Communication about maternal breast cancer with children in China

2017-02-24T01:43:40Z (GMT) by Huang, Xiaoyan
Introduction Breast cancer affects a large number of women across the world, including a significant proportion with dependent children. Previous studies indicated that both mothers with breast cancer and their children experienced various emotional concerns following the diagnosis. These mothers worried about how to appropriately communicate about their illness with their children. Until now, no studies concerning this topic have been done in mainland China. Chinese people are influenced by traditional Chinese culture; their understandings of cancer and death, as well as their mutual communication about maternal cancer in the family, may be distinct from those of their Western counterparts. Objective The purpose of this study was to explore how mothers in mainland China communicate with their children about non-terminal breast cancer, as well as to explore how Chinese children understand and cope with their mother’s illness. The ultimate purpose of this study was to develop recommendations to help Chinese mothers talk appropriately with their children about their diagnosis of, and treatment for, breast cancer. Method The research purpose was examined using qualitative design, choosing interpretive description as the methodology. Forty mothers with breast cancer in mainland China, and eight of their children, voluntarily participated in the study. Individual semi-structured interviews were used as the main data collection methods, accompanied by drawings and the application of ‘The Bears’ cards for interviews with children, according to their ages and personal needs. The interviews were transcribed and analysed following an ongoing process of free coding, descriptive coding, and interpretive coding, while drawings were analysed through interaction with the interviews. A thematic summary was finally generated to address the research questions. Results The findings of this study indicated that most Chinese mothers disclosed their diagnosis of breast cancer to their children because it was impossible to conceal the truth. They explained illness in a factual manner; however, rather than telling them directly, Chinese mothers tended to allow children to observe their physical changes and overhear conversations between adults, as mothers did not know how to communicate appropriately with their children about the illness. Most mothers emphasised to children that their illness could not be discussed with others. Chinese mothers rarely asked their children about their feelings; instead, they required their children to become more obedient, behave better and study harder after the mother’s diagnosis. Although children’s daily life was not dramatically affected, often due to care from their grandparents, the children did experience different forms of psychological distress and regression in their academic performance. Most mothers, however, were likely to underestimate their children’s distress as children tended to hide their emotions to protect their mother. Neither mothers nor children received any support from healthcare professionals to cope with the event of maternal breast cancer; they expressed a desire for resources to be developed. Conclusion Mothers and children may benefit from maintaining honest and open communication within the family, and from sharing their own feelings with each other. Further studies need to be undertaken to develop resources to help mothers and their children.