Dr Philippa Cahill1, Professor Elizabeth Lobb2, Dr Christine Sanderson3, Professor Jane Phillips4
1Previously doctoral candidate University of Notre Dame Australia, Ultimo, Australia, 2IMPACCT – Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney, Ultimo, Australia, 3Alice Springs Hospital, Territory Palliative Care, Central Australia, Australia, 4School of Nursing, Faculty of Health, Queensland University of Technology, Kelvin Grove, Australia
Biography:
Philippa Cahill is an experienced nurse leader in community, cancer, and palliative care services. Whilst a senior nurse manager Philippa collaboratively developed new models of care such as the now well-established palliative care consultant nursing roles designed to support patients and nurses in aged care facilities. In 2023, Philippa successfully completed her doctoral program of research. Her research focused on the experiences and outcomes of patients’, families’, and clinicians’ participation in a patient-centred family meeting in palliative care. This meeting model enabled the patient to set the meeting agenda which gave them a ‘voice’ in care planning and decision making.
Abstract:
Background: Family meetings are recognised as facilitating patient-family-team communication and decision making in palliative care settings. Few studies have demonstrated the impact of family meetings on patient and family outcomes using validated measures.
Aims: This study was designed to determine the feasibility and acceptability of Patient-Centred Family Meetings and build the evidence base for undertaking planned Patient-Centred Family Meetings (‘Meetings’) in specialist palliative care inpatient populations.
Methods: The study used a mixed methods design underpinned by a patient-centred care conceptual framework. The validated measures included the Distress Thermometer and the QUAL-EC and QUAL-E (family) quality-of-life measures.
Results: Participating patients and families considered these ‘Meetings’ valuable and acceptable as a forum for inpatients to speak openly about their end-of-life concerns and to clarify issues. Family members were given a voice to discuss their worries and have their needs addressed. The Distress Thermometer scores demonstrated significant post-Meeting reduction in family distress (p <0.05).
Clinicians confirmed that these Meetings, using a patient-set agenda, provided an opportunity for patients and families to articulate their questions and issues. Clinicians also gained unique patient and family insights but questioned the feasibility of these Meetings for all patients and families, despite the positive outcomes demonstrated. They considered the patient’s clinical status, family availability, and clinician workload capacity were factors in providing these Meetings.
Conclusions: For participating patients, families, and clinicians these Meetings provided benefits including everyone being ‘on the same page’. Clinicians gained an enhanced understanding of patients and their families, which in some cases was pivotal in the patient’s end-of-life preparation. A decrease in the family’s distress post-Meeting was significant. Further research is needed to understand how best to utilise this Meeting model in the specialist palliative care inpatient setting and for which patients and families these Meetings would provide the most benefit.