title: Family members' perceptions of inpatient palliative care consult services: a qualitative study.
abstract: BACKGROUND
  Family members are commonly involved in end-of-life decision making and typically involved in inpatient palliative care consultations. Although much research has documented patient outcomes following inpatient palliative care consultation, little is known about family member perceptions of the consultation.
  
  
  OBJECTIVE
  The purpose of this study was to determine how inpatient palliative care consultations impacted family members' understanding of the patient's condition, knowledge of available care options, and decision-making ability.
  
  
  METHODS
  An exploratory, qualitative study was conducted employing individual interviews among family members of seriously ill patients, recruited purposively. Interviews were conducted in person, at the hospital, or via telephone, using a semistructured protocol.
  
  
  METHODS
  Family members of seriously ill patients were recruited from a nonprofit, community hospital.
  
  
  RESULTS
  Interviews were conducted among 23 family members. Four themes were identified and included: perceived qualities of the inpatient palliative care consultation, family readiness, impact on decision-making process, and focus on comfort and quality of life. While most comments reflected positive aspects of the inpatient palliative care consult, such as improved pain control and communication, and increased access to medical professionals and time to discuss patient conditions, some themes reflected a lack of adequate preparation for the inpatient palliative care consultation and readiness for discussing prognosis.
  
  
  CONCLUSIONS
  Family members report discussion with the inpatient palliative care team results in improved communication and knowledge, which contributes to decision-making ability. However, palliative care consultation may be improved by developing stronger protocols for introducing palliative care and by including the attending physician in the process to preclude conflicting, inconsistent information and recommendations.
authors.affiliation: 1Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Enguidanos
authors.forename: Patricia
authors.initials: P
authors.lastname: Housen
authors.forename: Marcia
authors.initials: M
authors.lastname: Penido
authors.forename: Bill
authors.initials: B
authors.lastname: Mejia
authors.forename: Julie Anne
authors.initials: JA
authors.lastname: Miller
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000628:therapy; D003142:Communication; D003220:Conflict, Psychological; D003657:Decision Making; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D010348:Patient Care Team / Q000592:standards; D011368:Professional-Family Relations; D036301:Qualitative Research; D012017:Referral and Consultation / Q000592:standards* / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D013727:Terminal Care / Q000523:psychology; D014481:United States; D055815:Young Adult
keywords: Palliative care; decision making; family members; health communication; qualitative research