Forrest Gillian, Plumb Caroline, Ziebland Sue, Stein Alan
Section of Child and Adolescent Psychiatry, University of Oxford, Park Hospital for Children, Oxford OX3 7LQ.
BMJ. 2006 Apr 29;332(7548):998-1003. doi: 10.1136/bmj.38793.567801.AE. Epub 2006 Apr 13.
To explore how children of mothers newly diagnosed with breast cancer perceive their mother's illness and its initial treatment; to contrast their accounts with the mothers' perceptions of their children's knowledge.
Qualitative interview study with thematic analysis.
Home based interviews with mothers and children in Oxfordshire, England.
37 mothers with early breast cancer and 31 of their children aged between 6 and 18 years.
Awareness of cancer as a life threatening illness existed even among most of the youngest children interviewed. Children described specific aspects of their mother's treatment as especially stressful (seeing her immediately postoperatively, chemotherapy, and hair loss). Children suspected that something was wrong even before they were told the diagnosis. Parents sometimes misunderstood their children's reactions and underestimated the emotional impact or did not recognise the children's need for more preparation and age appropriate information about the illness and its treatment.
As part of their care, parents newly diagnosed with a life threatening illness need to be supported to think about how they will talk to their children. General practitioners and hospital specialists, as well as nurses, are well placed to be able to help with these concerns and if necessary to be involved in discussions with the children. The provision of appropriate information, including recommended websites, should be part of this care. More information specifically designed for young children is needed.
探讨初诊为乳腺癌的母亲的孩子如何看待母亲的疾病及其初始治疗;将他们的叙述与母亲对孩子知晓情况的看法进行对比。
采用主题分析的定性访谈研究。
在英国牛津郡对母亲和孩子进行居家访谈。
37名早期乳腺癌母亲及其31名年龄在6至18岁之间的孩子。
即使在接受访谈的大多数最小的孩子中,也存在将癌症视为危及生命疾病的认知。孩子们将母亲治疗的特定方面描述为特别有压力(术后立即见到她、化疗和脱发)。孩子们甚至在被告知诊断之前就怀疑出了问题。父母有时误解孩子的反应,低估情感影响,或者没有认识到孩子需要更多关于疾病及其治疗的准备和适合其年龄的信息。
作为护理的一部分,初诊患有危及生命疾病的父母需要得到支持,思考如何与孩子交谈。全科医生、医院专科医生以及护士能够很好地帮助解决这些问题,如有必要,参与与孩子的讨论。提供包括推荐网站在内的适当信息应成为这种护理的一部分。需要更多专门为幼儿设计的信息。