[ad_1]
Theme 1 mothers are lost in chaos
Most interviewees expressed experiences of feeling trapped in chaos when they were newly diagnosed with breast cancer, providing various example. We divided this theme into three subthemes: (1) inability to handle the shock of cancer, (2) feelings of powerlessness about the uncertainty of their life span, and (3) confusion about how to respond to daughter’s curiosity.
Inability to handle the shock of cancer
Mothers expressed that when they received the diagnosis of breast cancer, their family began a new trajectory. They tend to describe that moment as a bombardment and blindsided, when received information about the diagnosis and the treatment options. One mother who had not previously been familiar with breast cancer indicated:
(P2) At that time, I didn’t know how serious my illness was, I felt unsure about how to approach the issue. I’m confused!
Other mothers in our study also indicated that they tended to prioritize dealing with devastating crises (such as diagnosis/treatment and marital crisis) under the shock of cancer and overlook the mother-daughter relationship. They disclosed that their adolescent daughters were acutely aware of abrupt changes in the family atmosphere, for which mothers felt unprepared.
(P14) Of course, for a while after my diagnosis I was depressed about breast cancer…I don’t know how clear I am about the results and don’t have the energy to think about my relationship with my daughter.
Feelings of powerlessness about the uncertainty of their life span
Participants in our study expressed that the diagnosis of breast cancer is typically a great shock to them, as they often associate cancer with death. Most mothers (N = 20) spoke about their likely limited life expectancy, and even if the newer treatments could extend their lives, they felt that it would never be enough time.
(P6) I’m confused about the future. I’m still adjusting myself. I don’t know how long I can stay with my daughter and how to face her. Maybe I still need time to tidy up myself.
When asked about inner activities when interacting with their daughters after diagnosis, mothers indicated that they always hoped to give their daughters life advice and prevent them from associating with the “wrong crowd”. However, breast cancer hinders mothers’ role because they cannot experience rich interactions with their daughters in such a limited time, as demonstrated in the following quote:
(P19) The thing I think that makes me most upset is her (my daughter). I could talk about me “I’m going to die one day.” But it’s her (my daughter) I think may need my help on her life path.
(P1) I just have this fear that … if something happens in the next couple years.
Confusion about how to respond to daughter’s curiosity
Mothers always describe themselves as the preferred source of sexual knowledge and discussion for adolescent daughters, they stated said that they were special to their daughters in some way. And they should protect her daughter from the effects of cancer not only cancer itself but also of mother’s deformed breast because of the special nature of breast cancer. This burden is reflected in the following quote:
(P2) I dare not let her see my breast because I had a mastectomy. I’m afraid it will cause psychological shadow to her (fear of deformed breast). I’m walking on eggshells!
Further, mothers tend to limit the discussion to safe topics in order not to influence daughters’ views on secondary sexual characteristics (e.g., breasts). Fourteen mothers mentioned that their daughters would consciously want to discuss breast issues with them, but they would choose to avoid out of uncertainty about breast cancer. As the seventeenth mother expresses:
(P2) I feel puzzled. Actually, I want to communicate with her (about breast cancer), but I don’t know how to do. My daughter is in puberty and secretly discusses with me that her breasts are changing…
Some mothers (N = 13) indicated that they hoped to communicate about their physical condition and treatment with their daughters, but they felt unsure about how to do so and how much information to share, making them feel confused. The practical and emotional challenges of communicating with daughter complicate their mother–daughter interactions; mothers were aware that they lacked evidence-based guidelines to manage and often were unsure how to proceed.
(P14) I think I should tell my daughter about my illness, but I don’t know how to tell her. I didn’t get any professional help in communicating with my daughter.
(P17) I hope to get guidance on how to communicate and make it easier for children to accept the facts. This requires children’s cooperation, and mainly depends on adults to guide.
Theme 2 mothers struggle to maintain balance
A breast cancer diagnosis can have a devastating impact on both mothers and daughters. Mothers with breast cancer express that once they surmount the initial chaos, they strive to strike a delicate balance in their interactions with their daughters. We divided this theme into two subthemes: (1) torn between protecting daughters and letting them be independent and (2) making a tough choice between being a mother or a patient.
Torn between protecting daughters and letting them be independent
Mothers indicated that breast cancer affects the way they interact with their daughters, and they need to strive to strike a balance between protecting daughters and letting them be independent. On the one hand, they are worried that their daughters will have a psychological burden when they knew of the diagnosis. On the other hand, they felt they could not hide the diagnosis and acknowledged that the truth could make their daughters more independent, as echoed in the following:
(P8) I was afraid that telling her my illness would make her have a psychological burden, so I didn’t tell her at first, but later I found that she was more worried. She guessed every day and was very sad, so I told her after her enrollment and school choice were determined.
(P20) I think it’s better to show your down sides instead of trying to be strong all the time. I’ll need my daughter’s help, and I can make it with the courage she gives me. But… she doesn’t know what cancer is.
Some mothers (N = 9) expressed that factual explanation could simultaneously help their daughters become more independent and elicit emotional support from them (i.e., a mutually beneficial interaction). Most participants (N = 18) stated that they would tell their daughters the news when they could not hide it any longer, or they would observe their daughters’ reactions and decide whether to disclose the diagnosis at some point. Participants paid especially careful attention to their daughters’ behavior and language, which could be challenging.
