Family communication and coping among racial-ethnic minority cancer patients: A systematic review

Healthcare Communication Experiences of Hispanic Caregivers of Childhood Cancer Survivors

BACKGROUND

Interpersonal communication is a crucial component of the cancer experience that can contribute to managing cancer care and improving cancer survivors' and caregivers' quality of life. Cultural and contextual factors may impact Hispanic childhood cancer survivor (CCS) and parent caregiver relationships and communication. This study sought to describe the healthcare communication experiences of Hispanic parents with CCS, families, and medical providers.

METHODS

We conducted 15 semi-structured interviews with Hispanic caregivers from a safety-net hospital in Los Angeles County. Interviews were conducted in English and Spanish, audio-recorded and professionally transcribed, and analyzed using a thematic approach.

RESULTS

Caregivers shared the importance and impact of medical communication when exploring the "first big talk" of the diagnosis, uncertainty about treatment, navigating multiple providers, therapeutic communication (i.e., providing emotional reassurance), and current and lingering effects of cancer. All caregivers shared "good communication" experiences, while others shared various barriers to communication, including a lack of understanding of the cancer diagnosis and caregiver experience, psychological challenges impacting communication, cultural and language differences, physical factors that limit communication, and young age of child impacting communication with caregivers.

CONCLUSIONS

Our findings suggest that a strong interpersonal communication skill set for clinicians can contribute to managing cancer care and improving caregivers' psychological adjustment.

Talking About Prescription Opioid Misuse: The Effect of Family Communication Patterns and Messages Advocating Direct and Indirect Communication

Families play an important role in addressing substance misuse and addiction. Extant literature suggests patterns of communication within families influence the ways in which they engage loved ones who may be misusing substances like prescription opioids. However, little is known regarding how strategic health messages about family communication influence individuals' intentions to engage in conversations about substance misuse. Applying a normative approach, we conducted a (2 × 2) between-participants experiment examining whether messages advocating indirect (versus direct) communication are more effective for individuals (n = 613) who describe their family as having a low (versus high) conversation orientation. Univariate analysis of variance tests show match effects for message attitudes and message elaboration. For intentions to talk with a loved one about the risks of OUD, there was only evidence of a matching effect between the message advocating indirect communication with low conversation audiences. Both message types were equally effective at influencing intentions for high conversation participants. These findings suggest message designers should consider the kinds of communication behaviors and actions advocated in appeals targeting family members. Messages that are inclusive of the conversation dynamics of particular audiences may have greater effect. In particular, for low conversation audiences, messages advocating an indirect approach may be more effective at motivating intentions to engage someone who is misusing opioids.

Avoidant Parent-Child Communication About COVID-19: A Longitudinal Investigation of Associations with Youth Adjustment Across the First 6 Months of the Pandemic

In the aftermath of discrete disasters, how families discuss the event has been linked with child well-being. There is less understanding, however, of how family communication affects adjustment to a protracted and ongoing public health crisis such as the COVID-19 pandemic. The present research leveraged a large longitudinal sample of families (N = 1884) across the United States and Canada to investigate factors that predicted family communication styles (active versus avoidant communication) about the COVID-19 pandemic and examined the longitudinal sequelae of mental health outcomes for youth associated with different family communication styles. Parents of youth between 5 to 17 years old completed surveys about their own mental health, their child's mental health, and family communication about the COVID-19 pandemic at two time points 6 months apart. Overall, findings indicated that poorer parental mental health was related to greater use of avoidant communication, and avoidant communication styles were associated with poorer youth mental health over time. Findings suggest potential perils of avoidant family communication about ongoing threats and can help identify families at risk of negative mental health outcomes.

The Role of Islamic Beliefs in Facilitating Acceptance of Cancer Diagnosis

Although survival rates for patients with cancer have increased, this disease continues to affect couples significantly. Religion and culture seem to be part of the therapeutic process for people with cancer. Despite the abundance of the Arab Muslim community in Western countries, there is a lack of documented data on Arab Muslim couples experiencing cancer. A simple exploratory qualitative study was conducted through semi-structured interviews on six married couples (n = 12) identifying with the Arab Muslim culture and being affected by cancer. An iterative data analysis was performed. Results were reported under the following themes: accepting illness through coping strategies provided by Muslim religious beliefs and practices, experiencing problems with the expression of needs and feelings within the couple, experiencing closeness within the family, and experiencing illness in the hospital setting as Muslims. Our results show that Islamic beliefs can facilitate acceptance of a cancer diagnosis. It is also noted that religion seems to unite spouses in supporting each other and maintaining hope in a difficult context. Communication issues may persist between a couple due to stressors related to cancer. The results of this study could raise awareness about the importance of exploring religious and spiritual beliefs when supporting couples affected by cancer.

Social Wellbeing in Cancer Survivorship: A Cross-Sectional Analysis of Self-Reported Relationship Closeness and Ambivalence from a Community Sample

Improvements in early screening and treatment have contributed to the growth of the number of cancer survivors. Understanding and mitigating the adverse psychosocial, functional, and economic outcomes they experience is critical. Social wellbeing refers to the quality of the relationship with partners/spouses, children, or significant others. Close relationships contribute to quality of life and self-management; however, limited literature exists about social wellbeing during survivorship. This study examined positive and negative self-reported changes in a community sample of 505 cancer survivors. Fourteen items assessed changes in communication, closeness with partner/children, stability of the relationship, and caregiving burden. An exploratory factor analysis was conducted using a robust weighted least square procedure. Differences by sociodemographic and clinical characteristics were investigated. Respondents were mostly male, non-Hispanic white, and ≥4 years since diagnosis. Two factors, labeled Relationship Closeness and Ambivalence, emerged from the analysis. Women, younger survivors, individuals from minority groups, and those with lower income experienced greater negative changes in social wellbeing. Variations by treatment status, time since diagnosis, and institution were also reported. This contribution identifies groups of cancer survivors experiencing affected social wellbeing. Results emphasize the need to develop interventions sustaining the quality of interpersonal relationships to promote long-term outcomes.