Advertisement

Supportive Care in Cancer

, Volume 18, Issue 4, pp 439–447 | Cite as

A qualitative study of decision-making by breast cancer patients about telling their children about their illness

  • Saran Yoshida
  • Hiroyuki Otani
  • Kei Hirai
  • Akiko Ogata
  • Asuka Mera
  • Shiho Okada
  • Akira Oshima
Original Article

Abstract

Objective

Many breast cancer patients are troubled about telling their school-age children about their illness. However, little attention has been paid to the factors that encourage or discourage them from revealing the illness. This study explored decision-making by breast cancer patients about telling their children about their illness.

Methods

Participants were 30 breast cancer patients recruited from a regional cancer institution in Japan. Semi-structured interviews were conducted and content analysis was performed.

Results

Six preparatory stages of decision-making by Japanese breast cancer patients about telling their children about their illness were identified as follows: contemplation, preparation, action-hospitalization and surgery, action-adjuvant therapy, action-diagnosis, and action-prognosis. We also identified 11 categories of positive aspects and ten categories of negative aspects about revealing their illness to children. The categories of negative aspects with higher frequency were similar to those found by previous research, but categories of positive aspects were unique. The rate of reference to negative aspects in total reduces gradually as the preparatory stage advances, and in action-diagnosis and action-prognosis stages the balance between positive and negative aspects becomes about half and half.

Conclusions

Patients, especially in action-hospitalization and surgery, can be expected to tell their children about their illness although they find negative aspects much more compelling than positive aspects and experience great distress. These patients have special needs for support from others.

Keywords

Breast cancer Communication Children Illness 

Notes

Acknowledgements

This study was supported by a Grant-in-aid for Hospice and Palliative Care from Sasakawa Health Science Foundation and partly by a Grant-in-aid for Scientific Research (no. 19730430). We would like to thank Shinji Ohno, Yoshiaaki Nakamura, Hiroshi Yamaguchi, Yoko Uchida, Mayumi Ishida, Yoko Hata, and Akemi Kataoka for assistance.

References

  1. 1.
    Barnes J, Kroll L, Burke O, Lee J, Jones A, Stein A (2000) Qualitative interview study of communication between parents and children about maternal breast cancer. BMJ 321(7259):479–482CrossRefPubMedGoogle Scholar
  2. 2.
    Barnes J, Kroll L, Lee J, Burke O, Jones A, Stein A (2002) Factors predicting communication about the diagnosis of maternal breast cancer to children. J Psychosom Res 52(4):209–214CrossRefPubMedGoogle Scholar
  3. 3.
    Bloom JR, Kessler L (1994) Emotional support following cancer: a test of the stigma and social activity hypotheses. J Health Soc Behav 35(2):118–133CrossRefPubMedGoogle Scholar
  4. 4.
    Fallowfield LJ, Hall A, Maguire P, Baum M, A’Hern RP (1994) Psychological effects of being offered choice of surgery for breast cancer. BMJ 309:448PubMedGoogle Scholar
  5. 5.
    Forrest G, Plumb C, Ziebland S, Stein A (2006) Breast cancer in the family-children’s perceptions of their mother’s cancer and its initial treatment: qualitative study. BMJ 332(7548):998–1003CrossRefPubMedGoogle Scholar
  6. 6.
    Hirai K, Komura K, Tokoro A, Kuromaru T, Ohshima A, Ito T, Sumiyoshi Y, Hyodo I (2008) Psychological and behavioral mechanisms influencing the use of complementary and alternative medicine (CAM) in cancer patients. Ann Oncol 19(1):49–55CrossRefPubMedGoogle Scholar
  7. 7.
    Kroll L, Barnes J, Jones A, Stein A (1998) Cancer in parents: telling children. BMJ 316(7135):880PubMedGoogle Scholar
  8. 8.
    Lauver DR, Henriques JB, Settersten L, Bumann MC (2003) Psychosocial variables, external barriers, and stage of mammography adoption. Health Psychol 22:649–653CrossRefPubMedGoogle Scholar
  9. 9.
    Light RJ (1971) Measures of response agreement for qualitative data: some generalizations and alternatives. Psychol Bull 76:365–377CrossRefGoogle Scholar
  10. 10.
    Maguire P (1994) ABC of breast diseases—psychological aspects. BMJ 309:1649–1652PubMedGoogle Scholar
  11. 11.
    Manne S, Markowitz A, Winawer S, Meropol NJ, Haller D, Rakowski W, Babb J, Jandorf L (2002) Correlates of colorectal cancer screening compliance and stage of adoption among siblings of individuals with early onset colorectal cancer. Health Psychol 21:3–15CrossRefPubMedGoogle Scholar
  12. 12.
    Marugame T, Kamo K, Katanoda K, Ajiki W, Sobue T (2006) Cancer incidence and incidence rates in Japan in 2000: estimates based on data from 11 population-based cancer registries. Jpn J Clin Oncol 36(10):668–675CrossRefPubMedGoogle Scholar
  13. 13.
    Nelson E, Sloper P, Charlton A, While D (1994) Children who have a parent with cancer: a pilot study. J Cancer Educ 9:30–36CrossRefPubMedGoogle Scholar
  14. 14.
    Prochaska JO, DiClemente CC (1983) Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol 51:390–395CrossRefPubMedGoogle Scholar
  15. 15.
    Prochaska JO, DiClemente CC (1984) Self change processes, self efficacy and decisional balance across five stages of smoking cessation. Prog Clin Biol Res 156:131–140PubMedGoogle Scholar
  16. 16.
    Rait D, Lederberg M (1990) The family of the cancer patient. In: Holland JC, Rowland JH (eds) Handbook of psychooncology. Oxford University Press, New York, p 589Google Scholar
  17. 17.
    Rosenheim E, Reicher R (1985) Informing children about a parent’s terminal illness. J Child Psychol Psychiatry 26:995–998CrossRefPubMedGoogle Scholar
  18. 18.
    Shands ME, Lewis FM, Zahlis EH (2000) Mother and child interactions about the mother’s breast cancer: an interview study. Oncol Nurs Forum 27(1):77–85PubMedGoogle Scholar
  19. 19.
    Statistics and Information Dept., Minister’s Secretariat, Ministry of Health, Labor and Welfare: Vital Statistics of Japan (2000) Health and Welfare Statistics Association Press, TokyoGoogle Scholar
  20. 20.
    Stinson CH, Milbranch C, Reidbord SP (1994) Thematic segmentation of psychotherapy transcripts for convergent analyses. Psychotherapy 31:36–48Google Scholar
  21. 21.
    Wolf AW, Lozoff B (1989) Object attachment, thumbsucking, and the passage to sleep. J Am Acad Child Adolesc Psych 28:287–292CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Saran Yoshida
    • 1
  • Hiroyuki Otani
    • 2
  • Kei Hirai
    • 3
  • Akiko Ogata
    • 4
  • Asuka Mera
    • 5
  • Shiho Okada
    • 5
  • Akira Oshima
    • 6
  1. 1.Graduate School of EducationUniversity of TokyoTokyoJapan
  2. 2.Department of HospiceSeirei Mikatahara General HospitalShizuokaJapan
  3. 3.Center for the Study of Communication Design, Graduate School of Human Sciences & Graduate School of MedicineOsaka UniversityOsakaJapan
  4. 4.Faculty of Education and CultureUniversity of MiyazakiMiyazakiJapan
  5. 5.Graduate School of Human SciencesOsaka UniversityTokyoJapan
  6. 6.Department of Psycho-OncologyNational Kyushu Cancer CenterFukuokaJapan

Personalised recommendations