Typology of perceived family functioning in an American sample of patients with advanced cancer.
BACKGROUND
Poor family functioning affects psychosocial adjustment and the occurrence of morbidity following bereavement in the context of a family's coping with advanced cancer. Family functioning typologies assist with targeted family-centered assessment and intervention to offset these complications in the palliative care setting.


OBJECTIVE
Our objective was to identify the number and nature of potential types in an American palliative care patient sample.


METHODS
Data from patients with advanced cancer (N = 1809) screened for eligibility for a larger randomized clinical trial were used. Cluster analyses determined whether patients could be classified into clinically meaningful and coherent groups, based on similarities in their perceptions of family functioning across the cohesiveness, expressiveness, and conflict resolution subscales of the Family Relations Index.


RESULTS
Patients' reports of perceived family functioning yielded a model containing five meaningful family types.


CONCLUSIONS
Cohesiveness, expressiveness, and conflict resolution appear to be useful dimensions by which to classify patient perceptions of family functioning. "At risk" American families may include those we have called hostile, low-communicating, and less-involved. Such families may benefit from adjuvant family-centered psychosocial services, such as family therapy.
Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York, USA. Electronic address: schulert@mskcc.org.
Tammy A
TA
Schuler
Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Talia I
TI
Zaider
Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Yuelin
Y
Li
Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Shira
S
Hichenberg
Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Melissa
M
Masterson
Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York, USA; School of Psychology and Psychiatry, Monash University, Clayton, Victoria, Australia.
David W
DW
Kissane
D000223:Adaptation, Psychological; D000704:Analysis of Variance; D001601:Bereavement; D016000:Cluster Analysis; D003142:Communication; D003220:Conflict, Psychological; D005195:Family Relations; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D010166:Palliative Care / Q000523:psychology; D016032:Randomized Controlled Trials as Topic; D012959:Socioeconomic Factors; D014481:United States
Family; assessment; bereavement; cancer; cluster analysis; family functioning; family therapy; grief; psychotherapy