Interdisciplinary team members’ experiences of family meetings in an Irish rehabilitation hospital: a social work action-research project

Abstract

This study set out to gain a better understanding of how family meetings are facilitated and experienced in an Irish rehabilitation hospital setting from the perspectives of interdisciplinary team (IDT) members, patients and their family members. This article reports the findings from IDT members’ perspectives. A critical-realist action-research approach was utilised that involved medical social workers (N = 15) and a social work academic. A quantitative, descriptive study design was adopted, which utilised a cross-sectional survey of IDT members. A total of 85 clinical staff responded to the questionnaire, of which 69 were fully completed. Four key themes emerged: pre-meeting engagement and preparation – a critical step; the impact of organisational structures; supporting participation; and mechanisms for effective family meetings. Findings indicate the importance of pre-meeting preparation, the mutuality of the relationships between participants, a standardised approach and the use of patient-centred and inclusive practices to achieve truly participatory family meetings. Family meetings involve complex processes in which mutual influence, context, preferences, values, information shared, the nature of the relationships involved and the communicative style of participants all play significant roles in both the process and decision-making outcomes. This study concluded that social workers are perhaps in a unique position to work with IDTs in clarifying the reality of the limits of choice and the involvement of the patient and family in rehabilitation hospital settings. In preparation for the role of family-meeting facilitation, the implementation of education and training programmes for IDT members is strongly recommended.