Incongruent perceptions of pain and physical function among families living with lung cancer

The 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. Lung cancer patients and their family members (N = 108 family care dyads) rated the patient's physical function and pain severity. Multilevel 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. Open 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.