What works for therapists conducting family meetings: treatment integrity in family-focused grief therapy during palliative care and bereavement
Female; Humans; Male; Grief; Adult; Middle Aged; Treatment Outcome; bereavement; Family/psychology; Health Surveys; Quality Assurance; Australia/epidemiology; Family Therapy/methods/statistics & numerical data; Health Care/methods/standards; Hospice Care/methods/psychology/statistics & numerical data; Neoplasms/mortality/psychology; Palliative Care/psychology/statistics & numerical data; Professional Competence/statistics & numerical data; SSHRC CURA
The purpose of this study was to evaluate the treatment integrity of Family-Focused Grief Therapy (FFGT), a preventive intervention designed for families at high risk of poor functioning during palliative care and bereavement. From the 81 families participating in a randomized controlled trial (53 assigned to therapy), 28 were randomly selected for this study of treatment fidelity using the FFGT integrity measure. A total of 109 family sessions were appraised. This represented a review of 62% of treated families, 38% of total therapy sessions, and 87% of the 15 participating therapists. Weighted mean percentage occurrences of therapist behaviors permitted trends in therapy application to be observed. Inter-rater reliability using the FFGT integrity measure was satisfactory, with 88% overall agreement. Eighty-six percent of therapists adhered faithfully to core elements of the model. Therapist competence was evidenced by a strong therapeutic alliance (94%), affirmation of family strengths in over 90%, and focus on agreed themes in 76% of sessions. Therapists averaged 10 grief-related questions per session, 7 on communication-related issues during assessment, 7 on conflict late in therapy, and 4 on cohesiveness across the course of therapy. Consistent application of FFGT, with attention to its four key themes of family communication, cohesiveness, conflict resolution, and shared grief has been demonstrated. The model is generalizable when applied by family therapists.
2004
Chan EK; O'Neill I; McKenzie M; Love A; Kissane DW
Journal Of Pain And Symptom Management
2004
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1016/j.jpainsymman.2003.10.008" target="_blank" rel="noreferrer">10.1016/j.jpainsymman.2003.10.008</a>
The symptoms of dying children.
Child; Female; Humans; Male; Prevalence; Longitudinal Studies; adolescent; Preschool; infant; retrospective studies; Palliative Care/psychology/statistics & numerical data; Affective Symptoms/epidemiology/psychology; Hospitalized/psychology/statistics & numerical data; Intensive Care/psychology/statistics & numerical data; Neoplasms/epidemiology/psychology; Pain/epidemiology/psychology; Respiratory Insufficiency/epidemiology/psychology
The purpose of this study was to examine the symptom prevalence, characteristics, and distress of children dying in hospital. Symptoms during the last week of life were obtained from the medical records. Symptoms and their characteristics during the last day of life were determined by nurse interview. Thirty children with an average age of 8.9 years were evaluated. The dominant disease process was cancer (n=18), most likely location of death intensive care (n=20), and major physiological disturbances at the time of death respiratory failure (n=9) and encephalopathy (n=9). The majority of children (90%) did not have a pre-existing Do Not Resuscitate (DNR) order and 58% of these children had this addressed for the first time in the last day of life. The mean (+/-SD) number of symptoms per patient in the last week of life was 11.1+/-5.6 and six symptoms occurred with a prevalence of 50% or more. The location of death had a significant (P<0.02) impact on the mean number of symptoms: ward (14.3+/-6.1) vs. intensive care (9.5+/-4.7). In general, symptoms in the last day of life were not associated with a high level of distress. In summary, the symptom burden of dying children is high. Symptoms were, at times, distressing but children were generally comfortable. The findings suggest the application of the palliative care paradigm and a more aggressive approach to symptom control to all areas of the hospital may prove beneficial to dying children.
2003
Drake R; Frost J; Collins JJ
Journal Of Pain And Symptom Management
2003
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1016/s0885-3924(03)00202-1" target="_blank" rel="noreferrer">10.1016/s0885-3924(03)00202-1</a>