Communication in palliative medicine: a clinical review of family conferences

J Palliat Med. 2014 Oct;17(10):1167-77. doi: 10.1089/jpm.2013.0538. Epub 2014 Jul 3.

Abstract

Aim: Family conferences are an important forum for communication, particularly for those with serious illnesses.

Design: The strength of evidence was assessed by patient, intervention, comparator, and outcome (PICO).

Data source: We searched electronic databases (MEDLINE, CINAHL, PsycINFO, Embase, PubMed), published articles, and multidisciplinary resource textbooks.

Results: Four areas investigated family conferences: acute care, family medicine/geriatrics, intensive care units (ICU), and oncology/palliative medicine. A unifying theme was the importance of improved communication. A single randomized controlled ICU study demonstrated that family conferences positively influenced bereavement outcomes. A prospective (but single-arm) ICU study and several family medicine/geriatrics cohort studies, found that family conferences reduced hospital length of stay and/or decreased resource utilization. Other articles proposed guidelines or methods for the practical conduct of family conferences.

Conclusions: ICU studies supported the benefit of a family conference to the family, health care team, and hospital administration. The family conference in other clinical areas was not supported by a strong evidence base. Well-designed prospective studies are needed in multiple medical settings to assess the proposed and observed patient and financial benefits of the family conference, and determine their generalizability.

Publication types

  • Review

MeSH terms

  • Communication*
  • Humans
  • Palliative Medicine*
  • Professional-Family Relations*