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The Gerontologist Advance Access published online on August 11, 2009
The Gerontologist, doi:10.1093/geront/gnp121
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© The Author 2009. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org.

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

Betty J. Kramer, PhD, MSSW1,2, Melinda Kavanaugh, MSW2, Amy Trentham-Dietz, PhD3, Matthew Walsh, MPH3 and James A. Yonker, MS

2 School of Social Work, University of Wisconsin–Madison
3 Department of Population Health Sciences and Paul P. Carbone Comprehensive Cancer Center, University of Wisconsin–Madison
4 Sociology Department, University of Wisconsin–Madison

1 Address correspondence to Betty J. Kramer, PhD, MSSW, School of Social Work, University of Wisconsin–Madison, 1350 University Avenue, Madison, WI 53706-1510. E-mail: ejkramer{at}wisc.edu


  Abstract

Purpose: Guided by an explanatory matrix of family conflict at the end of life, the purpose of this article was to examine the correlates and predictors of family conflict reported by 155 spouses and adult children of persons with lung cancer. Design and Methods: A cross-sectional statewide survey of family members of persons who died from lung cancer was conducted as part of the larger study on the Assessment of Cancer CarE and SatiSfaction in Wisconsin. Results: Significant bivariate correlations were found between family conflict and family context variables (i.e., a history of conflict, younger respondent age, race, and specified end-of-life care wishes of the patient), conditions (i.e., greater physical and psychological clinical care needs of the patient), and contributing factors (i.e., communication constraints and family asserting control). In the multivariate model, significant predictors of family conflict included prior family conflict, race, communication constraints, and family members asserting control; the model explained 72% of the variance in conflict. Implications: 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.

Keywords: Palliative care, Family functioning, Family caregivers

Received April 13, 2009; Accepted July 13, 2009

Decision Editor: William J. McAuley, PhD


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