Resiliency in families with a mother diagnosed with breast cancer

Thesis (MA)--Stellenbosch University, 2018.ENGLISH SUMMARY: This study aimed to identify resources, characteristics and factors that assisted families in the adjustment and adaptation to the chronic illness of breast cancer. Breast cancer is a growing global public health-care issue and one of the leading causes of death among women worldwide. A breast cancer diagnosis entails a demanding chronic illness for the ill individual, and is psychologically, emotionally and financially draining for family members, especially for those from a lower socioeconomic population. Given these challenges, a mother diagnosed with breast cancer is considered a family crisis. Nevertheless, some families are resilient in the face of adversity and are able to emerge strengthened and better equipped to overcoming the challenges an illness produces. This study and its findings add to knowledge and fill the large gap that exists in family resilience research and cancer literature. The Resiliency Model of Family Stress, Adjustment, and Adaptation (McCubbin & McCubbin, 1996), combined with Walsh’s (2012) Family Resilience Framework, was used as theoretical foundation for this study to identify resilience resources associated with family adaptation. Both theories are situated within the realm of positive psychology (Antonovsky, 1996). Existing family resilience research after a breast cancer diagnosis is extremely scarce and a limited topic in the South African and worldwide context. A mixed-method convergent parallel research design was employed in this study. Non-probability convenience sampling was utilised to recruit 104 mothers, as representatives of their family, from the Breast Clinic at Tygerberg Hospital in Cape Town. The qualitative component included 11 semi-structured interviews that were conducted with the participants at the Breast Clinic. The qualitative data was analysed according to Braun and Clarke’s (2013) thematic analysis method. It was implemented to identify themes and subthemes associated with family adaptation. The quantitative component encompassed the completion of seven self-report questionnaires. The quantitative data was analysed using Pearson’s product-moment correlation coefficients and an analysis of variance (ANOVA), and a best-subset regression analysis was done to determine the independent variables that best predict family adaptation. The combined qualitative and quantitative results give an in-depth understanding of the resilience factors and characteristics that assisted families to adjust and adapt following a breast cancer diagnosis. The results revealed the following family resilience characteristics: acceptance, hope and optimism, positive reframing, affirmative communication patterns, minimising reactivity towards stressor events, religion and faith in God, family time that promotes togetherness, couple time together, family hardiness, social support from friends and family, community support and religious support. Finally, the importance of managing the breast cancer illness through the effective management of the side effects of cancer treatments came to the fore. The above-mentioned findings can be utilised by medical professionals, psychologists and medical personnel in breast clinics for early interventions for families that face the crisis of a newly diagnosed mother. This study is exploratory in nature and recommendations for future inquiries are provided.AFRIKAANSE OPSOMMING: Hierdie studie se doel was om hulpbronne, eienskappe en faktore te identifiseer wat families gehelp het om aan te pas by die chroniese siekte van borskanker. Borskanker is ’n groeiende, wêreldwye gesondheidsorgprobleem en een van die vernaamste oorsake van dood onder vroue wêreldwyd. Die diagnose van borskanker lei tot ’n veeleisende, chroniese siekte wat sielkundig, emosioneel en finansieel dreinerend vir familielede is, veral vir diegene van ’n laer sosio-ekonomiese bevolking. Gegewe hierdie uitdagings word die diagnosering van borskanker by ’n moeder as ’n krisis vir ’n familie beskou. Tog is sommige families veerkragtig wanneer hulle teenspoed in die gesig staar en is hulle in staat om sterker en beter toegerus te raak om die uitdagings wat ’n siekte veroorsaak, te oorkom. Hierdie studie en sy bevindinge dra kennis by en vul die groot gaping wat bestaan in navorsing oor veerkragtigheid in families en literatuur oor kanker. Die Resiliency Model of Family Stress, Adjustment and Adaptation (McCubbin & McCubbin, 1996), gekombineer met Walsh (2012) se Family Resilience Framework, is gebruik as teoretiese grondslag vir hierdie studie ten einde die hulpbronne vir veerkragtigheid wat verband hou met aanpassings in families te identifiseer. Albei teorieë lê binne die gebied van positiewe sielkunde (Antonovsky, 1996). Bestaande navorsing oor die veerkragtigheid van families ná ’n borskankerdiagnose is uiters skaars en ’n beperkte onderwerp in die Suid-Afrikaanse en wêreldwye konteks. ’n Gemengde-metode konvergente parallelle navorsingsontwerp is in hierdie studie gebruik. Nie-waarskynlikheid gerieflikheidsteekproefneming is gebruik om 104 moeders, as verteenwoordigers van hulle families, van die Borskliniek by die Tygerberg-hospitaal in Kaapstad te werf. Die kwalitatiewe komponent het 11 semi-gestruktureerde onderhoude ingesluit wat met die deelnemers by die Borskliniek gevoer is. Die kwalitatiewe data is geanaliseer volgens Braun en Clarke (2013) se tematiese-analise metode. Dit is geïmplementeer om temas en sub-temas wat verband hou met familie-aanpassing te identifiseer. Die kwantitatiewe komponent het die voltooiing van sewe selfbeskrywingsvraelyste ingesluit. Die kwantitatiewe data is met behulp van Pearson se produkmoment-korrelasiekoëffisiente en ’n variansieontleding (ANOVA) geanaliseer en ’n beste-substel regressieontleding is gedoen om die onafhanklike veranderlikes te bepaal wat aanpassings binne families die beste voorspel. Die gekombineerde kwalitatiewe en kwantitatiewe resultate verleen ’n in-diepte begrip van die veerkragtigheidsfaktore en eienskappe wat families gehelp het om aan te pas ná ’n borskankerdiagnose. Die resultate het die volgende veerkragtigheidseienskappe in families onthul: aanvaarding, hoop en optimisme, positiewe herberaming, bevestigende kommunikasiepatrone, die minimalisering van reaktiwiteit teenoor stressor-gebeurtenisse, godsdiens en geloof in God, familietyd wat samesyn bevorder, paartjies wat saam tyd spandeer, gesinsgehardheid, sosiale ondersteuning van vriende en familie, gemeenskapsondersteuning en godsdienstige ondersteuning. Ten slotte het die belangrikheid van die bestuur van die borskankersiekte deur die effektiewe bestuur van die newe-effekte van kankerbehandelings na vore gekom. Bogenoemde bevindings kan deur mediese beroepslui, sielkundiges en mediese personeel in borsklinieke gebruik word vir vroeë ingrypings vir families wat die krisis van ’n pas-gediagnoseerde moeder in die gesig staar. Hierdie studie is verkennend van aard en aanbevelings vir toekomstige ondersoeke word voorsien