February 15, 2007
Harborview program improves end-of-life communication
A palliative care family conference program developed at Harborview Medical Center improves communication between family members and clinicians, and helps reduce some of the symptoms related to the trauma of a loved one’s death, according to a study in the New England Journal of Medicine. The research was conducted at hospitals in France, and involved the family members of 126 critically ill patients in 22 intensive care units.
The research team in France was studying a palliative care communication method based on earlier research conducted by UW researchers, including J. Randall Curtis, professor of medicine in the Division of Pulmonary and Critical Care at the UW and Harborview. The communication method uses the mnemonic device VALUE: Value what family members say, Acknowledge their emotions, Listen, Understand the patient as a person by asking questions, and Elicit questions from the family members.
Researchers found that the system improved communication between ICU clinicians and family members of a dying patient. In each of the studied situations, physicians called a family conference when the patient was likely to die within a few days. In half of those conferences, the clinicians used standard ICU practices for the conversation. In the other half, they used the VALUE guidelines.
Compared to the standard practice, more family members on average attended the conferences using the new method, and the family spoke for more than twice as long. After the conference, 95 percent of family members exposed to the VALUE method reported that they were able to express their emotions to the clinicians, compared to only 75 percent in the standard conference. The communication guidelines also significantly reduced feelings of stress, anxiety, and depression in the family members up to three months after the death of their family member.
The research was led by Alexandre Lautrette of the Hopitaux de Paris, and was funded in part by the National Institute of Nursing Research, part of the National Institutes of Health. The study was published Feb. 1.
