Chinese Children's Experience When the Mother Has Breast Cancer: Voices From Mothers and Children

The nutritional literacy of breast cancer patients receiving chemotherapy and its association with treatment self-regulation and perceived social support

PURPOSE

Chemotherapy can lead to malnutrition and post-menopausal recurrence among breast cancer (BC) patients, who need to achieve nutritional literacy (NL) to cope. The objective of this study was to explore the NL level in Chinese BC patients receiving chemotherapy and its predictors including both internal motivation and the external environment.

METHODS

A total of 326 BC female patients from three hospitals were enrolled. Participants completed the Nutrition Literacy Measurement Scale for Chinese Adult (NLMS-CA), Chinese version from the Treatment Self-Regulation Questionnaire (TSRQ-C), and the Perceived Social Support Scale (PSSS) to assess NL, treatment self-regulation, and social support. Stepwise multivariate linear regression was used to identify the main factors of NL.

RESULTS

The total NL score was 151.31 ± 16.85, the "knowledge understanding" dimension had the lowest score. In the final regression model, patients with higher scores for "autonomous motivation" and "introjected regulation" on the TSRQ-C and "family support" and "other support" on the PSSS, higher educational levels and average monthly household incomes and endocrine therapy had higher NL levels (adjusted R2 = 66.7%, p < 0.05).

CONCLUSIONS

The overall NL score among Chinese BC patients receiving chemotherapy was satisfactory, but the knowledge understanding score was low. Higher autonomous motivation, introjected regulation, family support and other support scores, higher educational and household income levels, and endocrine therapy were predictors of NL in female patients. Interventions should be designed according to the specific performances and predictors of NL in female patients.

Cancer-related symptoms among young and middle-aged women undergoing chemotherapy for breast cancer: Application of latent class analysis and network analysis

PURPOSE

To identify subgroups and symptom networks of cancer-related symptoms for women under 60 years who are undergoing chemotherapy for breast cancer.

METHODS

A cross-sectional survey in Mainland China was conducted between August 2020 and November 2021. Participants completed questionnaires that collected demographic and clinical characteristics and featured the PROMIS-57 and the PROMIS-Cognitive Function Short Form.

RESULTS

A total of 1033 participants were included in the analysis, and three-class model was identified: "severe symptom group" (17.6%; Class 1), "moderately severe anxiety, depression, and pain-interference group" (38.0%; Class 2), and "mild symptom group" (44.4%; Class 3). Patients who were in menopause (OR = 3.05, P < .001), undergoing a combination of medical treatments (OR = 2.39, P = .003), and who had experienced complications (OR = 1.86, P = .009) were more likely to belong to Class 1. However, having two or more children increased the likelihood of belonging to Class 2. Additionally, network analysis showed that severe fatigue level was the core symptom among the full sample. As for Class 1, feeling helpless and severe fatigue level were the core symptoms. Regarding Class 2, the impact of pain interfere on the ability to participate in social activities and feeling hopeless were found to be the targeted symptoms for intervention.

CONCLUSION

Menopause, receiving a combination of medical treatments, and experiencing complications characterize the group with the most symptom disturbance. Moreover, different interventions should be performed for core symptoms in patients with varied symptom disturbances.

"I know I didn't ask for it, but I've got it and I've let my kids down": A secondary data analysis of qualitative maternal perspectives of their and adolescent children's unmet needs through a cancer diagnosis

PURPOSE

This article is a secondary data analysis which explores maternal unmet needs and their perception of the 'unmet needs' of adolescent children when they experienced maternal cancer. The analysis is underpinned by the theoretical framework of the Offspring Cancer Needs Instrument OCNI, (Patterson et al., 2013).

METHOD

A secondary data analysis was carried out with ten maternal interviews analyzed using a deductive Thematic Analysis. This was to identify maternal unmet needs as well as their perceptions of their adolescent children's unmet needs and determine whether the OCNI framework was suitable to identify unmet needs of mothers and adolescent children in an Irish context.

RESULTS

The study found cancer is a challenging emotional burden for both mothers and their adolescent children. Emotions related to cancer recurrence were particularly difficult to deal with. Mothers struggle to identify the unmet needs of adolescent children and recognize that they lack the skills to approach the children, which adds to the burden of their illness burden and feelings of guilt.

CONCLUSIONS

The study highlights the need to provide safe spaces for patients and adolescent children to deal with their emotions, strengthen relationships and improve communication associated with maternal cancer as these have a significant impact in their lives and may lead to tension and conflict within families.

“I’m walking on eggshells”: challenges faced by mothers with breast cancer in interacting with adolescent daughters

Background

With breast cancer becoming the most diagnosed cancer in the world, the number of breast cancer-afflicted mothers with adolescent daughters is also rising. Further, adolescent daughters’ mothers serve as role models for in identity formation processes, especially concerning gender and sexuality. Nevertheless, breast cancer threats mother’s health, including such a key symbol of her womanhood—the breast—which may adversely affect the development of an adolescent daughter’s own sense of personal identity and womanhood. However, few researchers and practitioners have paid attention to mother-daughter interactions in the context of breast cancer. Therefore, this study aimed to uncover the nuances of the interactive challenges with adolescent daughters from breast cancer-afflicted mothers’ perspective.

