• Palliative medicine · Mar 2016

    A multimethod analysis of shared decision-making in hospice interdisciplinary team meetings including family caregivers.

    • Karla T Washington, Debra Parker Oliver, L Ashley Gage, David L Albright, and George Demiris.
    • Department of Family and Community Medicine, University of Missouri, Columbia, MO, USA.
    • Palliat Med. 2016 Mar 1; 30 (3): 270278270-8.

    BackgroundMuch of the existing research on shared decision-making in hospice and palliative care focuses on the provider-patient dyad; little is known about shared decision-making that is inclusive of family members of patients with advanced disease.AimWe sought to describe shared decision-making as it occurred in hospice interdisciplinary team meetings that included family caregivers as participants using video-conferencing technology.DesignWe conducted a multimethod study in which we used content and thematic analysis techniques to analyze video-recordings of hospice interdisciplinary team meetings (n = 100), individual interviews of family caregivers (n = 73) and hospice staff members (n = 78), and research field notes.Setting/ParticipantsParticipants in the original studies from which data for this analysis were drawn were hospice family caregivers and staff members employed by one of five different community-based hospice agencies located in the Midwestern United States.ResultsShared decision-making occurred infrequently in hospice interdisciplinary team meetings that included family caregivers. Barriers to shared decision-making included time constraints, communication skill deficits, unaddressed emotional needs, staff absences, and unclear role expectations. The hospice philosophy of care, current trends in healthcare delivery, the interdisciplinary nature of hospice teams, and the designation of a team leader/facilitator supported shared decision-making.ConclusionThe involvement of family caregivers in hospice interdisciplinary team meetings using video-conferencing technology creates a useful platform for shared decision-making; however, steps must be taken to transform family caregivers from meeting attendees to shared decision-makers.© The Author(s) 2015.

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