(P13) I didn’t let my daughter go to the hospital before the treatment plan was decided. I don’t want to cause psychological shadow to her. But my hair will fall off after chemotherapy. I can’t hide it. I had to tell my daughter about my condition.
(P20) Telling her my condition may make her lose happiness, which is not what I want to see. I did not want to say too much to “scare them off”, yet I wanted to give my daughters knowledge to make her independent. I’m looking for a chance to let her understand my condition.
Making a tough choice between being a mother or a patient
Participants in this study reported that activities such as volunteering at their daughters’ schools, going on field trips, and driving daughters to and from school were difficult for them. They expressed the importance of doing everything that they had previously done. Nevertheless, this often required some adjustments for mothers with breast cancer in daily life. As some mothers described, even if they suffer from cancer and the painful treatment thereof, they still insisted on doing housework and helping maintain their daughter’s daily lives when their physical strength allows for it. They hoped to minimize the impact on their daughters’ study and lives and reduce the burden on others.
(P8) My daughter still asked me to send her to school and help her carry heavy things like I did when I was not ill, but sometimes my body can’t bear it. I was thinking about whether to show my daughter my wound, which might hit her, but let her know a little about my condition, maybe I wouldn’t be so tired.
(P12) I think if I were a single person without kids, this would be easier for me to deal with because the most difficult part is dealing with the kids. I still insist on housework and taking care of the children’s daily life even if I am ill.
Mothers explored that they need a long rest to recover from their exhausted physical strength due to the impact of breast cancer. During their illness, they make efforts to adjust and balance their roles as mother and patient, helping their daughters recognize that they will not be able to engage in certain activities for some time. Of course, some mothers (N = 4) believe that being a mother or a patient isn’t a though choice, because the role of mother takes precedence over other roles in their view.
Theme 3 mothers are immersed in guilt
Our participants indicated that they had been immersed in guilt since their diagnosis. This guilt tends to occur for a long time and is distinct from the short phase of feeling trapped in chaos and struggling to maintain balance in the mother-daughter relationship. We divided this theme into three subthemes: (1) increasing daughters’ risk of cancer, (2) influencing daughters’ development, and (3) imposing burdens on daughters.
Increasing daughters’ risk of cancer
Mothers expressed feeling especially guilty when their daughters blamed them for having passed along the increased cancer risk. This resulted in dysfunctional mother-daughter interactions. Though mothers understood that their risk or disease was neither their fault and not within their control, they still felt responsible for their daughter’s disease risk. It’s a challenge for breast cancer-afflicted mothers to intellectually overcome such guilt and repair relationships with their daughters, as evidenced by the following quote:
(P16) I’m very worried that my daughter will get breast cancer. Because my breast cancer can cause my daughter to have a higher rate of disease than others. Sometimes, when I see my daughter, I feel guilty for her because I think her future trajectory will have some bad changes because of my breast cancer.
(P4) I’m very afraid that this disease will be passed on to my daughter. I’m guilty… it is difficult to overcome.
Influencing daughters’ development
Participants in our study expressed that the adverse reactions of postoperative and radiotherapy seriously affect their image, which lead to psychological problems such as low self-esteem and self-doubt among patients’ daughters sometimes. Further, the experience of losing their mother also would affect adolescent daughters’ emotions and personality. Mothers always take raising their daughters as their duty, while adolescent daughters are in an important stage of learning, they worry that their diseases will put pressure on their children and affect their learning. As breast cancer mothers in our interview has said, dealing with these interwoven emotions is a huge challenge:
(P6) I used to take her swimming, but I can’t to take her anymore. I afraid others looking at me with strange eyes. My illness may affect my daughter’s mental health and make her feel inferior. I don’t think I’m a good mother…
(P14) My daughter’s grades are always ahead in the class, but I haven’t helped her with her homework since I was ill. Her teacher found the mistake and criticized her and she was unhappy when she came home. I feel sad about it…
Imposing burdens on daughters
Mothers believe that breast cancer as a family genetic disease will affect their daughter’s marriageability, deterring potential partners because of the breast cancer genes that they carry. Some participants informed us that their adolescent daughters even remarked that she would never marry because they knew they would eventually have breast cancer, which places immense pressure on the mothers.
(P21) My daughter kind of holds me responsible both for her cancer and marriage. I’m very worried… my breast cancer is bad for my daughter to get married. Her partner may be estranged from her.
Additionally, the enormous financial burden to families is also an important reason why mothers with breast cancer feel guilty. Mothers expressed that their daughters who are at high risk for breast cancer must pay close attention to their diet and physical examination, which may impose additional burdens. When mothers were asked why they felt guilty, they stated their illness had reduced the quality of life of the entire family. This effects the mother-daughter relationship, as demonstrated in the following quotes:
(P10) The cost of physical examination in the coming decades is also a great expense. Moreover, my daughter is more limited than other girls of the same age in terms of diet, living habits and even mate selection, which is unfair to her…
(P12) Our savings must be used for treatment and bear the education and living expenses of our two children. Bur now, I spend most of my money on cancer treatment, there will be no way to guarantee the future quality of life of my children.
[ad_2]
Source link