Exploring the Process of Fulfilling Mothering Role in Patient with Breast Cancer: A Grounded Theory Study

Abstract

Abstract: Introduction: Breast cancer is one of the most common malignancies in women and the fifth leading cause of death of Iranian women. Its peak incidence age in Iranian women is in the fourth and fifth decades of life, which is a decade younger than the global peak age of incidence. Many of these women affected by breast cancer have dependent children (under the age of 16) as well as multiple responsibilities and duties towards children and other family members. The mothering role may be threatened by the disease and through the impaired ability of a mother to care for their child. Therefore, the mother to make more efforts to balance maternal parenting and disease management. Therefore, the need the mothering role along with following the treatment of the disease forces the mother to make more efforts to balance the mothering role and disease management. Given that the process of the mothering role is a process, the basic theory, method with the aim of identifying, describing and interpreting the interactive processes between mothers and children, other family members, and the community can be a good approach. Therefore, this study was aimed to exploring the process of the mothering role in breast cancer patients. Methods: This qualitative study was carried out with a grounded theory approach. Participants of women with breast cancer had children under 16 years of age who were entered into the study using purposive and theoretical sampling. 23 mothers (2 repetitive interviews with mothers), 4 children, 2 spouses, and 2 participants from medical staff were interviewed. The main method of data collection was conducted with in-depth and face –to-face interviews from May 2018 to January 2019 at the Oncology Center, Shahid Ghazi Tabatabai University of Medical Sciences, Tabriz, and Reyhaneh Charity in Ardabil that continued until the data were saturated. Data analysis was analyzed by Corbin Strauss (2008) approach. Lincoln and Guba’s four criteria used to ensure the rigor of the study. Results: In data analysis for context, four main categories “role of physical limited ", “psychological burden of the disease ", consequences for the children by the mother, and "supports: being with and for mother “were identified. Data analysis of the process consisted of three main categories related to strategies with "self-preparation", "role reorganization" and "self-reorganization and family" and one main category related to the outcome of “redefined mothering role stability ". The final analysis showed that mothers with breast cancer were trying to continue their mothering role in a new way by making changes in the role of the mother and using alternatives. Accordingly, the core variable of the study was titled “supervisory participatory model" in playing of the mothering role. In order to continue their mothering role, by gaining the support of resources inside and outside the family, as alternatives playing the role of the mother, they delegated the power of care while maintaining the performance of the alternatives. Using the share/monitoring mechanism, they were trying to regain their mothering role and were able to continue their mothering role as a new normal mother by formulating a participatory supervisory model. This category included subcategories of 1) equity and 2) supervision. Conclusion: Mothers with planning to regain of the role, try to gain a greater share of the mothering role after the disease, and can gradually apply the role of participatory regulatory model, with the support of role alternatives and gradual liberation from dependence on others, the ability to respond. Increase expectations of their mothering role. Therefore, identifying this model and the strategies used can help health care professionals to support.