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Communication About Maternal Breast Cancer With Children: A Qualitative Study

Huang, Xiaoyan PhD; O’Connor, Margaret DN; Hu, Yan PhD; Gao, Hongyun MD, PhD; Lee, Susan PhD

doi: 10.1097/NCC.0000000000000456

Background: Communication with children is a major concern for mothers with breast cancer. Chinese people have specific understanding of cancer and death, which may affect their way of communication.

Objective: The aim of this study is to explore how Chinese mothers with breast cancer communicate about their illness with their children.

Methods: An interpretive description study was conducted. Forty mothers with nonterminal breast cancer in mainland China were interviewed individually. The data were analyzed using 3 steps of coding: free coding, descriptive coding, and interpretive coding.

Results: Four themes were identified: breaking the news, explaining to children, disclosing versus concealing, and information needs. Most Chinese mothers disclosed their diagnosis of breast cancer to their children mainly because it was impossible to conceal the truth. They explained illness in a factual manner; however, they tended to allow children to observe their physical changes and overhear conversations between adults. This was because they did not know how to communicate appropriately with their children, and they preferred to allow children to understand the event in a natural way.

Conclusions: The communication about maternal breast cancer between mothers and children was influenced by traditional culture. Quantitative studies with large sample sizes should be conducted to compare the opinions of mothers of different characteristics and to investigate the factors predicting communication.

Implications for Practice: Resources should be developed to help mothers with breast cancer communicate appropriately with their children about their illness. Healthcare professionals, especially nurses, need education to provide consultation services to these mothers and children.

Author Affiliations: School of Nursing, Fudan University, Shanghai, China (Drs Huang and Hu); School of Nursing and Midwifery, Monash University, Frankston, Australia (Drs Huang, O'Connor, and Lee); Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, Australia (Dr O’Connor); and Psychological Medicine Department, Children's Hospital of Fudan University, Shanghai, China (Dr Gao).

The authors have no funding or conflicts of interest to disclose.

Correspondence: Xiaoyan Huang, PhD, School of Nursing, Fudan University, 305 Fenglin Road, Shanghai, China, 200032 (

Accepted for publication October 12, 2016.

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