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

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.

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References

  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):479–482

    Article  CAS  PubMed  Google Scholar 

  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):209–214

    Article  PubMed  Google Scholar 

  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):118–133

    Article  CAS  PubMed  Google Scholar 

  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 309:448

    CAS  PubMed  Google Scholar 

  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):998–1003

    Article  PubMed  Google Scholar 

  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):49–55

    Article  CAS  PubMed  Google Scholar 

  7. Kroll L, Barnes J, Jones A, Stein A (1998) Cancer in parents: telling children. BMJ 316(7135):880

    CAS  PubMed  Google Scholar 

  8. Lauver DR, Henriques JB, Settersten L, Bumann MC (2003) Psychosocial variables, external barriers, and stage of mammography adoption. Health Psychol 22:649–653

    Article  PubMed  Google Scholar 

  9. Light RJ (1971) Measures of response agreement for qualitative data: some generalizations and alternatives. Psychol Bull 76:365–377

    Article  Google Scholar 

  10. Maguire P (1994) ABC of breast diseases—psychological aspects. BMJ 309:1649–1652

    CAS  PubMed  Google Scholar 

  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 21:3–15

    Article  PubMed  Google Scholar 

  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):668–675

    Article  PubMed  Google Scholar 

  13. Nelson E, Sloper P, Charlton A, While D (1994) Children who have a parent with cancer: a pilot study. J Cancer Educ 9:30–36

    Article  CAS  PubMed  Google Scholar 

  14. Prochaska JO, DiClemente CC (1983) Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol 51:390–395

    Article  CAS  PubMed  Google Scholar 

  15. Prochaska JO, DiClemente CC (1984) Self change processes, self efficacy and decisional balance across five stages of smoking cessation. Prog Clin Biol Res 156:131–140

    CAS  PubMed  Google Scholar 

  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 589

  17. Rosenheim E, Reicher R (1985) Informing children about a parent’s terminal illness. J Child Psychol Psychiatry 26:995–998

    Article  CAS  PubMed  Google Scholar 

  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):77–85

    CAS  PubMed  Google Scholar 

  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, Tokyo

  20. Stinson CH, Milbranch C, Reidbord SP (1994) Thematic segmentation of psychotherapy transcripts for convergent analyses. Psychotherapy 31:36–48

    Google Scholar 

  21. Wolf AW, Lozoff B (1989) Object attachment, thumbsucking, and the passage to sleep. J Am Acad Child Adolesc Psych 28:287–292

    Article  CAS  Google Scholar 

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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.

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Correspondence to Saran Yoshida.

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Yoshida, S., Otani, H., Hirai, K. et al. A qualitative study of decision-making by breast cancer patients about telling their children about their illness. Support Care Cancer 18, 439–447 (2010). https://doi.org/10.1007/s00520-009-0682-7

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  • DOI: https://doi.org/10.1007/s00520-009-0682-7

Keywords

  • Breast cancer
  • Communication
  • Children
  • Illness