Date Presented 4/8/2016
This mixed-methods study looked at the effect of chemotherapy on mothering for women with breast cancer. Results demonstrate the important role of mothering during chemotherapy. Implications for occupational therapy opportunities in oncology will be discussed.
Primary Author and Speaker: Julie Baltisberger
Contributing Author: Dana Howell
PURPOSE: The purpose of this study was to examine, using a mixed-methods approach, the impact of chemotherapy on mothering occupations for patients diagnosed with breast cancer.
BACKGROUND: Breast cancer is the most common cancer diagnosis of women, with an estimated 232,670 new cases in 2014. With 89.2% of breast cancer patients surviving ≥5 yr, studies are needed to investigate the long-term impact of breast cancer on women and families. Anecdotal information demonstrates the importance of parenting for cancer patients, but few studies conducted in the United States have addressed the parenting needs of women with breast cancer, especially the impact of side effects on the physical aspect of providing care.
DESIGN: A concurrent parallel mixed-methods design in which qualitative and quantitative data are collected independently of each other and are merged at the end of analysis
PARTICIPANTS: Thirty-one women (mean age = 39.6, standard deviation = 5.79), with breast cancer of any stage, who were currently undergoing chemotherapy and had at least one child under the age of 18 living in the home, were recruited from a comprehensive breast cancer care center.
METHOD: Institutional review board approval was obtained, and informed consent was obtained from all participants. For the quantitative portion of the study, participants completed the Fatigue Symptom Inventory Then Test, the Parent Disability Inventory, the FACT–G quality of life inventory, and a demographic questionnaire. Of these 31 participants, 10 were selected using purposeful sampling to participate in semistructured interviews focusing on the impact of chemotherapy on mothering occupations.
ANALYSIS: Qualitative data were analyzed using a grounded theory approach, and quantitative data were analyzed using SPSS Version 22 to determine descriptive statistics and correlations among variables.
RESULTS: After analysis, the central category that emerged from the data was “keeping life the same while weathering cancer treatments,” which was developed from categories of learning, adapting, accepting support, growing, and normalcy. Quantitative analyses found a correlation between fatigue and parent disability (Spearman ρ = –.476, p < .05), quality of life and fatigue interference (–.481, p < .001), and parent disability and quality of life (.745, p < .001).
DISCUSSION: Mothers undergoing chemotherapy for breast cancer identified a strong need to continue the mothering role. From this analysis, the overarching theme that emerged was “keeping life the same while weathering breast cancer treatments.” The ultimate goal for mothers was to keep their lives as normal as possible for their children. These mothers found a way to incorporate former routines and rituals while adapting them in order to find a new normal.
IMPACT STATEMENT: This study provides information about how mothers with breast cancer still participate in the mothering role despite treatment side effects. This study highlights that occupational therapists working with oncology patients need to focus on this valuable role, in addition to treating upper-extremity dysfunction. In primary care oncology settings, occupational therapists could work with breast cancer patients to help them understand the progression of their treatments and how to deal with side effects such as cancer-related fatigue and help problem solve new strategies for carrying out meaningful occupations.
