Impact of family‐oriented rehabilitation and prevention: an inpatient program for mothers with breast cancer and their children

John, Katja; Becker, Katja; Mattejat, Fritz

doi:10.1002/pon.3329

Cited by 41 publications

(73 citation statements)

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“…7 There are several reasons for considering expanding breast cancer prevention efforts within families and across the female life span to childhood and adolescence. There is increasing evidence to suggest that childhood is a key period of carcinogenic vulnerability and that childhood exposures are associated with breast cancer risk and as a result cancer prevention efforts must start decades earlier.…”

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confidence: 99%

Family-based Breast Cancer Prevention Efforts in Adolescence

Terry

Bradbury

2016

Pediatrics

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Drs Terry and Bradbury developed the ideas and jointly wrote this commentary; and all authors approved the fi nal manuscript as submitted. POTENTIAL CONFLICT OF INTEREST:The authors have indicated they have no potential confl icts of interest to disclose.Family history is 1 of the strongest predictors of most cancers. 1 Yet primary cancer prevention efforts are often not targeted toward individuals at greatest risk. This contrasts with a growing practice of targeting secondary prevention efforts and screening guidelines to those at greatest risk. The lack of targeted primary prevention behavioral interventions likely reflects the reality that all individuals are susceptible to cancer regardless of their family history and that most, if not all, individuals can substantially benefit from reducing cancer risk factors (eg, smoking, lack of physical activity, unhealthy diets, excessive weight gain) for optimal health and to lower chronic disease burden generally. We suspect, however, that another reason why cancer prevention efforts are not targeted toward those at highest risk is because of the lack of awareness that those at highest risk can benefit from cancer prevention interventions that target modifiable factors, and that their risk is not solely from genes. Using the example of breast cancer, we highlight the limited but growing evidence that even in women at highest risk, modifiable factors still contribute to cancer risk. We then discuss the benefits of considering family-based approaches to complement existing population approaches to cancer prevention.Growing evidence suggests that many of the modifiable risk factors that increase breast cancer also do so in those with a family history of breast cancer. For example, even in women at the highest risk of breast cancer due to mutations in BRCA1 and BRCA2 carriers, age of onset has been shown to be delayed for girls engaged in adolescent physical activity compared with more inactive girls, 2 and breast cancer risk has been associated with risk in carriers who smoked compared with those who do not. 3 Even within families that have strong family histories, sisters with breast cancer differ from their unaffected sisters in a number of biomarkers that are associated with environmental changes throughout life including markers of DNA repair phenotype, DNA methylation levels, and oxidative stress markers (as reviewed in Terry et al 1 ). The American Cancer Society (ACS) suggests that all women engage in weekly physical activity of 150 minutes of moderate physical activity, drink fewer than 7 alcoholic beverages per week, and maintain a BMI of <25. When we examined whether adherence to these ACS guidelines was also relevant to high risk women in a familybased cohort, we observed that adherence to ACS guidelines was associated with a 40% lower by guest on May 11, 2018 http://pediatrics.aappublications.org/ Downloaded from

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confidence: 99%

Family-based Breast Cancer Prevention Efforts in Adolescence

Terry

Bradbury

2016

Pediatrics

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Section: The Families' Need For Supportmentioning

confidence: 99%

“…However, the variability in study populations and intervention design makes it difficult to generalize findings from the studies (Inhestern et al, 2016). When evaluating family interventions in oncological care addressing the whole family, improvements were seen in quality of life, psychological health, and depressive symptoms in parents as well as children (John, Becker, & Mattejat, 2013;Thastum, Munch-Hansen, Wiell, & Romer, 2006). Further, families described how the counseling improved the communication between the family members, gave them a deeper understanding of one another's reactions and emotions, a normalization of their emotions, as well as a closer intimacy and unity within the family (Thastum et al, 2006).…”

Section: Literature Reviewmentioning

confidence: 99%

“…The families' experiences of a changed and stressful everyday life following a breast cancer diagnosis (Northouse et al, 2012) suggest that more empirical studies are needed in the context of families where a family member is diagnosed with breast cancer. This is further emphasised by the number of women and families afflicted by breast cancer and their unmet need of support John et al, 2013). Moreover, the positive impact previous research has shown in families participating in family health conversations (FamHC) in other contexts, for example, when a family member experienced chronic illness, cardiac and ischemic illness, depression or childhood cancer (Bell, 2015;Benzein et al, 2015;Östlund & Persson, 2014), points to the importance of empirical studies involving the whole family.…”

Section: Introductionmentioning

confidence: 99%

“…Although the findings also showed that the variability in study populations and intervention design makes generalising findings from studies difficult (ibid. ), family interventions in oncological care addressing the whole family have shown improvements in quality of life, psychological health and depressive symptoms in parents as well as children (John et al, 2013;Thastum et al, 2006).Family Health Conversations (FamHC) were developed in Sweden by Benzein and colleagues (2008; by culturally adapting the practice models of Family Systems Nursing , 2013. Family-focused care is grounded in the belief that health and illness in a family member affect the other family members both as individuals and as a family , and it has a systemic approach that focuses on the interactions and relationships within the family with the aim of preserving health and facilitate healing.…”

