Scoping Review of Communication Assessment Tools for Family Caregivers: Current Status, Clinical Translation Gaps, and Future Directions.

Purpose: Family caregivers (FCs) serve as essential intermediaries in illness-related communication; however, the instruments used to assess FC communication vary widely in terms of conceptual scope and methodological quality. This scoping review aimed to systematically identify the available instruments for assessing FC communication, map their conceptual domains and key psychometric characteristics, and delineate research gaps and future directions. Methods: This review was guided by the Arksey and O'Malley methodological framework and is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Six Chinese and English databases (China National Knowledge Infrastructure, Wanfang, PubMed, Embase, Web of Science Core Collection, and ProQuest) were searched from their inception to May 5, 2025, supplemented by citation tracking. Studies addressing the development, validation, cross-cultural adaptation, or application of FC communication instruments were eligible. Two reviewers independently screened the records and extracted the data using a structured form and synthesized the findings narratively using descriptive statistics. Results: In total, 21 studies published between 1997 and 2024 were analyzed, yielding nine instruments, most of which were developed after 2000 and were concentrated in the United States among patients with cancer. Conceptually, the instruments were mapped onto four domains: communication processes, attitudes, communication with healthcare professionals, and illness- and death-related communication. Most scales demonstrated satisfactory internal consistency (Cronbach's α ≥ 0.8), with the notable exception of the Cancer Communication Assessment Tool for Patients and Families and its non-Chinese adaptations (α = 0.43-0.68), and reported acceptable structural validity. However, content and criterion validity have rarely been examined. External validation beyond the original development teams is scarce, and cross-cultural adaptations frequently require substantial restructuring. Conclusion: Evidence on FC communication assessment is expanding but remains conceptually fragmented and methodologically uneven. Advancing the field requires a staged agenda: first, establishing a consensus-based conceptual taxonomy to clarify what each instrument measures; second, prioritizing rigorous validation and cross-cultural refinement of promising instruments over isolated new developments; and third, situating assessment within the organizational context of care, thereby strengthening the foundation for integrating communication assessment into clinical practice and intervention development.