Motherhood and Well-Being in Young Breast Cancer Survivors

Abstract

Practice pointsr 15 elements of well-being were identified in the literature and exploratory factor analysis revealed a four-factor structure of well-being in breast cancer survivors (BCS): recurrence worries, physical health, psychological adjustment and illness intrusiveness. r Analyses revealed that there was a stronger relationship between psychological adjustment and illness intrusiveness for young BCS with children. r Psychological distress (i.e., lack of psychological adjustment), illness intrusiveness and fear of recurrence co-occurred more frequently in young BCS with children than in BCS without children, thus potentially compromising their well-being. r Our findings indicate that young BCS with children are most in need of screening and interventions in these areas, and such initiatives should be incorporated in their medical care and visits.Aim: This exploratory study aimed to examine differences in well-being between young breast cancer survivors (BCS) with and without children. Materials & methods: Participants (n = 816) completed an online survey relating to quality of life, illness intrusiveness, fear of cancer recurrence, stress and social support. Results: Exploratory and confirmatory factor analyses revealed similar models of well-being between both groups, but with a stronger relationship between psychological adjustment and illness intrusiveness for BCS with children (r = -0.779, 95% CI: -0.711, -0.848 vs r = -0.525, 95% CI: -0.423, -0.627). Conclusion: Parenting compromises the overall well-being of young BCS with children and they would therefore benefit from interventions and social and oncological support programs, especially for those caring for minor children. In a recent population-based study of cancer survivors, Weaver et al. [1] examined the prevalence of parental cancer via the United States National Health Interview Survey (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007); they identified 13,385 adults with a history of cancer with one or more minor children under the age of 18. Only adults with minor children who were diagnosed with cancer less than 2 years before the survey were included in the study (n = 1769), but of that subset, approximately 85% of them were diagnosed under the age of 45 [1]. In the USA, the average age of breast cancer diagnosis is 61 years for women; but 11% of all new cases occur in women under the age of 45 [2]. Following these guidelines, we operationalized 'young breast cancer survivors' as individuals with a diagnosis of cancer under the age of 45 and who were currently considered cancer free [2]. A diagnosis of breast cancer at a young age can interfere with the demands of early adulthood and the short-and long-term effects of treatment can be especially problematic for this group [3]. Young breast cancer survivors with children (BCS with children) may, therefore, be a particularly vulnerable group because the stressors that accompany motherhood may compound the difficulties Breast Cancer Manag. (Epub ahead of print)

Psychological distress, role, and identity changes in mothers following a diagnosis of cancer: A systematic review

“…Nine quantitative and two mixed‐method studies were published between 1993 and 2018 from Canada (n = 3), USA (n = 5), Germany (n = 1), Israel (n = 1), and Sweden (n = 1) . The participants were predominantly middle‐class, well‐educated Caucasians.…”

“…The group comparisons varied, for example, comparing psychological distress in parents vs nonparents, parents with cancer vs without cancer, and women with children living at home vs without children living at home (which also included nonmothers) . Some studies involved the participants' partners and/or their children to further investigate possible mediating or moderating effects .…”

“…There was variability in the definition and measurement of psychological distress. Some quantitative studies assessed psychological distress using established measures; for depression and anxiety, Hospital Anxiety and Depression Scale (HADS) and Center for Epidemiological Studies–Depression (CES‐D); and for perceived stress or stress responses, Perceived Stress Scale (PSS), Brief Symptom Inventory (BSI), Impact of Event Scale (IES), and the Distress Thermometer. Some open‐ended questions or Likert‐type scales were used to assess participants' psychological well‐being, and the perceived severity and stress of cancer …”

“…Stinesen‐Kollberg and colleagues revealed that mothers who worried about their children were 2.26 times more likely to have poorer psychological well‐being than those who were not worried about their children, making it the most important factor associated with low psychological well‐being. Mothers were more likely to report higher illness intrusiveness (defined as the interference of disease and treatment with various life domains), fear of cancer recurrence, and perceived stress compared with nonmothers, particularly young mothers (45 y or younger) recently diagnosed with cancer . According to Wan and colleagues, the association between psychological distress, fear of cancer recurrence, and its associated worries about the negative physical, psychological, and social implications, as well as illness intrusiveness, persisted in young mothers who were cancer survivors.…”

On a journey for survival : everyday life during radiation therapy from the perspectives of women with breast cancer and their families

“…The strains and stressors the parents experience when the woman in the family is diagnosed with breast cancer are also shown in previous research (Inhestern & Bergelt, 2018;. According to Wan et al (2018), women diagnosed with breast cancer who have children, especially those with minor children, feel that being a mother is more important than anything else, an attitude that jeopardises their well-being and that warrants interventions and support programmes from health care professionals Families might manage their situation better, and maladjustment in the family members might be prevented, if they are offered help to enhance and activate their own resources and coping strategies (Inhestern & Bergelt, 2018). From the studies in this thesis it was seen that the difficulties of communicating emotions and fears gave rise to feelings of living in a divided world for both the women and their family members.…”