Caregivers of terminal cancer patients experience substantial communication difficulties with their loved ones about their illness. Existing communication scales focus on communication as perceived by the patient and do not include items that refer to his close death. The current study describes the development and initial validation of an instrument aimed at measuring caregivers' communication with patients about their illness and death. Two hundred thirty-six bereaved primary caregivers of cancer patients were recruited over a period of 18 months. The psychometric properties of the scale were explored by confirmatory factor analysis. Results provided support for a one factor solution. The discriminant and convergent validity of the responses to the scale were also supported. Future studies should further establish the validity of the scale with larger sample sizes and different populations of caregivers of patients with other terminal diseases.
Get full access to this article
View all access options for this article.
References
1.
ArbuckleJ. L. (2005). Amos 6.0 user's guide. Chicago, IL: SPSS.
2.
BabbieE., & BenaquistoL. (2002). Fundamentals of social research (Canadian Ed). Scarborough, ON: Thompson/Nelson.
3.
BachnerY. G.CarmelS., & SingerY. (2005). Dying at home: The perspective of the Israeli caregiving family. Gerontology, 32, 107–122 (in Hebrew).
4.
BachnerY. G.O'RourkeN., & CarmelS. (2007). Psychometric properties of a modified version of the Caregiver Reaction Assessment Scale measuring caregiving and post-caregiving reactions of caregivers of cancer patients. Journal of Palliative Care, 23, 80–86.
5.
BeckA. T., & SteerR. A. (1984). Internal consistencies of the original and revised Beck depression inventory. Journal of Clinical Psychology, 40, 602–606.
6.
BollenK. A. (1989). Structural equations with latent variables. New York: Wiley.
7.
CordovaM. J.CunninghamL. L. C.CarlsonC. R., & AndrykowskiM. A. (2001). Social constrains, cognitive processing, and adjustment to breast cancer. Journal of Consulting and Clinical Psychology, 69, 706–711.
8.
EdwardsH., & FosterE. (1999). Avoidance of issues in family caregiving. Contemporary Nursing, 8, 5–13.
9.
FigueiredoM. I.FriesE., & IngramK. M. (2004). The role of disclosure patterns and unsupportive social interactions in the well-being of breast cancer patients. Psychooncology, 13, 96–105.
10.
FloydF. J., & WidamanK. F. (1985). Factor analysis in the development and refinement of clinical assessment instruments. Psychological Assessment, 7, 286–299.
11.
FriedT. R.BradleyE. H.O'LearyJ. R., & ByersA. L. (2005). Unmet desire for caregiver-patient communication and increased caregiver burden. Journal of the American Geriatrics Society, 53, 59–65.
12.
GotcherJ. M. (1993). The effects of family communication on psychosocial adjustment of cancer patients. Journal of Applied Communication Research, 21, 176–188.
13.
HigginsonI. G., & ConstantiniM. (2002). Communication in end-of-life cancer care comparison of team assessments in three European countries. Journal of Clinical Oncology, 20, 3674–3682.
14.
HindsC. (1992). Suffering: A relatively unexplored phenomenon among family caregivers of non-institutionalized patients with cancer. Journal of Advanced Nursing, 17, 918–925.
15.
HuL., & BentlerP. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling6, 1–55.
16.
KellerM.HenrichG.SellschoppA., & BeutelM. (1966). Between distress and support: Spouses of cancer patients. In BaiderL.CooperC. L., & de-NourA. K. (Eds.), Cancer and the family (pp. 187–223) Chichester, England: Wiley.
17.
KilpatrickM. G.KristjansonL. J.TatarynD. J., & FraserV. H. (1998). Information needs of husbands of women with breast cancer. Oncology Nursing Forum, 25, 1595–1601.
18.
KoocherG. P., & PollinI. S. (2001). Preventive psychosocial intervention in cancer treatment: Implications for managed care. In BaumA. & AndersenB. L. (Eds.), Psychosocial interventions with cancer (pp. 363–374). Washington DC: American Psychological Association.
19.
KornblithA. B.ReganM. M.KimY.GreerG.ParkerB.BennettS., & WinerE. (2006). Cancer related communication between female patients and male partners scale: A pilot study. Psychooncology, 15, 780–794.
20.
