Family conferences in the approach to dependent patients with high clinical complexity: from family health teams to palliative care

Introduction: Family conferences (FC) are a structured and therapeutic tool in palliative care, promoting effective communication between the healthcare team, patient and family. They are especially relevant for patients with high clinical complexity, both in hospital settings and in primary care.Objective: To evaluate the impact of FC on patients followed by palliative care teams and on complex patients dependent on primary health care (PHC), as well as the perception of caregivers on the quality of care provided.Methods: Observational, analytical and cross-sectional study, with application of a specific questionnaire to caregivers of patients followed by a community palliative care team and a family health team. Sociodemographic and clinical variables and perceptions of the impact of FC on the understanding of the disease and its trajectory, on satisfaction and on the feeling of security and trust were analyzed.Results: The total sample included 38 caregivers, of whom 20 were accompanied by a team specialized in palliative care and 18 by a family health team. There was a high percentage of female caregivers (78.9%), with a mean age of 58.1 years, and the mean age of patients was 80.7 years. FC was associated with improved perception of communication (9.36 ± 0.65), collaboration (9.50 ± 0.86) and implementation of care strategies (9.45 ± 0.83). The presence of professionals such as social workers and psychologists in the FC of the palliative care team associated with greater family participation (p = 0.002) and greater perceived support (p = 0.001). Among the patients who died, there was a significant correspondence between the desired and actual place of death (p = 0.007), demonstrating FC as an effective instrument for planning. The presence of more family members in the FC correlated with greater hospital use in the previous month (p < 0.001) and with greater case complexity.Discussion: FCs have proven to be effective in improving communication, planning and aligning care with patient and family preferences. Their regular implementation, especially in PHC, should be promoted with multidisciplinary teams and specific training.