Patient and Family Participation in Hospice Team Meetings

Project Duration

September 2006 – September 2008

Funder

National Cancer Institute, USA

Aims

This project proposes to strengthen hospice care for cancer patients by enabling patient/family participation in hospice interdisciplinary teams (IDTs) through use of a commercially available videophone. 

Impediments to patients/families' involvement in IDT meetings have included the patient's physical impairments, care giving responsibilities, structural problems within the team, transportation concerns, and geographic distance from the home to IDT meeting locations. While the hospice team meets regularly to review plans of care and coordinate service provision, the patient/family is rarely, if ever, present. 

Through the use of videophone technology, patients/families will "participate virtually" in IDT meetings, and it is hypothesized that there will be more effective delivery of palliative care through better communication between all parties, improved pain management for the patient, and improvement in the quality of life for both the patient and the family caregiver. 

Specific aims 

1. Use qualitative methods to explore communication between the team and patient/family, assessing:
   1.1 Active involvement/participation by patients/family during team conferences
   1.2. Identification of bio-psychosocial concerns by patients and families
   1.3. Patient/family satisfaction with the IDT process
   1.4. Reaction and experience of hospice team members to patient and family participation 
2. Test the effect size of measures and assess changes in pain and symptom management as demonstrated by:
   2.1. Reduced impact of pain/symptoms on quality of life as reported by patients, measuring
   - 2.1.1 Differences between and within intervention and comparison groups for physical distress
   - 2.1.2 Differences between and within intervention and comparison groups for psychological distress
   2.2. Decreased caregiver fears related to reporting of pain, and administration of analgesics.
   - 2.2.1 Measure between and within intervention and comparison group differences 
3. Test the effect size of measures and assess changes in quality of life as demonstrated by:
   3.1. Improved quality of life for the patient, measuring
   - 3.1.1 Differences between and within intervention and comparison group differences in
   3.2. Improved quality of life for the caregiver, measuring
   - 3.2.2 Differences between and within intervention and comparison group differences

Methods

Phase I 

• Video-tape team meetings without the caregiver/patient
• Various instruments to measure caregiver and patient outcomes 

Phase II 

• Video-tape team meetings with the caregiver/patient present 
• Various instruments to measure caregiver and patient outcomes 
• Qualitative interview with caregivers following the video-phone meeting

Outcomes and Findings

The project is complete.

For more information please see top right.