KrantM. J., & JohnstonL. (1977). Family members' perceptions of communication in late stage cancer. International Journal of Psychiatry in Medicine, 8, 203–216.
21.
LazarusR. S. (1991). Emotion and adaptation. New York/London: Oxford University Press.
22.
LazarusR. S., & FolkmanS. (1984). Appraisal and coping. New York: Springer.
23.
LeporeS. J., & HelgesonV. S. (1998). Social constrains, intrusive thoughts, and mental health after prostate cancer. Journal of Social and Clinical Psychology, 17, 89–106.
24.
ManneS.ShermanM.RossS.OstroffJ.HeymanR. E., & FoxK. (2004). Couples' support-related communication, psychological distress, and relationship satisfaction among women with early stage breast cancer. Journal of Consulting and Clinical Psychology, 72, 660–670.
25.
MarshH. W.HauK. T., & WenZ. L. (2004). In search of golden rules: Comment on hypothesis-testing approaches to setting cutoff values for fit indexes and dangers in overgeneralizing Hu and Bentler's (1999) findings. Structural Equation Modeling, 11, 320–341.
26.
MaslachC. (1978). The client role in staff burnout. Journal of Social Issues, 34, 111–124.
27.
McGrathP. (2004). Affirming the connection: Comparative findings on communication issues from hospice patients and hematology survivors. Death Studies, 28, 829–848.
28.
MestersI.Van-Den BorneH.McCormickL.PruynJ.BoerM., & ImbosT. (1997). Openness to discuss cancer in the nuclear family: Scale, development, and validation. Psychosomatic Medicine, 59, 269–279.
29.
NorthouseP. G., & NorthouseL. (1987). Communication and cancer: Issues confronting patients, health professionals, and family members. Journal of Psychosocial Oncology, 5, 17–46.
30.
OlssonU. H.FossT.TroyeS. V., & HowellR. D. (2000). The performance of ML, GLS, and WLS estimation in structural equation modelling under conditions of misspecification and nonnormality. Structural Equation Modeling, 7, 557–595.
31.
O'RourkeN.HaverkampB.RaeS.TuokkoH.HaydenS., & BeattieB. L. (1996). Response biases as a confound to expressed burden among spousal caregivers of suspected dementia patients. Psychology and Aging, 11, 377–380.
32.
PalgiP. (1970). The adaptability and vulnerability of family types in changing Israeli Society. In JarusA.MarcusJ.OrenJ., & RapaportC. (Eds.), Children and families in Israel. New York: Gordon & Breach.
33.
Peters-GoldenH. (1982). Breast cancer: Varied perceptions of social support in the illness experience. Social Science and Medicine, 16, 483–491.
34.
PistrangN., & BarkerC. (1992). Disclosure of concerns in breast cancer. Psychooncology, 1, 183–192.
35.
PistrangN., & BarkerC. (1995). The partner relationship in psychological response to breast cancer. Social Science and Medicine, 40, 789–797.
36.
PorterL. S.KeefeF. J.HurwitzH., & FaberM. (2005). Disclosure between patients with gastrointestinal cancer and their spouses. Psychooncology, 14, 1030–1042.
37.
ShererM.MadduxJ. E.MercadenteB.Prentice-DunnS.JacobsB., & RogersR. W. (1982). The Self-Efficacy Scale: Construction and validation. Psychological Reports, 51, 663–671.
38.
ShokeidM. (1971). The dual heritage. Manchester: Manchester University Press.
39.
SingerY.BachnerY. G.ShvartzmanP., & CarmelS. (2005). Home death—The caregivers experiences. Journal of Pain and Symptom Management, 30, 70–74.
40.
ThomasC.MorrisS. M., & HarmanJ. C. (2002). Companions through cancer: The care given by informal carers in cancer contexts. Social Science and Medicine, 54, 529–544.
41.
ToselandR. W.BlanchardC. G., & McCallionP. (1995). A problem solving intervention for caregivers of cancer patients. Social Science and Medicine, 40, 517–528.
42.
VessJ. D.MorelandJ. R.SchwebelA. L., & KnautE. (1988). Psychosocial needs of cancer patients: Learning from patients and their spouses. Journal of Psychosocial Oncology, 6, 31–51.
43.
ZhangA. Y., & SiminoffL. A. (2003). Silence and cancer: Why do families and patients fail to communicate?Health Communication, 15, 415–429.
