Predictors of Family Conflict at the End of Life: The Experience of Spouses and Adult Children of Persons with Lung Cancer

Kramer, Betty J.; Kavanaugh, Melinda S.; Trentham‐Dietz, Amy; Walsh, Matthew C.; Yonker, James A.

doi:10.1093/geront/gnp121

Cited by 82 publications

(113 citation statements)

References 37 publications

Supporting

Mentioning

105

Contrasting

Order By: Relevance

“…The conceptual framework guiding this study was drawn from an explanatory matrix of family conflict originally generated from a case study of an innovative managed care organization providing end-of-life care to low-income elders. 11 This matrix was subsequently validated in a study of lung cancer caregivers 12 and then replicated and expanded in a study involving the hospice context. 13 As shown in Figure 1, this model proposes that conflict is best understood by considering the ''family context,'' ''conditions'' that shape family member actions or interactions, and ''contributing factors.''…”

Section: Introductionmentioning

confidence: 99%

“…11,13 Contextually, families entering hospice vary in relationship quality, resources and demands, and how they have approached advance care planning. Prior conflict in the family is a strong predictor of conflict at the end of life, 12 and spousal caregivers tend to be less aware of conflict than adult children. 14,15 Higher rates of violent forms of conflict are reported by younger, less educated, poorer, and female respondents.…”

Section: Introductionmentioning

confidence: 99%

“…16 Although advance care planning may reduce conflict in families facing difficult treatment decisions arising from uncertainty of patient wishes, 17 conflict is reportedly higher among lung cancer caregivers of patients with previously specified care preferences. 12 Not surprisingly, siblings report that conflict is higher when other siblings assert control and disregard the previously stated wishes of the parent. 18 The patient's clinical care needs and the phenomenon of ''family coming out of the woodwork'' at end of life are two primary conditions that underlie the processes of family conflict.…”

Section: Introductionmentioning

confidence: 99%

“…11 Communication constraints and asserting control were highly correlated with conflict at the end of life among lung cancer caregivers. 12 We hypothesize that: 1) the family context will be associated with family conflict. More specifically, we expect that higher levels of conflict will be found among family members with more demands (i.e., longer duration of caregiving and presence of children in the home), fewer resources (i.e., lower income, lower education, and younger age), and less advance care planning (i.e., absence of advance directives or conversations before illness onset); 2) certain conditions (i.e., patient care needs and family ''coming out of woodwork'') will be associated with contributing factors and family conflict; and 3) after controlling for family context and conditions, contributing factors (i.e., death anxiety, communication constraints, and family asserting control) will significantly predict family conflict.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Correlates and Predictors of Conflict at the End of Life Among Families Enrolled in Hospice

Kramer

Boelk

2015

Journal of Pain and Symptom Management

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Correlates and Predictors of Conflict at the End of Life Among Families Enrolled in Hospice

Kramer

Boelk

2015

Journal of Pain and Symptom Management

View full text Add to dashboard Cite

show abstract

“…Conversely, an active coping style seemed to positively influence survival in a study with 103 lung cancer patients [82]. Professional assessment and interventions should also focus on caregivers in order to give relief to their psychological distress, which is evident during the entire lung cancer continuum [83][84][85].…”

Section: Psychological Dimensionmentioning

confidence: 99%

The lung cancer patient, the pneumologist and palliative care: a developing alliance

