Challenges in providing family-centered support to families in palliative care Journal Article
| Authors: | Del Gaudio, F.; Zaider, T. I.; Brier, M.; Kissane, D. W. |
| Article Title: | Challenges in providing family-centered support to families in palliative care |
| Abstract: | Background: Supporting the family-as-a-whole presents challenges in palliative care, although family meetings are increasingly used in routine practice. The Family Focused Grief Therapy (FFGT) Model guides clinicians in using a range of intervention strategies. Aim: To examine the therapists' techniques used in assessing 'at risk' families in palliative care to better illuminate what helps and what remains challenging. Method: Recorded sessions 1 and 2 were coded using the FFGT fidelity coding measure, with its glossary of definitions. Interrater reliability between three coders was satisfactory at 88%. Frequencies of strategy utilization were computed, with extraction of examples of both successful and problematic approaches. Setting/participants: From within a larger study of family therapy during palliative care at a comprehensive cancer center, the first two sessions (n = 144) delivered to 74 families (299 individuals) by 32 therapists were coded and analyzed. Results: Therapists readily explored the story of illness and families' ways of coping (97%) and assessed communication and cohesiveness in the majority. Exploration of relational patterns occurred in 89% of sessions, use of a genogram in 80%, understanding members' roles in 65% and family values and beliefs in 62%. Less use was made of summaries (39%), family mottos (34%), exploration of family conflict (35%) and the formalization of a comprehensive family treatment plan (20%). Conclusions: Challenges exist in therapy with difficult families. Therapy in the home brings special issues. Therapists can apply most of the interventions prescribed by the FFGT model. © 2012 The Author(s). |
| Keywords: | adult; patient satisfaction; major clinical study; advanced cancer; cancer staging; palliative care; melanoma; breast cancer; randomized controlled trial; palliative therapy; lung cancer; digestive system cancer; prostate cancer; sarcoma; cancer center; brain cancer; family focused grief therapy; family therapy; gynecologic cancer; fidelity; family conflict; family centered care; cancer prognosis; family assessment; challenges and guidelines; therapy in the home |
| Journal Title: | Palliative Medicine |
| Volume: | 26 |
| Issue: | 8 |
| ISSN: | 0269-2163 |
| Publisher: | Sage Publications |
| Date Published: | 2012-12-01 |
| Start Page: | 1025 |
| End Page: | 1033 |
| Language: | English |
| DOI: | 10.1177/0269216311426919 |
| PROVIDER: | scopus |
| PUBMED: | 22075163 |
| PMCID: | PMC5177453 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 1" - "Export Date: 14 February 2013" - "CODEN: PAMDE" - "Source: Scopus" |
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