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



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.


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


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.


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.


Breast cancer Communication Children Illness 



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.


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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

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