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

Holst-Hansson¹

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To everyone who has believed in me Vi människor är sociala varelser. Vi kommer till denna värld som ett resultat av andras handlingar. För vår överlevnad är vi ömsesidigt beroende av varandra. Vare sig vi vill eller inte finns det inte en enda stund i livet då vi inte drar nytta av sådant som andra har gjort eller gör. Det är därför knappast förvånande att det mesta av vår lycka uppstår i relationer med andra. Inte heller är det anmärkningsvärt om vår största glädje uppstår när vi motiveras av omsorg om andra. Men det är mera än så. Allt tyder på att altruistiska handlingar inte bara skapar lycka, utan att de också minskar vår upplevelse av lidande. Vårt beteende mot andra blir automatiskt positivt när vi handlar av omsorg mot dem. Det är för att vi inte har plats för några misstankar när hjärtat är fyllt av kärlek. Det är som en inre dörr öppnas och låter oss komma ut. ABSTRACTThis thesis focuses on women diagnosed with breast cancer and their family members. Since a breast cancer diagnosis and its subsequent treatment are a strenuous experience not only for the woman afflicted but also for her family members, this thesis aimed to explore the experiences of everyday life during radiation therapy from the perspectives of the woman with breast cancer and her family, as well as exploring families' experiences of participating in short family health conversations (SFamHC). All included studies were interview studies (Papers I, II, III & IV), where 30 women (20 in Paper I and 10 in Paper II) with breast cancer, 19 family members including the women with breast cancer (Paper III) and 9 families (Paper IV) were interviewed. The data from the interviews was analysed using qualitative content analysis (Papers I & II), a hermeneutical phenomenological method (Paper III) and thematic analysis (Paper IV).The women's experiences of breathing adapted radiation therapy (BART) (Paper I) were identified in an overall theme, The breath of life, as the women experienced the breathing as a way to influence their treatment and thus their survival. The overall theme could be divided into one main category: Participating in one's treatment, for good or ill, with four subcategories: Knowing one has done something good, Getting an extra bonushealthwise, The experience of being in control and Being in a hightechnology environment.Women born in Iraq and the former Yugoslavia, diagnosed with breast cancer and living in Sweden, experienced their everyday life during radiation therapy as a narrow and challenging treatment road to survival (Paper II). Their experiences were structured into three categories: Strategies for survival, Keeping up appearances and Staying in control. More focus should be on acknowledging the woman behind the diagnosis, regardless of her origin, in order to 10 develop individualised support programmes to help women cope with everyday life during radiation therapy.The families' lived experience when a family member is diagnosed with breast cancer (Paper III) was described as a challenging endeavour to regain an or...

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Factors in Parenting Stress in Young Patients With Breast Cancer and Implications for Children’s Emotional Development

Shin,

Kim,

Lee

et al. 2023

JAMA Netw Open

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ImportanceThe number of patients with breast cancer who have children is substantial. However, the emotional burden of this disease and its implication for childhood development remain largely unknown.ObjectiveTo investigate the clinical factors in parenting stress in mothers with breast cancer and the association of maternal depression and parenting stress with their children’s emotional development.Design, Setting, and ParticipantsThis cross-sectional study involved a survey of females with stage 0 to 3 breast cancer and was conducted from June 2020 to April 2021 in Seoul, South Korea. Participants were aged 20 to 45 years and completed the Center for Epidemiologic Studies Depression–Revised scale and basic questionnaires on demographic and clinical characteristics. Participants with children completed the Korean Parenting Stress Index Short Form (K-PSI-SF), Child Behavior Checklist, Junior Temperament and Character Inventory, and Children’s Sleep Habits Questionnaire.ExposureHaving children in patients with breast cancer.Main Outcomes and MeasuresMultivariable logistic and linear regression analyses were performed to investigate the association between maternal depression and parenting stress.ResultsA total of 699 females (mean [SD] age, 39.6 [4.6] years) were included, of whom 499 had children (mean [SD] age of children, 8.0 [2.7] years). Depression was more common in patients with children (odds ratio [OR], 2.25; 95% CI, 1.01-5.05) and patients who had gonadotropin-releasing hormone treatment (OR, 1.68; 95% CI, 1.15-2.44). Disease duration was inversely associated with depression (OR, 0.85; 95% CI, 0.76-0.96). Cancer-related factors were not associated with the K-PSI-SF score. Having children aged 6 years or older (β = 3.09; 95% CI, 0.19-5.99); being the sole primary caregiver (β = −3.43; 95% CI, −5.87 to −0.99); and reporting certain temperament (eg, novelty seeking: β = 0.58; 95% CI, 0.46-0.71), emotional problems (eg, anxious/depressed: β = 8.09; 95% CI, 3.34-12.83), and sleeping pattern (eg, bedtime resistance: β = 0.57; 95% CI, 0.15-0.99) subscale scores in their children were associated with parenting stress. Depression and parenting stress were correlated (β = 0.56; 95% CI, 0.45-0.66; P &lt; .001). The emotional challenges encountered by children of mothers with breast cancer were not significantly different from reference values.Conclusions and RelevanceThis study found that in patients with breast cancer, child-related factors and depression were significantly associated with parenting stress, but breast cancer–related factors were not correlated. The findings suggest that mothers with breast cancer are susceptible to both depression and parenting stress and that tailored counseling and support are needed.

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Impact of family‐oriented rehabilitation and prevention: an inpatient program for mothers with breast cancer and their children

Cited by 41 publications

References 53 publications

Family-based Breast Cancer Prevention Efforts in Adolescence

Family-based Breast Cancer Prevention Efforts in Adolescence

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

Factors in Parenting Stress in Young Patients With Breast Cancer and Implications for Children’s Emotional Development

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