title: Examining family meetings at end of life: The model of practice in a hospice inpatient unit.
abstract: OBJECTIVE
  Our purpose was to rigorously examine the nature of family meetings as conducted in an inpatient hospice care unit in order to generate an inductive theoretical model.
  
  
  METHODS
  In this two-phase project, we first interviewed eight members of the interdisciplinary care team who participated in multiple family meetings each week. Interview questions explored why and how they conducted family meetings. Using an observation template created from these interview data, we subsequently conducted ethnographic observations during family meetings. Using the methods of grounded theory, our findings were synthesized into a theoretical model depicting the structure and process of formal family meetings within this setting.
  
  
  RESULTS
  The core of the family meeting was characterized by cognitive and affective elements aimed at supporting the family and facilitating quality care by clarifying the past, easing the present, and protecting the future. This inductive model was subsequently found to be highly aligned with a sense of coherence, an important influence on coping, and adaptation to the stress of a life-limiting illness.
  
  
  CONCLUSIONS
  Provider communication with family members is particularly critical during advanced illness and end-of-life care. The National Consensus Project clinical practice guidelines for quality palliative care list regular family meetings among the recommended practices for excellent communication during end-of-life care, but do not provide specific guidance on how and when to provide such meetings. Our findings provide a theoretical model that can inform the design of a family meeting to address family members' needs for meaningful and contextualized information, validation of their important contributions to care, and preparation for the patient's death.
authors.affiliation: University at Buffalo School of Nursing,Buffalo,New York.
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Meeker
authors.affiliation: University at Buffalo School of Social Work,Buffalo,New York.
authors.forename: Deborah P
authors.initials: DP
authors.lastname: Waldrop
authors.affiliation: University at Buffalo School of Nursing,Buffalo,New York.
authors.forename: Jin Young
authors.initials: JY
authors.lastname: Seo
mesh_terms: D000328:Adult; D000884:Anthropology, Cultural; D001291:Attitude of Health Personnel; D003142:Communication; D003657:Decision Making; D005190:Family / Q000523:psychology*; D005260:Female; D006738:Hospices; D006801:Humans; D007297:Inpatients; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009518:New York; D010166:Palliative Care / Q000523:psychology / Q000592:standards*; D010348:Patient Care Team / Q000458:organization & administration / Q000592:standards*; D017410:Practice Guidelines as Topic; D011368:Professional-Family Relations; D013637:Tape Recording; D013727:Terminal Care / Q000523:psychology / Q000592:standards*
keywords: Family meeting; Grounded theory; Hospice care; Inpatient care; Structured communication