Family conference Flashcards
Functions of Primary care Family conference
- Education
- Prevention
- Support
- Challenge
by means of a family meeting, the misperceptions of the members may be unearthed, by discussing their health beliefs, the physician can more effectively educate and can model the behavior being taught.
Education
the family meeting will help prevent family dysfunction if the impact of illness is discussed, the family’s strength and resources could be identified
Prevention
the moral support given by the physician could help unify the family as well as aid them in coping with the crisis
Support
the family meeting can be used as a way of challenging the family members to share their individual capabilities to help the member who is ill.
Challenge
In organizing a meeting the physician must consider these 4 things:
- Who should attend?
- When will the family meeting be set?
- Where will the family meeting be conducted?
- How will the family be convened?
4 situations where a family meeting could take place
- Hospitalization
- Death and dying
- Routine pregnancy
- Diagnosis of a chronic illness
Steps in conducting a family conference
- Socialize with family
- Set goals
- Discuss problems or issues
- Identify resource
- Give tasks
Level of Physician Involvement
- Level 1: minimal emphasis on the family
- Level 2 Providing medical information and advice
- Level 3: Eliciting feelings and providing emotional support.
- Level 4: Systematic family assessment and planned intervention
- Level 5: Family Therapy
Routinely convene the Family in the following circumstances
a. Hospitalization
b. Routine obstetrical and well-child care
c. Terminal illness and death
d. Serious chronic illness
Consider convening the family in the following circumstances:
a. Serious illness
b. Compliance problems
c. Poor control of chronic illness
d. High utilization of medical service by
an individual or family
e. Somatization
f. Anxiety or depression
g. substance abuse
h. Parent- child problems
i. Marital and sexual difficulties
Avoid the following when convening the family
- Being ambivalent and uncertain
2. Accepting patients word that his family will not come
Steps in family counselling
- Discuss clinical problem
- Define clinical problem
- Reflect the feeling
How to discuss the clinical problem
- Reason for consult
- Medical history
- Assess health condition by physical exam
How to Define the clinical Problem
- Explore the patient’s and the family’s health understanding
- Identify the emotionally critical misperception
How to Reflect the feeling
- Show empathy
Sample Questions:
Patient:
a. What does your sickness do to you?
b. What can you no longer do that you would like to do?
c. How do you feel about your sickness?
d. How does your family react to you because of your illness?
e. How do you feel about their reaction?
Sample Questions:
family members:
a. How does his sickness affect to you?
b. How do you fell about his sickness?
Sample Questions:
Both patient and family members:
a. What do you think will happen to the illness in the future ?
b. What do you fear most about the illness? What is the worst thing that could happen?
How to correct the misinterpretation
- Define the problem
- Etiology (Emphasize genetic predisposition Vs. transmission)
- Signs and symptoms
- Treatment
How to address the patient’s problem
- Share findings with the patient and family.
- Involve the patient and the family in the management plan to the appropriate extent.
- Further discuss treatment to correct remaining misperception
Sample questions for addressing the patient’s and family’s problem
a. What type of treatment do you think would be most helpful?
b. What important results do you expect from this treatment?
Sample questions for addressing the patient’s problem
a. What might make healing difficult for you?
b. What do you like your doctor to do for you?
How to do Goal –setting
- Summarize discussion
2. Mutual needs explicated
Sample questions for addressing the goal to the patient
What would you like your family to do for you?
Sample questions for addressing the goal to the family
What would you like him to do for you?
Sample question for re-contracting to meet each other’s needs.
Will each one of you state what you are willing to do for each other in response to the needs expressed?
What to do during Closing and Follow –up
- Ask for clarificatory questions or ask for important learnings.
- Do a feelings check
- Se specific date and time for follow up.
