• Tammy A Schuler, Talia I Zaider, Yuelin Li, Shira Hichenberg, Melissa Masterson, and David W Kissane.
• Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York, USA. Electronic address: schulert@mskcc.org.
• J Pain Symptom Manage. 2014 Aug 1; 48 (2): 281-8.

ContextPoor family functioning affects psychosocial adjustment and the occurrence of morbidity following bereavement in the context of a family's coping with advanced cancer. Family functioning typologies assist with targeted family-centered assessment and intervention to offset these complications in the palliative care setting.ObjectivesOur objective was to identify the number and nature of potential types in an American palliative care patient sample.MethodsData from patients with advanced cancer (N = 1809) screened for eligibility for a larger randomized clinical trial were used. Cluster analyses determined whether patients could be classified into clinically meaningful and coherent groups, based on similarities in their perceptions of family functioning across the cohesiveness, expressiveness, and conflict resolution subscales of the Family Relations Index.ResultsPatients' reports of perceived family functioning yielded a model containing five meaningful family types.ConclusionCohesiveness, expressiveness, and conflict resolution appear to be useful dimensions by which to classify patient perceptions of family functioning. "At risk" American families may include those we have called hostile, low-communicating, and less-involved. Such families may benefit from adjuvant family-centered psychosocial services, such as family therapy.Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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