Caregiving needs of patients with terminal cancer and their families: a field study of family meetings

Family meetings are critical communication and decision-making junctures for patients with terminal cancer and their families during the palliative care process. However, within the Chinese cultural context, the multifaceted functions of family meetings, their dynamic negotiation processes, and their role in meeting multilevel needs remain underexplored. This study guided by family systems theory, aimed to investigate how the care needs of terminal cancer patients and their families are expressed, negotiated, and constructed within the specific context of family meetings. Employing a qualitative field research methodology characterized by descriptive, focused, and selective observation, this study was conducted at a leading tumor center in Central China. Purposive sampling was used to recruit 14 families affected by terminal cancer, consisting of 14 patients with terminal cancer and 34 family members. Data were systematically recorded during family meetings, with a focus on the expression of needs. Content analysis was applied to observational records, interview transcripts, and experiential notes to perform an in-depth analysis. This study’s content analysis ultimately yielded 4 core themes and 13 subthemes, illuminating the process through which care needs are expressed, negotiated, and constructed within family meetings: (1) The comfort needs of the physical and mental aspects are centered on reducing chronic anxiety; (2) The balancing needs of individuals and families with the goal of enhancing self-differentiation; (3) The family and medical care aggregation needs based on the strategy of stabilizing the triangular relationship; (4) The continuation of life’s values needs of meeting a closed-loop family system. Within the Chinese cultural context, family meetings for patients with terminal cancer are a multidimensional and dynamically evolving cultural practice. The requirements of patients with terminal cancer and their families emerge from worries regarding physiological suffering, advance to relieving chronic anxiety, promote self-differentiation, and strengthen the familial triangle, resulting in the symbolic continuation of life’s value. These findings provide significant guidance for healthcare professionals in developing culturally adaptive and humanistic intervention strategies.