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Validation of a model of family caregiver communication types and related caregiver outcomes

Published online by Cambridge University Press:  01 April 2016

Elaine Wittenberg*
Affiliation:
Division of Nursing Research and Education, City of Hope National Medical Center, Duarte, California
Kate Kravits
Affiliation:
Division of Nursing Research and Education, City of Hope National Medical Center, Duarte, California
Joy Goldsmith
Affiliation:
Department of Communication, University of Memphis, Memphis, Tennessee
Betty Ferrell
Affiliation:
Division of Nursing Research and Education, City of Hope National Medical Center, Duarte, California
Rebecca Fujinami
Affiliation:
Division of Nursing Research and Education, City of Hope National Medical Center, Duarte, California
*
Address correspondence and reprint requests to: Elaine Wittenberg, City of Hope National Medical Center, Division of Nursing Research and Education, 1500 East Duarte Road, Popular Science Building 173, Duarte, California 91010. E-mail: ewittenberg@coh.org.

Abstract

Objective:

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.

Method:

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.

Results:

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.

Significance of results:

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.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2016 

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References

REFERENCES

Adelman, R.D., Tmanova, L.L., Delgado, D., et al. (2014). Caregiver burden: A clinical review. The Journal of the American Medical Association, 311(10), 10521060.Google Scholar
Davis, L.L., Chestnutt, D., Molloy, M., et al. (2014). Adapters, strugglers, and case managers: A typology of spouse caregivers. Qualitative Health Research, 24(11), 14921500.Google Scholar
Family Caregiver Alliance (2015). Selected long-term care statistics. Available from https://http://www.caregiver.org/selected-long-term-care-statistics.Google Scholar
Ferrell, B.R., Ferrell, B.A., Rhiner, M., et al. (1991). Family factors influencing cancer pain management. Postgraduate Medical Journal, 67(Suppl. 2), S64S69.Google Scholar
Ferrell, B.R., Grant, M., Borneman, T., et al. (1999). Family caregiving in cancer pain management. Journal of Palliative Medicine, 2(2), 185195.Google Scholar
Fitzpatrick, M.A. (2004). Family communication patterns theory: Observations on its development and application. Journal of Family Communication, 4(3/4), 167179.Google Scholar
Fujinami, R., Sun, V., Zachariah, F., et al. (2015). Family caregivers' distress levels related to quality of life, burden, and preparedness. Psycho-Oncology, 24(1), 5462.Google Scholar
Goldsmith, J. (2015). Family communication goals and messages. In Oxford textbook of communication in palliative care. Wittenberg, E. et al. (eds.), pp. 114152. New York: Oxford Press.Google Scholar
Goldsmith, J., Wittenberg, E., Platt, C.S., et al. (2015). Family caregiver communication in oncology: Advancing a typology. Psycho-Oncology, June 4. doi: 10.1002/pon.3862. Epub ahead of print.Google Scholar
Grant, M., Sun, V., Fujinami, R., et al. (2013). Family caregiver burden, skills preparedness, and quality of life in non-small-cell lung cancer. Oncology Nursing Forum, 40(4), 337346.Google Scholar
Hendriksen, E., Williams, E., Sporn, N., et al. (2015). Worried together: A qualitative study of shared anxiety in patients with metastatic non-small-cell lung cancer and their family caregivers. Supportive Care in Cancer, 23(4), 10351041.Google Scholar
Kim, H.H., Kim, S.Y., Kim, J.M., et al. (2015). Influence of caregiver personality on the burden of family caregivers of terminally ill cancer patients. Palliative & Supportive Care, 14(1), 512.Google Scholar
Koehly, L.M., Peters, J.A., Kenen, R., et al. (2009). Characteristics of health information gatherers, disseminators, and blockers within families at risk of hereditary cancer: Implications for family health communication interventions. American Journal of Public Health, 99(12), 22032209.Google Scholar
Kristjanson, L.J., Atwood, J. & Degner, L.F. (1995). Validity and reliability of the Family Inventory of Needs (FIN): Measuring the care needs of families of advanced cancer patients. Journal of Nursing Measurement, 3(2), 109126.Google Scholar
Litzelman, K, Barker, K, Puccetti, D, et al. (2013). Socioeconomic disparities in the quality of life in children with cancer or brain tumors: The mediating role of family factors. Psycho-Oncology, 22, 10811088.Google Scholar
Litzelman, K, Kent, K & Rowland, J. (2015). Social factors in informal cancer caregivers: The interrelationships among social stressors, relational quality, and family functioning in the CanCOR data set. Cancer, 122(2), 278286.Google Scholar
Mosher, C.E., Given, B. & Ostroff, J. (2015). Barriers to mental health service use among distressed family caregivers of lung cancer patients. European Journal of Cancer Care, 24, 5059.Google Scholar
National Comprehensive Cancer Network (2008). Distress: Treatment guidelines for patients, version 2. Available from http://www.asociatiapavel.ro/userfiles/NCCN%20Distress%20Guidelines.pdf.Google Scholar
National Consensus Project for Quality Palliative Care (2013). Clinical practice guidelines for quality care, 3rd ed. Available from http://www.nationalconsensusproject.org.Google Scholar
Rusinak, R.L. & Murphy, J.F. (1995). Elderly spousal caregivers: Knowledge of cancer care, perceptions of preparedness, and coping strategies. Journal of Gerontological Nursing, 21(3), 3341.Google Scholar
Schuler, T.A., Zaider, T.I., Li, Y., et al. (2014). Typology of perceived family functioning in an American sample of patients with advanced cancer. Journal of Pain and Symptom Management, 48(2), 281288.Google Scholar
Shin, D.W., Cho, J., Roter, D.L., et al. (2013). Preferences for and experiences of family involvement in cancer treatment decision-making: Patient–caregiver dyads study. Psycho-Oncology, 22(11), 26242631.Google Scholar
Tsilika, E, Parpa, E, Zgogianni, A, et al. (2015). Caregivers' attachment patterns and their interactions with cancer patients' patterns. Supportive Care in Cancer, 23, 8794.Google Scholar
Wittenberg-Lyles, E., Demiris, G., Oliver, D.P., et al. (2012 a). Stress variances among informal hospice caregivers. Qualitative Health Research, 22(8), 11141125.Google Scholar
Wittenberg-Lyles, E., Goldsmith, J., Demiris, G., et al. (2012 b). The impact of family communication patterns on hospice family caregivers: A new typology. Journal of Hospice & Palliative Nursing, 14(1), 2533.Google Scholar
Wittenberg-Lyles, E., Goldsmith, J., Oliver, D.P., et al. (2012 c). Targeting communication interventions to decrease caregiver burden. Seminars in Oncology Nursing, 28(4), 262270.Google Scholar
Wittenberg-Lyles, E., Kruse, R.L., Oliver, D.P., et al. (2014). Exploring the collective hospice caregiving experience. Journal of Palliative Medicine, 17(1), 5055.Google Scholar