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Table 5 Post-Family Meeting Primary Family Carer Questionnaire

From: Family meetings in palliative care: Multidisciplinary clinical practice guidelines

Nb Conducted by phone [] or face to face []. Completed by ............ [insert name]

As a follow up to the recent family meeting we are interested in finding out how things are for you at the moment. Before the family meeting

You nominated:

.................................................................................................................................................................

as the main problem to be discussed at the family meeting, and

.................................................................................................................................................................

as your second greatest problem.

How upset/worried are you about this problem (or these problems) at the present time? (Place a cross on the line)

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(1) Not at all

As worried as I could possibly be (10)

How often do these problems happen? (Place a cross on the line)

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(1) Not at all

All the time (10)

How much is the problem (or problems) interfering in your life? (Place a cross on the line)

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(1) Not at all

Dominating my life completely (10)

In what ways?...........................................................................................................................................

How confident do you feel in dealing with the problem(s)? (Place a cross on the line)

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(1) Not at all

Extremely (10)

You nominated the following questions as those you would like addressed in the family meeting:

.................................................................................................................................................................

To what extent do you feel these questions were addressed?

.................................................................................................................................................................

Office use only:

   
 

Pre-session

Post-session

Difference

How upset/worried:

........................

........................

........................

Problem frequency:

........................

........................

........................

Life interference:

........................

........................

........................

Confidence:

........................

........................

........................