Betty J Kramer1, Amy Z Boelk2. 1. School of Social Work, University of Wisconsin-Madison, Madison, Wisconsin, USA. Electronic address: ejkramer@wisc.edu. 2. Department of Sociology and Social Work, University of Wisconsin-Stevens Point, Stevens Point, Wisconsin, USA.
Abstract
CONTEXT: Despite the palliative care mandate to view family as the unit of care, and the high prevalence and detrimental consequences of conflict at the end of life, little research has been conducted with hospice families to understand what contributes to family conflict. OBJECTIVES: Using a recently generated explanatory matrix of family conflict at the end of life, this study sought to identify the correlates and predictors of family conflict. METHODS: As part of a larger mixed methods cross-sectional study, a 100-item survey was administered to 161 hospice family caregivers enrolled in a Medicare/Medicaid certified non-profit hospice organization located in the Midwest U.S. RESULTS: Although overall levels of conflict were relatively low, 57% of hospice caregivers reported experiencing some family conflict at the end of life. Contextual variables associated with family conflict included a history of family conflict, female gender, younger caregiver age, presence of children in the home, and less advance care planning discussions. Significant main effects in the prediction of family conflict in the final hierarchical multiple regression model included prior family conflict, caregiver age, caregiver gender, advance care planning discussions, family "coming out of the woodwork," communication constraints, and family members asserting control. The model explained 59% of the variance in family conflict. CONCLUSION: Results support the multidimensional theoretical model of family conflict specifying the importance of the family context, key conditions that set the stage for conflict, and essential contributing factors. Implications for routine assessment and screening to identify families at risk and recommendations for future research are highlighted.
CONTEXT: Despite the palliative care mandate to view family as the unit of care, and the high prevalence and detrimental consequences of conflict at the end of life, little research has been conducted with hospice families to understand what contributes to family conflict. OBJECTIVES: Using a recently generated explanatory matrix of family conflict at the end of life, this study sought to identify the correlates and predictors of family conflict. METHODS: As part of a larger mixed methods cross-sectional study, a 100-item survey was administered to 161 hospice family caregivers enrolled in a Medicare/Medicaid certified non-profit hospice organization located in the Midwest U.S. RESULTS: Although overall levels of conflict were relatively low, 57% of hospice caregivers reported experiencing some family conflict at the end of life. Contextual variables associated with family conflict included a history of family conflict, female gender, younger caregiver age, presence of children in the home, and less advance care planning discussions. Significant main effects in the prediction of family conflict in the final hierarchical multiple regression model included prior family conflict, caregiver age, caregiver gender, advance care planning discussions, family "coming out of the woodwork," communication constraints, and family members asserting control. The model explained 59% of the variance in family conflict. CONCLUSION: Results support the multidimensional theoretical model of family conflict specifying the importance of the family context, key conditions that set the stage for conflict, and essential contributing factors. Implications for routine assessment and screening to identify families at risk and recommendations for future research are highlighted.
Authors: David L Albright; Karla Washington; Debra Parker-Oliver; Alexandria Lewis; Robin L Kruse; George Demiris Journal: J Pain Symptom Manage Date: 2015-11-03 Impact factor: 3.612
Authors: M Ten Koppel; H R W Pasman; J T van der Steen; H P J van Hout; M Kylänen; L Van den Block; T Smets; L Deliens; G Gambassi; K Froggatt; K Szczerbińska; B D Onwuteaka-Philipsen Journal: BMC Palliat Care Date: 2019-08-29 Impact factor: 3.234