Background 

Palliative care family meetings (PCFMs) are a means of education, emotional support, and detailed care planning. They provide an opportunity to explore issues that could significantly affect the experience and memory of the dying. This presentation provides the qualitative findings of an ARC-funded sub-study of PCFMs for cancer patients at two Brisbane hospitals [1]. 

The aim of this presentation is to explore how cancer-specific PCFMs intersect with the broader health system; to understand ways to support quality improvement in PCFMs; to strengthen support for the dying, and to enhance clinical palliative care tools and environments. 
 

Research design  

Analysis and interpretation of the dataset is guided by Actor-Network Theory. 

114 interviews involving 39 clinicians, 9 patients and 21 carers, with diagnoses including motor neuron disease and cancer. This resulted in a total of 114 transcripts and 13 video-recordings. Nine meetings focused on patients with cancer.

 

Each cancer PCFM was observed repeatedly on video and in transcript, identifying various medical staff, languages, environments, movements, tools, and practices within the field. Intensive field noting and annotation were employed to initially organise the data. Raw data were then coded and thematized consistent with the principles of the underlying Actor-Network Theory. 
 

Findings 

Twelve key themes were identified, which collectively provide a nuanced description and signpost areas of practice and policy that require closer attention. These include home or family, alongside an understanding of community support or the role of pain and pain relief. 
 

The findings indicate there are valuable ways to conduct important conversations around death and dying, and alternatives that could improve current approaches. The findings intersect with the known challenges of our current health system, providing further opportunities to strengthen the provision of palliative care.

 

1.            Kirby, E., et al., Hopeful dying? The meanings and practice of hope in palliative care family meetings. Soc Sci Med, 2021. 291: p. 114471-114471.