title: Validation of a model of family caregiver communication types and related caregiver outcomes.
abstract: Caring for the family is included as one of the eight domains of quality palliative care, calling attention to the importance of the family system and family communications about cancer during care and treatment of the disease. Previously, a model of family caregiver communication defined four caregiver communication types-Manager, Carrier, Partner, Lone-each with a unique communication pattern. The purpose of the present study was to extend the model of family caregiver communication in cancer care to further understand the impact of family communication burden on caregiving outcomes.
  
  
  
  This mixed-method study employed fieldnotes from a family caregiver intervention focused on quality of life and self-reported caregiver communication items to identify a specific family caregiver type. Caregiver types were then analyzed using outcome measures on psychological distress, skills preparedness, family inventory of needs, and quality-of-life domains.
  
  
  
  Corroboration between fieldnotes and self-reported communication for caregivers (n = 21, 16 women, mean age of 53 years) revealed a definitive classification of the four caregiver types (Manager = 6, Carrier = 5, Partner = 6, Lone = 4). Mean scores on self-reported communication items documented different communication patterns congruent with the theoretical framework of the model. Variation in caregiver outcomes measures confirmed the model of family caregiver communication types. Partner and Lone caregivers reported the lowest psychological distress, with Carrier caregivers feeling least prepared and Manager caregivers reporting the lowest physical quality of life.
  
  
  
  This study illustrates the impact of family communication on caregiving and increases our knowledge and understanding about the role of communication in caregiver burden. The research provides the first evidence-based validation for a family caregiver communication typology and its relationship to caregiver outcomes. Future research is needed to develop and test interventions that target specific caregiver types.
authors.affiliation: Division of Nursing Research and Education,City of Hope National Medical Center,Duarte,California.
authors.forename: Elaine
authors.initials: E
authors.lastname: Wittenberg
authors.affiliation: Division of Nursing Research and Education,City of Hope National Medical Center,Duarte,California.
authors.forename: Kate
authors.initials: K
authors.lastname: Kravits
authors.affiliation: Department of Communication,University of Memphis,Memphis,Tennessee.
authors.forename: Joy
authors.initials: J
authors.lastname: Goldsmith
authors.affiliation: Division of Nursing Research and Education,City of Hope National Medical Center,Duarte,California.
authors.forename: Betty
authors.initials: B
authors.lastname: Ferrell
authors.affiliation: Division of Nursing Research and Education,City of Hope National Medical Center,Duarte,California.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Fujinami
mesh_terms: D000328:Adult; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D003142:Communication; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D010166:Palliative Care / Q000379:methods; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology; D015203:Reproducibility of Results; D012944:Social Support; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology / Q000628:therapy; D000078329:Workforce
keywords: Cancer caregiver; Communication; Family caregiver; Mixed methods