Perceptions of family functioning and cancer

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Abstract
Family function was assessed in 102 families (342 members) of palliative care patients and grouped into classes by a computer‐based taxonomic program. Five classes were defined through the dimensions of cohesiveness, conflict and expressiveness of the Family Environment Scale (FES). One third of families we namedsupportivefor their high cohesiveness; a further 21%resolved conflicteffectively; both of these classes contained low psychological morbidity. Two classes (15%) were clearly dysfunctional:hostilefamilies (6%) were distinguished by high conflict whilesullenfamilies (9%) displayed moderate conflict, poor cohesion and limited expressiveness. These two classes had significantly higher levels of psychological morbidity and poorer social functioning. The remaining class (31%) had intermediate levels of cohesion, expressiveness and conflict (termedordinary) yet more moderate psychosocial morbidity. Screening of families with the FES would facilitate a more family‐centred approach to treatment, with relatively early identification of families at‐risk; preventive interventions would also then be feasible.