The Significance of Motherhood for Adolescents Whose Mothers Have Breast Cancer

Donna A. Clemmens

family, adolescent, breast cancer
ONF 2009, 36(5), 571-577. DOI: 10.1188/09.ONF.571-577

Purpose/Objectives: To describe adolescents' experiences of living with mothers with breast cancer.

Research Approach: Qualitative.

Setting: Northeastern United States.

Participants: 11 adolescents aged 13-19 years whose mothers were diagnosed with breast cancer within a year prior to the study.

Methodologic Approach: With Van Manen's phenomenologic interpretive paradigm, multiple levels of analysis of transcribed semistructured interviews yielded common themes and a unique account and understanding of adolescents' lives when their mothers have breast cancer.

Main Research Variables: Adolescent coping and maternal breast cancer.

Findings: Five distinct themes were identified: life changed, turning to self, learning to be with my mother, needing to normalize, and speaking openly—the importance of communication. Study findings uncovered the powerful role mothers held in the adolescents' lives.

Conclusions: The depth of the feelings and conflicts expressed by the adolescent participants, who appeared to be coping with their mothers' breast cancer, emphasizes the need to explore coping responses used in adolescent adjustment to maternal breast cancer. Given that all the adolescents reported some level of anxiety and conflict in their lives, further research should address factors that underlie their coping mechanisms.

Interpretation: Study findings and insights underscore the significance of the maternal-adolescent relationship. Healthcare professionals need to ask more directed questions and develop interviewing and counseling skills to support mothers through this difficult illness. Adolescent children require support and guidance in coping with their mothers' breast cancer journey.

