FAMCARE: A Tool for Measuring Effectiveness of End-of-Life Care

This comprehensive narrative review examines FAMCARE as a measurement tool for evaluating the effectiveness of end-of-life care, exploring its development, psychometric properties, applications across various healthcare setting, and impact on quality improvement initiatives. Originally developed for assessing family satisfaction in advanced cancer care, FAMCARE has evolved into various validated versions (FAMCARE-2, FAMCARE-6, FAMCARE-P13) adapted for different healthcare settings and cultural contexts. The tool demonstrates robust psychometric properties, with high internal consistency (Cronbach’s alpha 0.93-0.96) across multiple studies and strong cross-cultural validity through successful adaptations in various languages and healthcare systems. Review of its implementation across diverse settings, including hospice, hospital-based palliative care units, home-based care, and oncology departments, reveals its effectiveness in measuring and improving care quality. The tool’s multidimensional structure, encompassing information provision, availability of care, physical patient care, and psychosocial support, provides comprehensive insights into family satisfaction with end-of-life care. However, potential limitations including ceiling effects and retrospective assessment challenges have been identified. This review also highlights FAMCARE’s significant contribution to quality improvement initiatives, particularly in enhancing communication skills training, symptom management, and psychosocial support services. Future directions for FAMCARE development include real-time assessment capabilities, personalization options, and integration with emerging healthcare technologies. These findings underscore FAMCARE’s value as both a research instrument and a practical tool for improving end-of-life care quality, while identifying areas for future refinement to ensure its continued relevance in evolving healthcare landscapes.