• Lyndsey M Miller, Karen S Lyons, and Jill A Bennett.
• School of Nursing, Oregon Health and Science University, 3455 SW US Veterans Hospital Rd., SN-ORD, Portland, OR, 97239, USA, millerly@ohsu.edu.
• Support Care Cancer. 2015 Sep 1; 23 (9): 2755-62.

PurposeThe purpose of the study was to examine the roles of concealment and communication in incongruence in perceptions of the lung cancer patient's physical function and pain severity.MethodsLung cancer patients and their family members (N = 108 family care dyads) rated the patient's physical function and pain severity.ResultsMultilevel modeling revealed that family members, on average, rated patient physical function significantly worse than patients; incongruence did not significantly differ from 0, on average, for pain severity. However, there was significant variability across family care dyads in how much incongruence existed within dyads. Controlling for depressive symptoms, family member role overload, family member physical function, the patients' cognitive impairment, relationship type, and stage of lung cancer, the patients' level of concealment was significantly associated with incongruence for both physical function and pain severity. Additionally, the family members' perceptions of communication problems in the dyad were significantly associated with incongruence for pain severity. Models accounted for 23 and 30 % of the incongruence in physical function and pain severity, respectively.ConclusionsOpen communication and disclosure play important roles in the appraisal of symptoms within the lung cancer patient-family member dyad. These interpersonal factors may be promising targets for interventions to maximize patient and family member outcomes.

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