An empirical study of 102 families of palliative care patients was undertaken to identify the prevalence of psychological morbidity in family members. Beck Depression Inventory‐derived caseness was identified in one‐half of patients, one‐third of spouses and one‐quarter of offspring, suggesting that psychological distress reverberates substantially throughout the nuclear family. Anger was significantly more common in the offspring, who perceived their families to have poorer communication, cohesion and more conflict than their parents, suggesting that information about the illness may not be adequately transmitted to them. The family as a group is the most appropriate recipient of care, and family meetings are advocated to promote communication, support and mutual understanding.
Based on its improved safety profile, capecitabine has the potential to replace 5-FU/LV as standard adjuvant treatment for patients with colon cancer. Efficacy results are expected to be available in Keywords: Adjuvant treatment, capecitabine, chemotherapy, colorectal cancer
Family function was assessed in 102 families (342 members) of palliative care patients and grouped into classes by a computer‐based taxonomic program. Five classes were defined through the dimensions of cohesiveness, conflict and expressiveness of the Family Environment Scale (FES). One third of families we named supportive for their high cohesiveness; a further 21% resolved conflict effectively; both of these classes contained low psychological morbidity. Two classes (15%) were clearly dysfunctional: hostile families (6%) were distinguished by high conflict while sullen families (9%) displayed moderate conflict, poor cohesion and limited expressiveness. These two classes had significantly higher levels of psychological morbidity and poorer social functioning. The remaining class (31%) had intermediate levels of cohesion, expressiveness and conflict (termed ordinary) yet more moderate psychosocial morbidity. Screening of families with the FES would facilitate a more family‐centred approach to treatment, with relatively early identification of families at‐risk; preventive interventions would also then be feasible.
Information searching is common in ambulatory Australian oncology patients, with the Internet being a frequently used resource. To ensure patients find reliable and relevant information and to minimize the risk of harm, health professionals involved in treating oncology patients should provide guidance in finding information sources and assistance in interpreting the information obtained.
Objective: To investigate attitudes of Australian health professionals working in oncology to health‐related information in the media and on the Internet and to patients who search for this information.
Design: Questionnaire‐based survey.
Setting and participants: Questionnaires were mailed in January 2003 to all 333 health professionals belonging to the Victorian Cooperative Oncology Group.
Main outcome measures: 27 items about attitudes to information in the media and the Internet, patient information‐seeking and its effects on the doctor–patient relationship.
Results: 226 surveys (68%) were returned and assessable. Most respondents took notice of medical information reported on television/radio, in newspapers (80% each) and on the Internet (56%), mainly to be informed when patients ask questions (82%) and to check its accuracy (60%). Most were concerned about this accuracy (64% believed it accurate only sometimes, and 23% rarely), and 91% believed information from the Internet had the potential to cause harm to patients. Nevertheless, they generally supported patients’ information‐searching, believing it allowed them to be better informed (58%), and did not affect their ability to cope with their illness (49%), or their trust in, and relationship with, their doctor (69% and 67%, respectively).
Conclusions: Oncology health professionals are aware of patients’ use of the Internet and other media to obtain medical information. To ensure oncology patients find reliable and relevant information and to minimise the risk of harm, the health professionals treating them should provide guidance in finding information sources, and assistance in interpreting the information obtained.
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