Family distress in palliative medicine: A pilot study of the Family APGAR Scale

Abstract

The family is essential to patients with advanced cancer. Family and caregiver distress, however, can impair optimal care and support of the patient. A five-item questionnaire, the Family APGAR Scale, was evaluated to determine family functioning levels of selected patients. The APGAR Scale has five components for measuring family functioning: Adaptation, Partnership, Growth, Affection, and Resolve. Fifty consecutive patients admitted to a palliative medicine inpatient unit were reviewed for a pilot study. Eligibility requirements included admission to the unit for the first time, and the ability to speak English and give informed consent. Fifteen patients and 11 primary care-givers participated. Despite the small sample, some significant family functioning issues were identified. Completing the study later with a larger sample will provide information that will help the multidisciplinary team better meet the needs of both patient and family.

Keywords

palliative care family satisfaction Family APGAR Scale care-givers psychosocial issues

Get full access to this article

View all access options for this article.

References

Miller RD , Walsh D : Psychosocial aspects of palliative care in advanced cancer. J Pain Symptom Manag. 1991; 6: 24-29.

Walsh D : Palliative care: Management of the patient with advanced cancer. Semin Oncol. 1994; 21: 100-106.

Powazki RD , Walsh D : Acute care palliative medicine: Psychosocial assessment of patients and primary caregivers. Palliat Med. 1999; 13: 367-374.

Mayberg HS , Liotti M , Brannan SK , et al. : Reciprocal limbic-cortical function and negative mood: Converging PET findings in depression and normal sadness. Am J Psychiatry. 1999; 156(5): 675-682.

Miller RD , Krech R , Walsh D : The role of a palliative care service family conference in the management of the patient with advanced cancer. Palliat Med. 1991; 5: 34-39.

Larkby C : The influence of marital status on health. West Penn Fam Center Quarterly. 1995; 7: 1-3.

Kerr M : Cancer and the family emotional system. In Goldberg J (ed.), Psychotherapeutic Treatment of Cancer Patients. New York: Free Press, 1981.

Leavitt MB : Family recovery after vascular surgery. Heart & Lung. 1990; 19(5): 486-490.

Hilbert GA : Family satisfaction and affect of men and their wives after myocardial infarction. Heart & Lung. 1993; 22(3): 200-205.

10.

Smilkstein G , Ashworth C , Montano D : Validity and reliability of the Family APGAR as a test of family function. J Fam Prac. 1982; 15(2): 303-311.

11.

Thomas V , Olson, DH : Problem families and the Circumplex Model: Observational assessment using the Clinical Rating Scale (CRS). J Marit Fam Ther. 1993; 19(2): 159-175.

12.

Smilkstein G : The Family APGAR: A proposal for a family function Test and its use by physicians. J Fam Prac. 1978; 6(6): 1231-1239.

13.

Kissane DW , Bloch S , McKenzie DP : Family coping and bereavement outcome. Palliat Med. 1997; 11: 191-201.

14.

McClement SE , Woodgate RI : Research with families in palliative care: Conceptual and methodological challenges. Eur J Cancer Care. 1998; 7: 247-254.

15.

Powazki RD , Palcisco C , Richardson M , et al. : Psychosocial care in advanced cancer. Semin Oncol. 2000; 27(1): 101-108.

16.

Finlay IG , Jones NK : Unresolved grief in young offenders in prison. Br J of Gen Prac. 2000; 50: 569-570.

17.

Liossi C , Mystakidou K : New paradigm research in palliative care. Eur J Palliat Care. 1998; 5: 130-133.