The impact of breast cancer on the family

Abstract

T O DATE, primary emphasis in research on the psychosocial aspects of breast cancer has been on the individual patient's response to the illness and its medical management. 1-3 Early work by clinicians was typified by seminal case studies, 4-7 but no studies systematically documented the impact of cancer on the family. Thus, although there has been a proliferation of authoritative literature on women's psychosocial adjustment to breast cancer, comparatively little attention has focused on the family's immediate and long-term adaptation to the illness. The tradition of examining the impact of cancer or life-threatening illness on the individual continues but fails to include the broader context of family-level impact and coping; 89 despite the growing awareness of the importance of the social support network in which the diagnosed member belongs ~°-19 and despite the recognition that it is the family, and not the isolated patient, that experiences the illness~ j'2°-z3 The family is often treated as a bystander rather than an influencing, organizing, and creative agent. Only recently have clinicians turned their attention toward systematic documentation of the family's functional status during an episode of illness. 24-27 This article has three purposes: to review selected concepts that characterize the impact of breast cancer on the family; to highlight selected preliminary research results from a longitudinal study of the impact of breast cancer on the family; and to draw implications for clinical practice for nurses working with women who have breast cancer and their families.