Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Palliative Care Team, Department of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, Japan.
Psychooncology. 2018 Jan;27(1):302-308. doi: 10.1002/pon.4508. Epub 2017 Sep 6.
Family conflict has several adverse impacts on caregivers. Thus, there is significant value in determining the prevalence and predictors of family conflict, which can enable the health care provider to intervene if family conflict arises during end-of-life care. Accordingly, we aimed to explore the prevalence and predictors of conflict among the families of patients with advanced cancer who died in palliative care units.
This study was a nationwide multicenter questionnaire survey of bereaved family members of cancer patients who died in Japanese palliative care units participating in evaluation of the quality of end-of-life care.
We sent out 764 questionnaires, and 529 questionnaires (69.2%) were returned. As 70 family members refused to participate and we could not identify the answers in one questionnaire, we analyzed a total of 458 responses. The average Outcome-Family Conflict score was 13.5 ± 4.9 (maximum score: 39.5), and 42.2% of family members reported at least one family conflict during end-of-life care. Greater family conflict was significantly associated with younger family age, with family members asserting control over decision making for patient care and with communication constraints among family members, although absent family members "coming out of the woodwork" reduced family conflict.
Many families of patients with advanced cancer experienced conflict during end-of-life care. Family members asserting control over decision making and communication constraints among family members after diagnosis of cancer can predict the occurrence of family conflict. Absent family members "coming out of the woodwork" might reduce family conflict in particular cultures.
家庭冲突对护理人员有多种不良影响。因此，确定家庭冲突的发生率和预测因素具有重要意义，如果在临终关怀期间出现家庭冲突，医疗保健提供者可以进行干预。因此，我们旨在探讨在姑息治疗病房死亡的晚期癌症患者的家庭中发生冲突的发生率和预测因素。
这是一项针对参与评估临终关怀质量的日本姑息治疗病房中癌症患者死亡的丧亲家庭成员的全国性多中心问卷调查研究。
我们发出了 764 份问卷，其中 529 份（69.2%）被退回。由于 70 位家庭成员拒绝参与，并且我们无法识别一份问卷中的答案，因此我们共分析了 458 份答复。家庭冲突的平均结局评分是 13.5±4.9（最高分为 39.5），42.2%的家庭成员报告在临终关怀期间至少发生了一次家庭冲突。家庭冲突与家庭成员年龄较小、对患者护理决策的控制以及家庭成员之间的沟通限制显著相关，尽管缺席的家庭成员“突然出现”会减少家庭冲突。
许多晚期癌症患者的家庭在临终关怀期间经历了冲突。家庭成员在诊断癌症后对决策的控制和家庭成员之间的沟通限制可以预测家庭冲突的发生。在某些文化中，缺席的家庭成员“突然出现”可能会减少家庭冲突。