Blum

Schönfeld

2014

Eur Respir J

View full text Add to dashboard Cite

Considerable evidence is now available on the value of palliative care for lung cancer patients in all stages and at all times during the course of the disease. However, pneumologists and their institutions seem to be widely in arrears with the implementation of palliative care concepts and the development of integrated structures.This review focuses on the available evidence and experience of various frequently unmet needs of lung cancer patients, especially psychological, social, spiritual and cultural ones. A PubMed search for evidence on these aspects of palliative care as well as on barriers to the implementation, on outcome parameters and effectiveness, and on structure and process quality was performed with a special focus on lung cancer patients.As a consequence, this review particularly draws pneumologists' attention to improving their skills in communication with the patients, their relatives and among themselves, and to establish team structures with more far-reaching competences and continuity than existing multilateral cooperations and conferences can provide. Ideally, any process of structural and procedural improvement should be accompanied by scientific evaluation and measures for quality optimisation. @ERSpublications Pneumologists should get more widely involved in palliative care for lung cancer patients

show abstract

Association of Participation in an End-of-Life Conversation Game With Advance Care Planning Behavior and Perspectives Among African American Individuals

et al. 2020

View full text Add to dashboard Cite

IMPORTANCE Less than 25% of African American individuals have completed advance directives and are thus vulnerable to poor end-of-life care. Low-cost interventions are needed to increase engagement in advance care planning (ACP).OBJECTIVES To investigate whether an end-of-life conversation game motivates African American attendees to engage in ACP and to assess whether the game is well received and endorsed.EXPOSURES Attendance at an end-of-life conversation game (Hello) played in groups of 4 to 6 participants for 60 minutes. DESIGN, SETTING, AND PARTICIPANTS Prospective, mixed-methods cohort study conducted from 2018 to 2019 with a 3-to 11-month follow-up interview. Game events were held in 53 community venues across the US; 15 were purposively sampled for onsite research procedures. Of 428 attendees at purposively sampled sites, 386 (90%) consented to research procedures (6 attendees were removed from analysis for protocol deviation). Of 367 attendees who provided accurate contact information, 232 (63%) were contacted, and 220 were included in follow-up analyses. MAIN OUTCOMES AND MEASURESThe primary outcome was advance directive completion rates after the intervention. Secondary outcomes included rates of other ACP behaviors, ACP engagement, conversation satisfaction and realism, and participants' Net Promoter Score (a measure of endorsement). Follow-up telephone interviews explored the game experience and relevant ACP behaviors of attendees. RESULTS Of 380 individuals who participated (mean [SD] age, 62.2 [13.8] years; 304 were female [80%], and 348 were [92%] African American), none withdrew because of an adverse event. After the intervention, 91 of 220 attendees (41%) completed a new advance directive; 176 of 220 attendees (80%) discussed end-of-life wishes with loved ones, and 214 of 219 attendees (98%) completed at least 1 ACP behavior. There was a moderate increase in the self-efficacy domain on the ACP Engagement Survey (mean [SD] change from before to after the game, 0.54 [0.98]; P < .001).The mean (SD) conversation satisfaction score was 6.21 (0.93) (range, 1-7, with 7 being highest satisfaction), and the overall Net Promoter Score was 57.89 (range, −100 to 100, with 100 being highest endorsement). Interviews revealed 5 themes about the game: (1) it was a useful forum for ACP; (2) it provided new information and perspective; (3) it was emotionally beneficial; (4) it increased appreciation for ACP; and (5) it empowered and motivated participants to perform ACP.Mixed-methods integration showed convergence across data sets. (continued) Key Points Question Can a low-cost, easily scaled, end-of-life conversation game motivate underserved African American individuals to engage in advance care planning? Findings This national mixed-methods cohort study reaching 384 underserved African American individuals found that high rates of advance care planning behavior were associated with participation in game events at community venues. Meaning The end-of-life conversation game may be a useful tool for engaging und...

show abstract

Predictors of Family Conflict at the End of Life: The Experience of Spouses and Adult Children of Persons with Lung Cancer

Abstract: 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.

Cited by 82 publications

References 37 publications

Correlates and Predictors of Conflict at the End of Life Among Families Enrolled in Hospice

Correlates and Predictors of Conflict at the End of Life Among Families Enrolled in Hospice

The lung cancer patient, the pneumologist and palliative care: a developing alliance

Association of Participation in an End-of-Life Conversation Game With Advance Care Planning Behavior and Perspectives Among African American Individuals

Contact Info

Product

Resources

About