Fisher Carla L, Campbell-Salome Gemme, Bagautdinova Diliara, Wright Kevin B, Forthun Larry F, Bacharz Kelsey C, Mullis M Devyn, Wolf Bianca, Pereira Deidre B, Spiguel Lisa, Bylund Carma L
Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA.
Geisinger Medical Center, Danville, PA 17822, USA.
Cancers (Basel). 2023 Jul 29;15(15):3864. doi: 10.3390/cancers15153864.
For many diagnosed mothers and their daughters, breast cancer is a shared experience. However, they struggle to talk about cancer. This is particularly true when the daughter is in adolescence or young adulthood, as they tend to be more avoidant, which is associated with poorer biopsychosocial outcomes. When daughters are their mother's caregivers, daughters' burden and distress are heightened. Young adult caregiving daughters (YACDs) are the second most common family caregiver and encounter more distress and burden than other caregiver types. Yet, YACDs and their diagnosed mothers receive no guidance on how to talk about cancer. Thirty-nine mother/YACD pairs participated in an online survey to identify challenging topics and strategies for talking about cancer, and to explore associations between openness/avoidance and psychosocial outcomes. YACDs and mothers reported the same challenging topics (death, treatment-related issues, negative emotions, relational challenges, YACDs' disease risk) but differed on why they avoided the topic. YACDs and mothers identified the same helpful approaches to navigate conversations (openness, staying positive, third-party involvement, avoidance). Avoidance was correlated with more distress whereas openness was correlated with better psychosocial outcomes. These results provide a psychosocial map for a mother-YACD communication skills intervention, which is key to promoting healthy outcomes.
对于许多被诊断出患有乳腺癌的母亲及其女儿来说,乳腺癌是她们共同的经历。然而,她们很难谈论癌症。当女儿处于青春期或年轻成年期时尤其如此,因为她们往往更倾向于回避,而这与较差的生物心理社会结果相关。当女儿成为母亲的照顾者时,女儿的负担和痛苦会加剧。年轻成年照顾者女儿(YACDs)是第二常见的家庭照顾者类型,比其他照顾者类型面临更多的痛苦和负担。然而,YACDs及其被诊断出患有癌症的母亲在如何谈论癌症方面没有得到任何指导。39对母亲/YACD参与了一项在线调查,以确定谈论癌症的挑战性话题和策略,并探讨开放性/回避与心理社会结果之间的关联。YACDs和母亲报告了相同的具有挑战性的话题(死亡、与治疗相关的问题、负面情绪、关系挑战、YACDs的患病风险),但在回避话题的原因上存在差异。YACDs和母亲确定了相同的有助于引导对话的方法(开放性、保持积极、第三方参与、回避)。回避与更多的痛苦相关,而开放性与更好的心理社会结果相关。这些结果为母亲-YACD沟通技巧干预提供了一个心理社会图谱,这是促进健康结果的关键。