The family meetings in oncology: some practical guidelines

Abstract

Somatic illness is not only an individual experience of physical and psychological suffering, but also a psychosocial status that modulates the patient’s interpersonal relationships. Receiving a diagnosis of cancer causes severe distress. The patient’s family, too, feels the emotional ups and downs of the patient. Like the patient, they feel distressed during the onset, course and outcome of the disease. Minimizing the interpersonal impact of the illness contributes to an improved quality of life for both patients and caregivers. Thus, it is widely assumed that cancer treatments should include some kind of psychological support for the patient and family members. All of these treatments are aimed at improving collaboration and illness perception among family, patients and healthcare professionals, and support the family during the course of the disease and cancer therapies. The family system theory is a valuable framework to explain how the disease of the patient and the family’s daily life are interconnected. The therapeutic alliance with the family is a powerful tool to improve the quality of life for the patient, as well as to relieve the psychological distress of the family members who are involved. The following pages describe the objectives and conversational techniques that can be a tool for psychosocial work with the family of a cancer patient. The goal of this intervention is to help the patient’s family to understand their problems and acknowledge the anxiety and fear of mourning that can impede their capacity to face the everyday problems they must cope with. To achieve this goal, it is recommended that a meeting (or a series of meetings) be scheduled, and conducted both in hospital and in the home. The steps to set up and conduct a family meeting are described in the paper, with special emphasis on communication skills required to meet family expectations and discuss the crucial issues of their everyday life.

Root Cause Analysis of Oncology Adverse Events in the Veterans Health Administration

“…Have a designated private consultation area within the oncology physical environment for patient intake and social work interactions while discussing the veteran's current distress level. [52][53][54][55] Use a curtain or wall or divider as a physical barrier between patients. [52][53][54][55] Intermediate actions: Use a tablet to allow patients to privately fill out a risk assessment tool.…”

Ethical aspects in managing patients diagnosed with digestive cancers; a review of literature

“…One should plan meetings to inform patients and home-care providers to accept the new disability and to monitor the functionality of the devices used. Special communication skills are required to meet the family's expectations during the discussions regarding the aspects of the patient's everyday life (12). Before meeting the family, it is essential to know the details regarding the patient's family, such as composition, residence, the living standards, the lifestyle and the social life and, whenever possible, the aspects about culture, values and spiritual beliefs.…”

“…The physician should emphasize the suffering, the communication difficulties, the commitment to active participation to treatment and the influence of emotional distress on relatives. Counseling experience proved that physicians should always be aware of the patient's constant shifts, from the expectation of endless support from the family members to the effort of being autonomous and independent in the management of the disease, and act consequently (12).…”

Pivotal role of families in doctor-patient communication in oncology: a qualitative study of patients, their relatives and cancer clinicians

“…A recent review on the key modules for basic communication skills training included “running a family meeting” (Kissane et al., ). Despite this, barring a few exceptions (Delvaux et al., ; Dumont & Kissane, ; Gritti, ; Gueguen, Bylund, Brown, Levin & Kissane, ), cancer communication skills training and guidelines rarely include family members. The literature is limited to techniques to conduct family meetings with cancer patients (Dumont & Kissane, ; Gueguen et al., ).…”