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    Allen, J.P., McElhaney, K.B., Land, D.J., Kuperminc, G.P., Moore, C.W., O'Beirne-Kelly, H., et al. (2003). A secure base in adolescence: Markers of attachment security in the mother-adolescent relationship. Child Development, 74(1), 292-307.
    Armsden, G.C., & Lewis, F.M. (1993). The child's adaptation to parental medical illness: Theory and clinical implications. Patient Education and Counseling, 22(3), 153-165.
    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. Journal of Psychosomatic Research, 52(4), 209-214.
    Beck, C.T. (1993). Qualitative research: The evaluation of credibility, fittingness, and auditability. Western Journal of Nursing Research, 15(2), 263-266.
    Behar, L. (1999). Getting through it alone: A descriptive study of the experience of single mothers with breast cancer and adolescent children. (Doctoral dissertation, University of Washington, 2000). Dissertation Abstracts International, 60, 3135.
    Chalmers, K.I., Kristjanson, L.J., Woodgate, R., Taylor-Brown, J., Nelson, F., Ramserran, S., et al. (2000). Perceptions of the role of the school in providing information and support to adolescent children of women with breast cancer. Journal of Advanced Nursing, 31(6), 1430-1438.
    Cicchetti, D., & Toth, S.L. (1998). The development of depression in childhood and adolescents. American Psychologist, 53(2), 221-241.
    Compas, B.E., Worsham, N.L., Epping-Jordan, J.E., Grant, K.E., Mireault, G., Howell, D.C., et al. (1994). When mom or dad has cancer: Markers of psychological distress in cancer patients, spouses, and children. Health Psychology, 13(6), 507-515.
    Compas, B.E., Worsham, N.L., Ey, S., & Howell, D.C. (1996). When mom or dad has cancer: II. Coping, cognitive appraisals, and psychological distress in children of cancer patients. Health Psychology, 15(3), 167-175.
    Conway, P. (1995). Children's understanding and adaptation to maternal breast cancer. (Doctoral dissertation, Massachusetts School of Professional Psychology, 1995). Dissertation Abstracts International, 56, 3439.
    Davis Kirsch, S.E., Brandt, P.A., & Lewis, F.M. (2003). Making the most of the moment: When a child's mother has breast cancer. Cancer Nursing, 26(1), 47-54.
    Edwards, L., Watson, M., St. James-Roberts, I., Ashley, S., Tilney, C., Brougham, B., et al. (2008). Adolescent's stress responses and psychological functioning when a parent has early breast cancer. Psycho-Oncology, 17(10), 1039-1047.
    Elmberger, E., Bolund, C., & Lutzen, K. (2000). Transforming the exhausting to energizing process of being a good parent in the face of cancer. Health Care for Women International, 21(6), 485-499.
    Gates, M.F., & Lackey, N.R. (1998). Youngsters caring for adults with cancer. Image: Journal of Nursing Scholarship, 30(1), 11-15.
    Grabiak, B.R., Bender, C.M., & Puskar, K.R. (2007). The impact of parental cancer on the adolescent: An analysis of the literature. Psycho-Oncology, 16(2), 127-137.
    Harpham, W.S. (1997). When a parent has cancer: A guide to caring for your children. New York: Harper-Collins.
    Hilton, B.A., & Elfert, H. (1996). Children's experiences with mother's early breast cancer. Cancer Practice, 4(2), 96-104.
    Hoskins, C.N., & Haber, J. (2000). Adjusting to breast cancer. American Journal of Nursing, 100(4), 26-33.
    Issel, L.M., Ersek, M., & Lewis, F.M. (1990). How children cope with mother's breast cancer. Oncology Nursing Forum, 17(3, Suppl.), 5-12.
    Jemal, A., Siegel, R., Ward, E., Hao, Y., Xu, J., & Thun, M.J. (2009). Cancer statistics, 2009. CA: Cancer Journal for Clinicians, 59(4), 225-249.
    Kristjanson, L.J., Chalmers, K.I., & Woodgate, R. (2004). Information and support needs of adolescent children of women with breast cancer. Oncology Nursing Forum, 31(1), 111-119.
    Lewis, F.M. (1996). The impact of breast cancer on the family: Lessons learned from the children and adolescents. In L. Baider, C.L. Cooper, & A. Kaplan De-Nour (Eds.), Cancer in the family (pp. 271-287). New York: John Wiley and Sons, Ltd.
    Lewis, F.M. (1998). Family-level services in oncology nursing: Facts, fallacies, and realities revisited. Oncology Nursing Forum, 25(8), 1378-1388.
    Lewis, F.M., & Darby, E.L. (2003). Adolescent adjustment and maternal breast cancer: A test of the "faucet" hypothesis. Journal of Psychosocial Oncology, 21(4), 81-104.
    Lewis, F.M. (2004). Shifting perspectives: Family-focused oncology nursing research. Oncology Nursing Forum, 31(2), 288-291.
    Lewis, F.M., Ellison, E.S., & Woods, N.F. (1985). The impact of breast cancer on the family. Seminars in Oncology Nursing, 1(3), 206-213.
    Lewis, F.M., & Hammond, M.A. (1996). The father's, mother's, and adolescent's functioning with breast cancer. Family Relations, 45(4), 456-465.
    Lewis, F.M., Hammond, M.A., & Woods, N.F. (1993). The family's functioning with newly diagnosed breast cancer in the mother: The development of an explanatory model. Journal of Behavioral Medicine, 16(4), 351-370.
    Lichtman, R.R., Taylor, S.E., Wood, J.V., Bluming, A.Z., Dosik, G.M., & Leibowitz, R.L. (1984). Relations with children after breast cancer: The mother-daughter relationship at risk. Journal of Psychosocial Oncology, 2(3/4), 1-19.
    Mendell, D., & Turrini, P. (2003). The inner world of the mother. Madison, CT: Psychosocial Press.
    Nelson, E., Sloper, P., Charlton, A., & While, D. (1994). Children who have a parent with cancer: A pilot study. Journal of Cancer Education, 9(1), 30-36.
    Northouse, L.L., Templin, T., Mood, D., & Oberst, M. (1998). Couples' adjustment to breast cancer and benign breast disease: A longitudinal analysis. Psycho-Oncology, 7(1), 37-48.
    Pasacreta, J., McCorkle, R., & Margolis, G. (1990). Psychosocial aspects of breast cancer. In B. Fowble (Ed.), Breast cancer treatment (pp. 551-561). New York: Mosby.
    Quinn-Beers, J. (2001). Attachment needs of adolescent daughters of women with cancer. Journal of Psychosocial Oncology, 19(1), 35-48.
    Rauch, P.K., Muriel, A.C., & Cassem, N.H. (2002). Parents with cancer: Who's looking after the children? Journal of Clinical Oncology, 20(21), 4399-4402.
    Salter Ainsworth, M.D., Blehar, M.C., Waters, E., & Wall, S. (1978). Patterns of attachment: A psychological study of the strange situation. Hillsdale, NJ: Erlbaum.
    Shands, M.E., Lewis, F.M., & Zahlis, E. (2000). Mother and child interactions about the mother's breast cancer: An interview study. Oncology Nursing Forum, 27(1), 77-85.
    Van Manen, M. (1990). Researching the lived experience: Human science for an action sensitive pedagogy. London, Ontario: Althouse Press.
    Welch, A.S., Wadsworth, M.E., & Compas, B.E. (1996). Adjustment of children and adolescents to parental cancer: Patients' and children's perspectives. Cancer, 77(7), 1409-1418.
    Worsham, N.L., Compas, B.E., & Ey, S. (1997). Children's coping with parental illness. In S. Wolchik & I.N. Sandler (Eds.), Handbook of children's coping: Linking theory and intervention (pp. 195-213). New York: Plenum Press.
    Zahlis, E.H. (2001). The child's worries about the mother's breast cancer: Sources of distress in school-aged children. Oncology Nursing Forum, 28(6), 1019-1025.