PERCEPTIONS OF FAMILY FUNCTIONING AND 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.