title: Silence and cancer: why do families and patients fail to communicate?
abstract: This study examined the phenomenon of avoidance of family communication about cancer. Thirty-seven Stage III or IV lung cancer patients and 40 caregivers, including 24 primary and 16 secondary caregivers, were interviewed; a total of 26 families were studied. The interviews were audiotaped and transcribed. Analysis of the interviews indicated that two thirds of the families (65%) experienced communication problems. The avoidance of family communication was associated with several underlying thought processes: avoidance of psychological distress; desire for "mutual protection;" and belief in positive thinking. Family communication was further hindered by the increasing difficulty of issues inherent to late-stage cancer. The adverse impact of communication avoidance and the implications of our findings are discussed.
authors.affiliation: School of Medicine, Case Western Reserve University, Cleveland, OH 44106-4961, USA. axz16@po.cwru.edu
authors.forename: Amy Y
authors.initials: AY
authors.lastname: Zhang
authors.forename: Laura A
authors.initials: LA
authors.lastname: Siminoff
mesh_terms: D000368:Aged; D002173:Cancer Care Facilities / Q000706:statistics & numerical data; D017028:Caregivers / Q000523:psychology*; D003142:Communication; D005195:Family Relations; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007407:Interviews as Topic; D008175:Lung Neoplasms / Q000145:classification / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009820:Ohio; D012803:Sick Role; D013315:Stress, Psychological / Q000523:psychology