Palliative Medicine Family Conferences Reduce Spokesperson Distress and Enhance Communication in Advanced Cancer.

INTRODUCTION: Family conferences (FCs) may be important in communication. There is limited evidence about their value in palliative medicine. We examined specific information needs of patient-identified spokespersons (SP) and if the needs were met by a subsequent FC. Further data were collected on FC attendee characteristics, changes in SP distress, and SP assessment of FC value.

METHODS: We conducted a prospective observational study of the family SP perspective of consecutive first time palliative medicine FCs for cancer patients. The SP completed standardized questionnaires and a Distress Thermometer pre- and post-FC.

RESULTS: Seventy-eight FCs were eligible. Daughters/sons were the largest single attendee group. The median FC duration was 45 minutes (range 30-100). The location was usually at the bedside. Distress thermometer (DT) scores fell in 51%, rose in 26%, were stable in 23%, and were unaffected by patient presence. On average, there was a one-unit reduction in DT scores post compared to pre (p = 0.0059, 95% CI -1.5 to -0.3). The SP wanted information on a median of 15 (range 13, 17; 83%) questionnaire items beforehand; a median of 12 (range 10-14; 67%) were discussed. Overall, 62% of the total items were "needs met" in ≥50% of the SP.

CONCLUSIONS: The FC attracted multiple participants; usually sons and daughters. Duration was typically 45 minutes and usually at the bedside. Nearly all SPs found the concept valuable both before and after the FC. Distress decreased or remained stable in most SPs. Most of their self-identified information needs were met. Thematic analysis of qualitative data supported the value of FC. Formal FCs are powerful and important communication tools in advanced cancer.