Breast cancer in the family--children's perceptions of their mother's cancer and its initial treatment: qualitative study.

OBJECTIVES 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. DESIGN Qualitative interview study with thematic analysis. SETTING Home based interviews with mothers and children in Oxfordshire, England. PARTICIPANTS 37 mothers with early breast cancer and 31 of their children aged between 6 and 18 years. RESULTS 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. CONCLUSIONS 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.