title: Family functioning and psychological distress among Japanese breast cancer patients and families.
abstract: OBJECTIVE
  The purpose of this study was to develop a typology of family functioning in the families of breast cancer patients.
  
  
  METHODS
  Seventy-four families (189 individuals: 74 patients, 54 spouses, 46 offspring, and 15 other relatives) completed self-report questionnaires. Perception of family functioning was assessed using the family relationship index (FRI) and its three dimensions (cohesiveness, expressiveness, and conflict) and was classified into groups by a cluster analytic approach. Psychological distress was assessed using the Zung self-rating depression scale (SDS) and the Zung self-rating anxiety scale (SAS).
  
  
  RESULTS
  Cluster analysis yielded three groups of patients and their family members: one cluster with high cohesiveness, high expressiveness, and low conflict ("supportive" type: n=64); a second group with low cohesiveness, low expressiveness, and high conflict ("conflictive" type: n=65); and a third group with limited cohesiveness, limited expressiveness, and low conflict ("intermediate" type: n=60). Analysis of variance revealed that conflictive families manifested the highest level of depression and anxiety among these clusters.
  
  
  CONCLUSIONS
  Typology of family functioning can identify psychologically at-risk families. A family-focused approach can help to reduce psychological distress, especially in conflictive families.
authors.affiliation: Department of Psychiatry and Neurosciences, Division of Frontier Medical Science, Programs for Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Ozono
authors.forename: Toshinari
authors.initials: T
authors.lastname: Saeki
authors.forename: Shinichi
authors.initials: S
authors.lastname: Inoue
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Mantani
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Okamura
authors.forename: Shigeto
authors.initials: S
authors.lastname: Yamawaki
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000523:psychology*; D005195:Family Relations; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D012650:Self Disclosure; D013315:Stress, Psychological; D011795:Surveys and Questionnaires