Evidence map›Paper›PMID 39725045›Full record

ArticleJournal of pain and symptom management2025

"You Want to Shield Your Kids": Patients' and Their Adult-Children's Serious Illness Conversations.

Anny Thr Fenton, Bernadette Blashill, Anna C Revette, Alexis Mann, Maija Reblin, Andrea C Enzinger, Katherine A Ornstein, Supriya Jain, Christopher R Manz, James A Tulsky and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of pain and symptom management, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Anny Thr FentonDana-Farber Cancer Institute (A.T.F., A.C.R., A.C.E., S.J., C.R.M., J.A.T., A.A.W.), Boston, Massachusetts, USA; Harvard Medical School (A.T.F., A.C.R., A.C.E., C.R.M., J.A.T., A.A.W.), Boston, Massachusetts, USA. Electronic address: annyt_fenton@dfci.harvard.edu.
Bernadette BlashillGraduate School of Arts & Sciences, Harvard University (B.B.), Cambridge, Massachusetts, USA.
Anna C RevetteDana-Farber Cancer Institute (A.T.F., A.C.R., A.C.E., S.J., C.R.M., J.A.T., A.A.W.), Boston, Massachusetts, USA; Harvard Medical School (A.T.F., A.C.R., A.C.E., C.R.M., J.A.T., A.A.W.), Boston, Massachusetts, USA.
Alexis MannNorthbound Research Consulting (A.M.), Bath, Maine, USA.
Maija ReblinUniversity of Vermont Cancer Center (M.R.), Burlington, Vermont, USA.
Andrea C EnzingerDana-Farber Cancer Institute (A.T.F., A.C.R., A.C.E., S.J., C.R.M., J.A.T., A.A.W.), Boston, Massachusetts, USA; Harvard Medical School (A.T.F., A.C.R., A.C.E., C.R.M., J.A.T., A.A.W.), Boston, Massachusetts, USA.
Katherine A OrnsteinSchool of Nursing at John Hopkins University (K.A.O.), Baltimore, Maryland, USA.
Supriya JainDana-Farber Cancer Institute (A.T.F., A.C.R., A.C.E., S.J., C.R.M., J.A.T., A.A.W.), Boston, Massachusetts, USA.
Christopher R ManzDana-Farber Cancer Institute (A.T.F., A.C.R., A.C.E., S.J., C.R.M., J.A.T., A.A.W.), Boston, Massachusetts, USA; Harvard Medical School (A.T.F., A.C.R., A.C.E., C.R.M., J.A.T., A.A.W.), Boston, Massachusetts, USA.
James A TulskyDana-Farber Cancer Institute (A.T.F., A.C.R., A.C.E., S.J., C.R.M., J.A.T., A.A.W.), Boston, Massachusetts, USA; Harvard Medical School (A.T.F., A.C.R., A.C.E., C.R.M., J.A.T., A.A.W.), Boston, Massachusetts, USA.
Alexi A WrightDana-Farber Cancer Institute (A.T.F., A.C.R., A.C.E., S.J., C.R.M., J.A.T., A.A.W.), Boston, Massachusetts, USA; Harvard Medical School (A.T.F., A.C.R., A.C.E., C.R.M., J.A.T., A.A.W.), Boston, Massachusetts, USA.

Funding

Training in Oncology Population Sciences (TOPS)T32CA092203 · NCI · DANA-FARBER CANCER INST · PI Nancy L Keating, JENNIFER W MACK · 2018 to 2026
$3.7M
NCI NIH HHS T32 CA092203
6 · The paper itself

Abstract

contextTimely and transparent serious illness conversations (SIC) between family caregivers and patients facilitate high-quality end-of-life care and patients' and family caregivers' mental wellbeing, but frequently do not occur, happen too late, or are incomplete. While social relations and roles shape communication, few studies explore their influence on patient-caregiver SICs.

objectivesInvestigate how the parent-child relation and roles shape SICs between cancer patients and their adult-child caregivers (ACC), the largest caregiver population.

methodsQualitative interviews were conducted with 47 participants: advanced cancer patients (n = 16), their ACCs (n = 23), and bereaved ACCs (n = 8). Interviews were transcribed and analyzed using a theoretical thematic approach.

resultsRespondents' experiences with SICs centered on three key themes: (1) the parent role could hinder SICs in an attempt to protect their ACC while expectations to prepare one's child promoted SICs; (2) adult-children's busy life phase (e.g., marriage, children, career) hampered their prognostic awareness and added emotional weight to parent-child SICs; and (3) the child role dictated expectations for SICs and amplified distress when ACCs felt they were expected to engage in SICs in ways concordant with another role (e.g., patient's spouse or nurse).

conclusionThe fundamental rebalancing of the parent-child relation and roles when an adult-child cares for their parent creates unique challenges for patients and their ACC to discuss and plan for end-of-life. To encourage timely, effective SICs, clinicians and caregiver services in and outside the clinic need awareness and guidance on how goals of care conversations must incorporate family caregivers' and patients' familial role expectations.

Indexed as

Adult ChildrenCaregiversCommunicationNeoplasmsParent-Child RelationsAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedQualitative ResearchTerminal CareCaregiversEnd-of-life careFamily issuesPrognosisSerious illness communication

Identifiers

PMID39725045
PMCPMC11993343

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.