Perceived family functioning predicts baseline psychosocial characteristics in U.S. participants of a family focused grief therapy trial Journal Article


Authors: Schuler, T. A.; Zaider, T. I.; Li, Y.; Masterson, M.; McDonnell, G. A.; Hichenberg, S.; Loeb, R.; Kissane, D. W.
Article Title: Perceived family functioning predicts baseline psychosocial characteristics in U.S. participants of a family focused grief therapy trial
Abstract: Context and Objectives Screening and baseline data on 170 American families (620 individuals), selected by screening from a palliative care population for inclusion in a randomized controlled trial of family-focused grief therapy, were examined to determine whether family dysfunction conferred higher levels of psychosocial morbidity. We hypothesized that greater family dysfunction would, indeed, be associated with poorer psychosocial outcomes among palliative care patients and their family members. Methods Screened families were classified according to their functioning on the Family Relationships Index (FRI) and consented families completed baseline assessments. Mixed-effects modeling with post hoc tests compared individuals' baseline psychosocial outcomes (psychological distress, social functioning, and family functioning on a different measure) according to the classification of their family on the FRI. Covariates were included in all models as appropriate. Results For those who completed baseline measures, 191 (30.0%) individuals were in low-communicating families, 313 (50.5%) in uninvolved families, and 116 (18.7%) in conflictual families. Family class was significantly associated (at ps ≤ 0.05) with increased psychological distress (Beck Depression Inventory and Brief Symptom Inventory) and poorer social adjustment (Social Adjustment Scale) for individual family members. The family assessment device supported the concurrent accuracy of the FRI. Conclusion As predicted, significantly greater levels of individual psychosocial morbidity were present in American families whose functioning as a group was poorer. Support was generated for a clinical approach that screens families to identify those at high risk. Overall, these baseline data point to the importance of a family-centered model of care. © 2017 American Academy of Hospice and Palliative Medicine
Keywords: controlled study; major clinical study; clinical trial; palliative care; medical decision making; classification; morbidity; palliative therapy; oncology; disease model; screening; psycho-oncology; brief symptom inventory; american; mental stress; grief; post hoc analysis; family functioning; psychological; social adaptation; social interaction; rct; beck depression inventory; family study; family assessment; family-centered care; human; male; female
Journal Title: Journal of Pain and Symptom Management
Volume: 54
Issue: 1
ISSN: 0885-3924
Publisher: Elsevier Inc.  
Date Published: 2017-07-01
Start Page: 126
End Page: 131
Language: English
DOI: 10.1016/j.jpainsymman.2017.03.016
PROVIDER: scopus
PUBMED: 28479412
DOI/URL:
Notes: Article -- Export Date: 2 August 2017 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Yuelin Li
    140 Li
  2. David W Kissane
    161 Kissane
  3. Talia I Zaider
    45 Zaider
  4. Tammy Ann Schuler
    27 Schuler
  5. Rebecca Rose Loeb
    13 Loeb