Date of Award

2002

Degree Type

Dissertation

First Advisor

Lisa Harlow

Abstract

This dissertation extends our knowledge of the relationships among complex communication variables involved in medical staff-family member communication in the context of adult cancer. It does this in three ways. First, communication variables are quantified using qualitative data from previous studies in the area of cancer, communication and the family to provide a more systematic means of studying these variables. Manuscript 1 examines the psychometric soundness of these instruments with results indicating a single factor structure for each instrument, preliminary evidence for construct and content validity and good to excellent internal consistency (.77, .91, .93., .97). Second, a model of medical staff-family communication is developed, integrating both theory and research in the area of family, cancer and communication. Hypothesized relationships among select variables are formulated and then tested using hierarchical multiple regression analyses. Findings provide strong support for the theoretical framework and hypotheses of the model. Specifically, significant relationships and noteworthy effect sizes among six of the seven variables were found. Results show that demographic factors (age, education, income) influence, to some degree, family member accessibility to and attitudes toward communicating with staff. These variables combined influence the degree to which family members' communication needs from staff are met (R2 = .54, F(4,66) = 19.39, p < 001). Family members' communication satisfaction with staff is, in turn, influenced by these preceding variables (R2 = .46, F(5,65) = 10.92, p < .001). Finally, demographics, accessibility, attitudinal inhibitions, communication needs met and communication satisfaction together influence family member perceived stress (R2 = .25, F(6,64) = 3.54, p = .004), but not anxiety as measured by the BAI (R2 = .08, F(6,64) = .91, p = .493). Third, a full, mediational and direct model of medical staff-family communication was tested using structural equation modeling (SEM). The results showed that the present data best fit the mediational model. Thus, accessibility to staff and attitudes toward communicating with staff were not directly associated with communication satisfaction and perceived stress, but, instead, were mediated by communication needs met (X2(5) = 9.462, AASR = .036, CFI = .95). This model accounted for 41% and 16% of the variance in communication satisfaction and perceived stress respectively.

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