Content, timing, participants and documented outcomes of family meetings in a specialist palliative care unit in Portugal: a retrospective descriptive study

Family meetings are a core communication strategy in palliative care, but their content in routine clinical practice remains insufficiently described. This study aimed to characterize the timing, participants, goals, problems identified, and decisions reached in family meetings conducted in a specialist palliative care unit.

We conducted a retrospective descriptive study of all formally documented family meetings held in a certified palliative care unit in Portugal between October 2012 and December 2019. Data were extracted from standardized meeting records and electronic health records. Variables included patient characteristics, Palliative Performance Scale scores, meeting timing, participants, goals, problems identified, and final decisions. Free-text entries were thematically recoded when needed. Descriptive statistics were used.

A total of 272 formally documented family meeting records were analysed. The unit of analysis was the meeting record. Physicians attended 99.3% of meetings, nurses 65.4%, social workers 45.2%, psychologists 23.5%, and patients 11.4%. The median time from admission to meeting was 9 days, and the median time from meeting to death was 13 days. Median Palliative Performance Scale score declined from 40% at admission to 30% at the meeting. Discharge after the meeting occurred in 84 records (30.9%).

Common goals included clarifying expectations, building rapport, and discussing therapeutic options. Frequently identified problems concerned prognosis, symptoms, adequacy of clinical information, end-of-life issues, and discharge planning. Common decisions related to psychological or social support, discharge planning, comfort-focused care, and symptom management.

Family meetings provided a structured forum for communication, problem identification, and care planning across clinical and psychosocial domains. Their late timing and low patient participation suggest that earlier implementation and broader interdisciplinary involvement may strengthen patient- and family-centred care.