Methods

We conducted a qualitative study following the sample saturation principle, collecting data through semi-structured interviews with 21 breast cancer patients who met the inclusion criteria. We utilized thematic analysis and partially integrated the Foucauldian discourse approach to analyze the data.

Results

Three major themes emerged from the data: (1) mothers are lost in chaos (inability to handle the shock of cancer, feelings of powerlessness about the uncertainty of their life span, and confusion about how to respond to daughter’s curiosity); (2) mothers struggle to maintain balance (torn between protecting daughters and letting them be independent, and making a tough choice between being a mother or a patient); and (3) mothers are immersed in guilt (increasing daughters’ risk of cancer, influencing daughters’ development, and imposing burdens on daughters).

Conclusions

Our research explored the interactive experience of breast cancer-afflicted mothers and adolescent daughters. The insights uncovered by this study will help mothers enhance interaction with their daughters and assist health practitioners in devising interventions.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12905-022-01872-1.

Mother-child dyad support needs to be expressed by mothers diagnosed with breast cancer

AIMS AND OBJECTIVES

To investigate the support needs identified by Taiwanese breast cancer diagnosed mothers for themselves and their 6-12-year-old children for implementation in a support group.

BACKGROUND

Mothers with dependent children are burdened with diverse child-centered concerns while battling breast cancer. A better understanding of the concomitant support needs of mothers and their children can yield tailored support for ill mothers and their children.

DESIGN

A qualitative descriptive study employing content analysis of collected data.

METHODS

Between February and June of 2020, semi-structured individual interviews were conducted with 20 mothers who had been diagnosed with breast cancer in the last 2 years. Qualitative content analysis was used. This study followed the COREQ guidelines.

RESULTS

Ill mothers favoured a hybrid format for support groups, consisting of mother-only, child-only, and mother-child group sessions. The content analysis yielded four themes for mother-only group sessions: (1) learning to reach out to children; (2) dealing with negative emotions; (3) how to say goodbye to children; and (4) resetting for the future. Three themes related to child-only group sessions emerged: (1) emotional and health education; (2) getting along with a sick mother; and (3) preparing for uncertainty. The core theme for mother-child group sessions was relationship enhancement.

CONCLUSION

The findings revealed that mother-reported support needs of ill mothers and their children included support for improving children's emotional well-being and mothers' emotional coping, preparing for uncertainty, and promoting intimacy in the mother-child relationship.

RELEVANCE TO CLINICAL PRACTICE

A relation-focused approach to psychosocial support group development that allows mother-child mutual influences on each other's coping to be addressed bilaterally is suggested.

PATIENT OR PUBLIC CONTRIBUTION

Mothers diagnosed with breast cancer were interviewed for data collection and invited to review and validate the synthesised data for enhancing the credibility of the study.

Parent-Child Relationships and Academic Performance of College Students: Chain-Mediating Roles of Gratitude and Psychological Capital

This study used the Social Cognitive Theory and Broaden-and-Build Theory to propose and validate a chain mediation model. In total, 417 Chinese college students were studied to explore the effects of parent-child relationships on their academic performance. In addition, we investigated the chain-mediating roles of gratitude and psychological capital. The results showed that (1) the parent-child relationship significantly and positively affected the academic performance of college students; (2) gratitude partially mediated the parent-child relationship and the academic performance of college students; (3) psychological capital partially mediated the parent-child relationship and the academic performance of college students; and (4) gratitude and psychological capital exerted a chain-mediating effect between parent-child relationships and the academic performance of college students. Based on the results of the study, we conclude that the parent-child relationship not only directly affects the academic performance of college students but also indirectly affects it through the chain mediation of gratitude and psychological capital. Moreover, we proposed reasonable suggestions on how colleges and universities can guide students to deal with parent-child relationships, strengthen gratitude education, and improve psychological capital.

Children's experiences of living with maternal breast cancer: A qualitative study

AIMS

To investigate the experiences of Taiwanese school-aged children coping with maternal breast cancer.

DESIGN

A qualitative interview study.

METHODS

A cohort of 10 boys and 12 girls aged 6 to 13 years (mean age, 9.86 years) whose mothers were diagnosed with breast cancer in the last 2 years were recruited from patient networks in Taiwan. Data were collected from February to June 2019 via semi-structured individual interviews. Their responses were subjected to content analysis.

RESULTS

Content analysis yielded six themes: (1) reluctance to share feelings with others; (2) recognizing changes in the tone of family life; (3) casting the cause of breast cancer onto oneself; (4) engaging in active coping; (5) maturing and gaining life lessons; and (6) family communication matters.

CONCLUSION

The findings shed light on how family processes and cultural beliefs shape children's experiences. School-aged children came to terms with the significance of maternal breast cancer from a broad context of family experiences over time, and thus gained insights into their self-expectations and future aspirations.

IMPACT

Healthcare professionals can help school-aged children develop a rational view of breast cancer pathogenesis. In addition, we suggest nursing interventions to support a family-oriented approach to coping. Such interventions should address changes in family processes to improve coping abilities of children and the entire family.