Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
Department of Neuropsychiatry, Chamjoeun Hospital, Gyeonggi-do, Korea.
JAMA Netw Open. 2023 Nov 1;6(11):e2344835. doi: 10.1001/jamanetworkopen.2023.44835.
The 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.
To 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 PARTICIPANTS: This 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.
Having children in patients with breast cancer.
Multivariable logistic and linear regression analyses were performed to investigate the association between maternal depression and parenting stress.
A 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 < .001). The emotional challenges encountered by children of mothers with breast cancer were not significantly different from reference values.
This 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.
患有乳腺癌并育有子女的患者数量相当多。然而，这种疾病的情绪负担及其对儿童发展的影响在很大程度上仍未可知。
调查患有乳腺癌的母亲在育儿压力方面的临床因素，以及母亲的抑郁和育儿压力与子女情绪发展的关系。
设计、地点和参与者：这是一项横断面研究，对韩国首尔的 0 至 3 期乳腺癌女性进行了调查，时间为 2020 年 6 月至 2021 年 4 月。参与者年龄在 20 至 45 岁之间，完成了中心流行病学研究抑郁修订量表和基本的人口统计学和临床特征问卷。有子女的参与者完成了韩国育儿压力指数短表（K-PSI-SF）、儿童行为检查表、青少年气质与性格问卷和儿童睡眠习惯问卷。
患有乳腺癌的患者育有子女。
采用多变量逻辑和线性回归分析，调查了母亲抑郁与育儿压力之间的关系。
共纳入 699 名女性（平均[标准差]年龄，39.6[4.6]岁），其中 499 名有子女（平均[标准差]子女年龄，8.0[2.7]岁）。有子女的患者（比值比[OR]，2.25；95%置信区间[CI]，1.01-5.05）和接受促性腺激素释放激素治疗的患者（OR，1.68；95% CI，1.15-2.44）更常见抑郁。疾病持续时间与抑郁呈负相关（OR，0.85；95% CI，0.76-0.96）。癌症相关因素与 K-PSI-SF 评分无关。有 6 岁或以上子女（β=3.09；95% CI，0.19-5.99）；作为唯一的主要照顾者（β=-3.43；95% CI，-5.87 至-0.99）；以及报告某些气质（如寻求新奇：β=0.58；95% CI，0.46-0.71）、情绪问题（如焦虑/抑郁：β=8.09；95% CI，3.34-12.83）和睡眠模式（如就寝时间抗拒：β=0.57；95% CI，0.15-0.99）子量表评分与育儿压力相关。抑郁和育儿压力呈正相关（β=0.56；95% CI，0.45-0.66；P<0.001）。母亲患有乳腺癌的儿童所面临的情绪挑战与参考值没有显著差异。
本研究发现，在患有乳腺癌的患者中，与子女相关的因素和抑郁与育儿压力显著相关，但与乳腺癌相关的因素无关。研究结果表明，患有乳腺癌的母亲容易同时出现抑郁和育儿压力，需要提供有针对性的咨询和支持。
