Family Communication When a Parent of Dependent Children is Diagnosed With Late-Stage Cancer: A Constructivist Grounded Theory Study.
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OBJECTIVE: The study aimed to explore how patients with late-stage cancer, their spouses and their dependent children communicate about parents' cancer from parents' perspectives, and to develop a theory of family communication within the context of late-stage cancer. METHODS: This qualitative study was conducted from a grounded theory perspective. Forty-nine participants, including patients with late-stage cancer (n = 27) and their spouses (n = 22), were interviewed between November 2024 and September 2025. Data analysis followed the framework of Charmaz's constructivist grounded theory, including initial coding, focused coding and theory coding. RESULTS: This study found that family communication in the context of late-stage cancer constituted a stage-based process of relational reconstitution. This process progressed from dyadic buffering through triadic transition to collective reconstitution, and was driven by strategic communication, including proactive engagement, avoidant regulation and receptive waiting across verbal and non-verbal modes. The communication topics families navigated were multifaceted, centering on illness and treatment management, daily living and care coordination, financial burden and resource allocation, reassurance and emotional support, existential concerns of death and the future, and the education and development for children. The family communication was influenced by individual, family, and societal factors. Ultimately, this process led to collective coping, transforming an individual crisis into a manageable collective experience. CONCLUSION: This study developed a grounded theory of family communication from parental perspectives within the context of late-stage cancer. The findings emphasized the importance of family-centered clinical support, including personalized communication guidance for patients, spouses and children. Further research integrating children's perspectives and exploring contextual variations is needed to further develop this theoretical model and inform supportive interventions.