Predictors of family conflict at the end of life: the experience of spouses and adult children of persons with lung cancer.
OBJECTIVE
Guided by an explanatory matrix of family conflict at the end of life, the purpose of this article was to examine the correlates and predictors of family conflict reported by 155 spouses and adult children of persons with lung cancer.


METHODS
A cross-sectional statewide survey of family members of persons who died from lung cancer was conducted as part of the larger study on the Assessment of Cancer CarE and SatiSfaction in Wisconsin.


RESULTS
Significant bivariate correlations were found between family conflict and family context variables (i.e., a history of conflict, younger respondent age, race, and specified end-of-life care wishes of the patient), conditions (i.e., greater physical and psychological clinical care needs of the patient), and contributing factors (i.e., communication constraints and family asserting control). In the multivariate model, significant predictors of family conflict included prior family conflict, race, communication constraints, and family members asserting control; the model explained 72% of the variance in conflict.


CONCLUSIONS
Implications for routine assessment and screening to identify families at risk and recommendations for the development and testing of interventions to facilitate shared decision making and enhance open communication among at-risk families are highlighted.
Kramer
Betty J
BJ
MSSW, School of Social Work, University of Wisconsin-Madison, 1350 University Avenue, Madison, WI 53706-1510, USA. ejkramer@wisc.edu
Kavanaugh
Melinda
M
Trentham-Dietz
Amy
A
Walsh
Matthew
M
Yonker
James A
JA
D000368:Aged; D017028:Caregivers; D003220:Conflict, Psychological; D003430:Cross-Sectional Studies; D005195:Family Relations; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000451:nursing*; D008297:Male; D008875:Middle Aged; D013727:Terminal Care / Q000458:organization & administration*; D014922:Wisconsin