) for oncology physicians and nurses to better manage several complex/challenging situations involving family members. METHODS: TRIO Guidelines were based on a comprehensive review of literature, relevant guidelines, and feedback from an expert advisory group (n = 10). Draft guidelines underwent two rounds of evaluation via an online Delphi consensus process involving international experts (n = 35). RESULTS: Guidelines incorporate topic areas, strategies, and sub-strategies on managing challenging family involvement (7 topics). Example wording, behaviours and level of evidence are provided. CONCLUSION: Challenging triadic interactions require skillful navigation, and the TRIO Guidelines provide clear, specific, and evidence-based strategies for clinicians to utilise in these potentially stressful encounters. Training based on these guidelines may improve both patient care and clinician confidence. PRACTICE IMPLICATIONS: Implementation of these guidelines into medical/nursing curricula and as a component of continuing professional development programs will likely be highly beneficial.
OBJECTIVE: Family caregivers can, at times, add complexity to clinical encounters. Difficult family caregivers and dynamics may: derail consultation communication, reduce patient autonomy, and compromise effective clinical care. A paucity of practical strategies guiding effective clinician-family communication exists. This study aimed to develop and evaluate the first comprehensive, evidence-based guidelines (the TRIO guidelines) for oncology physicians and nurses to better manage several complex/challenging situations involving family members. METHODS:TRIO Guidelines were based on a comprehensive review of literature, relevant guidelines, and feedback from an expert advisory group (n = 10). Draft guidelines underwent two rounds of evaluation via an online Delphi consensus process involving international experts (n = 35). RESULTS: Guidelines incorporate topic areas, strategies, and sub-strategies on managing challenging family involvement (7 topics). Example wording, behaviours and level of evidence are provided. CONCLUSION: Challenging triadic interactions require skillful navigation, and the TRIO Guidelines provide clear, specific, and evidence-based strategies for clinicians to utilise in these potentially stressful encounters. Training based on these guidelines may improve both patient care and clinician confidence. PRACTICE IMPLICATIONS: Implementation of these guidelines into medical/nursing curricula and as a component of continuing professional development programs will likely be highly beneficial.
Authors: Joan M Griffin; Catherine Riffin; Lauren R Bangerter; Karen Schaepe; Rachel D Havyer Journal: Health Serv Res Date: 2022-01-26 Impact factor: 3.734
Authors: Bea L Dijkman; Wolter Paans; Hanneke Van der Wal-Huisman; Barbara L van Leeuwen; Marie Louise Luttik Journal: Support Care Cancer Date: 2022-09-01 Impact factor: 3.359