Caregiver perceptions of the impact and effect of family conferences for patients with complex and high-level palliative care needs: a cross-sectional survey study.

introductionFamily conferences (FC) are a structured and therapeutic tool in palliative care, promoting effective communication between the healthcare team, patient and family. They are especially relevant for patients with high clinical complexity, both in hospital settings and in primary care.

objectiveTo evaluate caregivers' perceptions of the impact of FC on patients cared for by palliative care teams and/or primary healthcare clinicians (PHC). This included measuring quality of care, communication effectiveness, interprofessional collaboration, successful implementation of care strategies, clarity of information received, and overall satisfaction and confidence. Secondary objectives were to assess caregivers' perceptions of the importance of FCs for their knowledge and attitudes/skills, and to evaluate their perception of the overall quality of care provided to the patient, including the concordance between desired and actual place of death as an indicator of effective end-of-life planning.

methodsObservational, analytical and cross-sectional study, with application of a specific questionnaire to caregivers of patients followed by a community palliative care team and a family health team. Sociodemographic and clinical variables and perceptions of the impact of FC on the understanding of the disease and its trajectory, on satisfaction and on the feeling of security and trust were analysed.

resultsThe total sample included 38 caregivers, of whom 20 were accompanied by a team specialized in palliative care and 18 by a family health team. There was a high percentage of female caregivers (78.9%), with a mean age of 58.1 years, and the mean age of patients was 80.7 years. FC was associated with improved perception of communication (9.36 ± 0.65), collaboration (9.50 ± 0.86) and implementation of care strategies (9.45 ± 0.83). The presence of professionals such as social workers and psychologists in the FC of the palliative care team associated with greater family participation (p = 0.002) and greater perceived support (p = 0.001). Among the patients who died, there was a significant correspondence between the desired and actual place of death (p = 0.007), demonstrating FC as a potential effective instrument for planning. The presence of more family members in the FC correlated with greater hospital use in the previous month (p < 0.001) and with greater case complexity. DISCUSSION: Despite being an exploratory study with inherent limitations, FCs were perceived as effective in improving communication, planning and aligning care with patient and family preferences. Their regular implementation, especially in PHC, should be promoted with multidisciplinary teams and specific training.