Family functioning and psychological distress among Japanese breast cancer patients and families

Abstract

The purpose of this study was to develop a typology of family functioning in the families of breast cancer patients. Seventy-four families (189 individuals: 74 patients, 54 spouses, 46 offspring, and 15 other relatives) completed self-report questionnaires. Perception of family functioning was assessed using the family relationship index (FRI) and its three dimensions (cohesiveness, expressiveness, and conflict) and was classified into groups by a cluster analytic approach. Psychological distress was assessed using the Zung self-rating depression scale (SDS) and the Zung self-rating anxiety scale (SAS). Cluster analysis yielded three groups of patients and their family members: one cluster with high cohesiveness, high expressiveness, and low conflict ("supportive" type: n=64); a second group with low cohesiveness, low expressiveness, and high conflict ("conflictive" type: n=65); and a third group with limited cohesiveness, limited expressiveness, and low conflict ("intermediate" type: n=60). Analysis of variance revealed that conflictive families manifested the highest level of depression and anxiety among these clusters. Typology of family functioning can identify psychologically at-risk families. A family-focused approach can help to reduce psychological distress, especially in conflictive families.