Why breast cancer patients avoid communicating disease‐related information to their dependent children: A qualitative study

Abstract

Aim and objectives: This qualitative study explores why breast cancer patients do not share disease-related information with their dependent children.Background: 'Open' communication between breast cancer patients and their children is beneficial to both. However, some still try to avoid discussing their diagnosis and related information with their children. Some worries lie in communicating with dependent children, but the underlying cause remains unclear.Design: Qualitative descriptive study.Methods: Semi-structured interview was used in this study. Twenty breast cancer patients with children (aged 8-18 years) were recruited at two urban tertiary hospitals in mainland China. Qualitative content analysis was conducted to analyse and identify themes and subthemes. This study followed the COREQ checklist for qualitative studies.Results: Three main themes were identified: (1) Uncertainty about the future: Their struggles with cancer remain a sensitive subject with their children. They described the uncertainty surrounding their disease prognosis and their children's response.They were also unsure whether, when and how to inform their children of their conditions; (2) Useless and risky for their children to know the truth: They considered it useless because their children can neither understand nor change the existing facts.They were concerned that it could affect their children's emotional state, character and academic performance; and (3) All for their children's sake: They were willing to take care of their affairs without troubling their dependent children as much as possible. Conclusion:Most mothers delayed communicating disease-related information to their dependent children. However, they often underestimated children's abilities and ignored their thoughts and wishes. Motherhood leads to avoidance and concealment in discussing health issues with their children.

Cancer parents’ experiences of parenting concerns about minor children: A meta-synthesis of qualitative studies

“… Meta-themes Category Results The impact of parents'disease on their children Worrying about the physical and mental health of children Cancer may be passed on to children ( Davey et al, 2012 ; Zhu et al, 2022 ; Huang et al, 2020 ); Separation anxiety in young children, lack of self-confidence and escapism in adolescents ( Chin et al, 2021 ; Lundquist et al, 2020 ; Steiner et al, 2020 ; Elmberger et al, 2005 ; Chin et al, 2021 ; Davey et al, 2012 ; Stiffler et al, 2008 ; Shands and Lewis, 2021 ); Physical changes in parents with cancer lead to fear, low self-esteem and self-doubt in children ( Check et al, 2017 ; Tamura et al, 2021 ; Zhu et al, 2022 ; Asbury et al, 2014 ; Chin et al, 2021 ). Worrying about the life and future of their children A parent's cancer diagnosis can rob a child of a happy childhood ( Kissil et al, 2014 ; Lundquist et al, 2020 ; Zhang et al, 2023 ; Campbell-Enns and Woodgate, 2013 ); Parents rush to teach their children life skills ( Loggers et al, 2019 ; Lundquist et al, 2020 ; Park et al, 2017 ); Children's excessive worry about their parents' illnesses leads to poor academic performance or even dropping out of school ( Zhu et al, 2022 ; Huang et al, 2020 ; Zhang et al, 2023 ; Wang et al, 2020 ; Lundquist et al, 2020 ); Decreased participation of children in recreational and social activities ( Kim et al, 2012 ; Park et al, 2017 ; Huang et al, 2020 ); Children may associate with the wrong crowd ( Lundquist et al, 2020 ; Huang et al, 2020 ); Children miss the opportunity to find a suitable partner bec...…”

Adolescents' needs for information and psychosocial support during their mother's breast cancer trajectory: A systematic review

“…We found that changed family roles due to a mother's breast cancer diagnosis impacted adolescents. Previous research found that mothers experience various challenges in interacting with adolescents about breast cancer due to feelings of guilt, uncertainty about their own life span and how to respond to adolescents' curiosity, and being a mother or patient, leading them to underestimate and ignore adolescents' thoughts and wishes 21,22,24 . Zahlis 67 and Mazaheri et al 22 .…”

“…Previous research found that mothers experience various challenges in interacting with adolescents about breast cancer due to feelings of guilt, uncertainty about their own life span and how to respond to adolescents' curiosity, and being a mother or patient, leading them to underestimate and ignore adolescents' thoughts and wishes. 21,22,24 Zahlis 67 and Mazaheri et al 22 reported that mothers who usually notice small changes in their children's behavior could fail to notice changes due to their shock at a breast cancer diagnosis. Tavares et al 68 report that mothers need support in communicating with their children and dealing with their children's responses and difficult questions related to breast cancer.…”

“…Many find themselves in a situation in which it is difficult to identify and share thoughts and emotions with peers, which usually is a normal part of an adolescent's developmental process of becoming more self‐reliant 7,14,16,18 . Access to reliable information is important for adolescents to cope with their mother's breast cancer, 4,7,19,20 but many parents experience difficulties communicating with their children about breast cancer 15,19,21–24 . The potential for high dissonance between the developmental needs of the adolescent, the fear of losing their mother, and the lack of information and a place to share thoughts and feelings can interrupt adolescent development 4,7,15,16,19,20,25–27 .…”

“…7,14,16,18 Access to reliable information is important for adolescents to cope with their mother's breast cancer, 4,7,19,20 but many parents experience difficulties communicating with their children about breast cancer. 15,19,[21][22][23][24] The potential for high dissonance between the developmental needs of the adolescent, the fear of losing their mother, and the lack of information and a place to share thoughts and feelings can interrupt adolescent development. 4,7,15,16,19,20,[25][26][27] However, just as adolescents are susceptible to negative influences, they are susceptible to positive influences, even in times of crisis.…”