The Melbourne Family Grief Study, II: Psychosocial morbidity and grief in bereaved families

Kissane, David W.; Bloch, Sidney; Onghena, Patrick; McKenzie, Dean Philip; Snyder, Ray D.; Dowe, David L.

doi:10.1176/ajp.153.5.659

Cited by 104 publications

(8 citation statements)

References 23 publications

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“…11,13,14 FRI comprises three subscales: 1) cohesiveness (e.g., “There is a feeling of togetherness in our family”), 2) expressiveness (e.g., “We tell each other about our personal problems”), and 3) conflict resolving (e.g., “Family members fight a lot”). The subscales form a global measure of family interaction.…”

Section: Methodsmentioning

confidence: 99%

“…12 The remaining family type, 5) intermediate , reported moderately reduced cohesiveness 11 and also carried high rates of poorer psychosocial outcomes. 13 Although families are never labeled as such in the clinical setting, screening for “risk” by identifying more difficult interpersonal relations allows the offer of adjuvant family-centered services, including family therapy.…”

Section: Introductionmentioning

confidence: 99%

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Typology of Perceived Family Functioning in an American Sample of Patients With Advanced Cancer

Schuler

Zaider

et al. 2014

Journal of Pain and Symptom Management

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Context 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. Objectives 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. Conclusion 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.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Typology of Perceived Family Functioning in an American Sample of Patients With Advanced Cancer

Schuler

Zaider

et al. 2014

Journal of Pain and Symptom Management

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“…Family conflict is correlated with distress, loneliness, and abandonment of hospice patients, 1,2 and has adverse impacts on caregivers, resulting in poor mental health, a greater perceived burden, anger and depression, and grief. [2][3][4][5] Furthermore, family conflict makes it difficult to deal with the needs of the patient and family, and interferes with providing highquality end-of life (EOL) care.…”

Section: Introductionmentioning

confidence: 99%

Are family relationships associated with family conflict in advanced cancer patients?

et al. 2021

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Objectives: Family conflict during end-of-life care is an important issue for advanced cancer patients and their families, although studies are lacking. We investigated the association between family relationships and family conflict in advanced cancer patients. Methods:This study was a secondary analysis of a nationwide multicenter questionnaire survey targeting the bereaved family members of cancer patients who died in palliative care units, general wards, or at home to evaluate the quality of end-of-life care in Japan.Results: A total of 1084 questionnaires (63.0%) were returned and we analyzed a total of 908 responses. In total, 38.0% of family members reported at least one family conflict during end-of-life care, and the most frequent family conflict was "about certain family members not pulling their weight" (23.5%). Multivariate linear analysis revealed family members who asserted their opinions (p < 0.001), family assessment device score (p < 0.001), worries about family finances during cancer treatment (p < 0.001), family members contacted after illness were helpful (p = 0.003), female patients (p = 0.03), and family with family relationship index ≤7 (p = 0.04) were positively associated with the outcome-family conflict (OFC) score. Proxy decision maker was selected by the patient (p = 0.003), people listened to families' worries or problems (p = 0.003), physician gave sufficient explanation (p = 0.003), living will before their illness (p = 0.038) and female bereaved family members (p = 0.046) were negatively associated with the OFC score.Conclusions: It may be important for health care providers to actively assess the possibility of family conflicts according to family relationships, such as a proxy decision maker having been selected by the patient.

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“…Hostile families are chaotic and help-rejecting, while sullen families carry the highest rates of depression, yet show willingness to accept help (Kissane et al , 2003). The fifth type, called ‘intermediate’, shows moderately-reduced cohesiveness (Kissane, Bloch & Dowe et al, 1996), with its members also at heightened risk of poorer psychosocial outcomes (Kissane, Bloch & Onghena et al , 1996). …”

Section: Introductionmentioning

confidence: 99%

Family focused grief therapy: a versatile intervention in palliative care and bereavement

2013

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A diagnosis of advanced stage cancer is a difficult life event for the entire family. Previous studies have demonstrated the negative psychosocial outcomes associated with the burden of caregiving in conjunction with dysfunctional family relations. Family Focused Grief Therapy (FFGT) is a time-limited intervention that has been shown to be effective in aiding dysfunctional families through the promotion of family functioning, communication, cohesiveness, and conflict management. This paper outlines the content of FFGT therapy and highlights its unique aspects as well as the challenges of providing therapy to different types of families in the context of palliative care. FFGT shows promise as an effective intervention applicable across multiple settings in the future.

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The Melbourne Family Grief Study, II: Psychosocial morbidity and grief in bereaved families

Abstract: More intense grief and greater psychosocial morbidity are found in sullen, hostile, and intermediate bereaved families than in the more adaptive supportive and conflict-resolving types. At-risk families are identifiable and could be treated preventively to reduce morbidity.

Cited by 104 publications

References 23 publications

Typology of Perceived Family Functioning in an American Sample of Patients With Advanced Cancer

Typology of Perceived Family Functioning in an American Sample of Patients With Advanced Cancer

Are family relationships associated with family conflict in advanced cancer patients?

Family focused grief therapy: a versatile intervention in palliative care and bereavement

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