Family conferences in palliative care: a survey of health care providers in France.
BACKGROUND
Family conferences are conducted to assist with end-of-life discussions and discharge planning.


OBJECTIVE
This study describes the current practices of family conferences in palliative care units (PCUs) in France.


METHODS
A cross-sectional descriptive survey was sent to each PCU in France (n = 113). Members of the interdisciplinary health care team (palliative care physician, nurse, psychologist, and social worker) who were active in each PCU at the time of the survey were asked to respond.


RESULTS
Two hundred seventy-six of 452 responses (61%) were obtained from members of the health care team in 91 units (81%). Two hundred seventy-two of 276 health care providers (HCPs) (99%) reported conducting family conferences in their clinical practice. Only 13 participants (5%) reported that they followed a structured protocol. Most respondents completed the questionnaire: palliative care physicians (n = 225; 82%), nurses (n = 219; 79%), and psychologists (n = 181; 66%). The three primary goals of family conferences were to allow family members to express their feelings (n = 240; 87%), identify family caregivers (n = 233; 84%), and discuss the patient's plan of care (n = 219; 79%). The primary reasons for conducting a family conference were: the patient's illness was terminal (n = 216; 78%), family caregivers requested a conference (n = 208; 75%), or terminal sedation was required (n = 189; 69%). One hundred six of 452 HCPs (38%) reported that patients were not invited to participate. The primary indications and goals for a family conference were significantly different among the four health care disciplines.


CONCLUSIONS
Most HCPs in our study conducted family conferences. However, most of the family conferences had no structured protocol, half of the participants preferred no patient participation, and a significant variation was noted in the primary indications and goals among disciplines.
Department of Palliative Care and Rehabilitation Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA; Department of Palliative Care, Centre Hospitalier de Lyon-Sud, Pierre Bénite, France; Laboratoire EA, Santé-Individu-Société, Université Lyon, Lyon, France. Electronic address: wadihrhondali@me.com.
Wadih
W
Rhondali
Department of Palliative Care and Rehabilitation Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Rony
R
Dev
Department of Palliative Care, Centre Hospitalier de Lyon-Sud, Pierre Bénite, France.
Cécile
C
Barbaret
Psychology Institute, Université Lyon 2, Bron, France.
Anne
A
Chirac
Department of Medicine, Centre Hospitalier de Bourg-Saint-Maurice, Bourg-Saint-Maurice, France.
Celine
C
Font-Truchet
Department of Palliative Care, Centre Hospitalier William-Morey, Chalon-sur-Saône, France.
Fabienne
F
Vallet
Department of Palliative Care and Rehabilitation Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Eduardo
E
Bruera
Department of Palliative Care, Centre Hospitalier de Lyon-Sud, Pierre Bénite, France.
Marilene
M
Filbet
D000328:Adult; D003256:Community Participation; D003430:Cross-Sectional Studies; D005190:Family; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D010166:Palliative Care / Q000379:methods*; D010348:Patient Care Team; D011795:Surveys and Questionnaires
Family conferences; end-of-life discussions; palliative care units