ADOLESCENTS COPING WITH MOM’S BREAST CANCER: DEVELOPING FAMILY INTERVENTION PROGRAMS Silva Redigonda

INTRODUCTION Research Question: How are African American and Caucasian adolescents affected by their mothers’ breast cancer treated in the last two years? How do African American and Caucasian adolescents think future intervention programs should be designed? What are the aims of the paper? The abstract indicates that the purpose was to gain a deeper understanding of how adolescents are affected by their mothers’ breast cancer and to discover their opinions about how future intervention programs should be designed. But the introduction more specifically indicates that the purpose of this study is to elicit opinions from an ethnically diverse group of adolescents about the effects of maternal breast cancer on their lives and to discover their opinions about how future intervention programs should be designed. This may be construed as a contradiction. The paper under the heading of Aims of the Study indicates that “the purpose of this study was to investigate adolescents’ thoughts on and experiences with a mother who had been treated for breast cancer in the last two years.”(p 250) METHODOLOGY This is a pilot study which is a small-scale study conducted prior to conducting an actual experiment; designed to test and refine procedures. When the researcher has decided on all the specific aspects of the procedure, it is possible to conduct a pilot study in which the researcher does a trial run with a small number of participants. The pilot study will reveal whether participants understand the instruction, whether the total experimental setting seems plausible, whether any confusing questions are being asked etc..Such procedures provide the researcher with an opportunity to make any necessary changes in the procedure before doing the entire study. Reference: Cozby Paul, Methods in Behavioral Research, 9th ed. McGraw-Hill Comp. New York, 2007 pp 181-182, 383) I believe that the model used was the interpretive model. This stems from qualitative research. The study consisted of three focus groups according to the paper: The first focus group comprised of four Caucasian adolescents (gender not specified) but deduced from information provided as two females and two males. The second focus group had two African American females The third focus group comprised of two African American females and two African male adolescents. with a total of 10 adolescents ranging from 13 to 18 years of age (five males and five females consisting of four Caucasian and six African Americans). The six African American adolescents has been determined for focus group two and three. Of the remaining four adolescents who are Caucasian, we know that two are female. Therefore the remaining two Caucasian adolescents in the first focus group is male. The report indicates that the focus groups were “split” along racial lines with Caucasian and African American in each focus group. All the African American adolescents are identified as being in group two and three. Each adolescent has a mother who had been treated with a stage of 0 to lll breast cancer within the last two years. Six set of parents were married, one mother remarried and three African American mothers were divorced and single parents. Three of the adolescent girls (two Caucasian and one African American) had mothers who were initially diagnosed five to 15 years earlier. It is not specified if the mothers were Caucasian and African American the same as their children. Nor is it known which adolescent is connected to who’s mother. Therefore this study cannot be replicated. It should be noted that each adolescent indicated that the reason she/he was participating because of the mother’s encouragement. Did the teens therefore feel they were coerced? Two female moderators conducted each focus group. At least one moderator’s was matched with each participant group, that being Caucasian or African American. What was consistent is that one Caucasian moderator was in each of the three focus groups. Since there were two moderators in each group and one is African American then it can be presumed that at least two moderators, one Caucasian and one African American were in the study. Wording cannot conclude that there were not more than two moderators. Each focus group was provided with a guided discussion and seven questions pertaining to “parental cancer”. Questions were asked within the same order. This occurred between 2002 and 2003. More specific dates are not provided. Recurrent themes were determined and developed with a definition for each. These categories were derived independently by three of the five coauthors. To be classified as a major theme, at least one half of the adolescents interviewed (five) had to report such. RESULTS The four Caucasian teenagers two male and two females, who had mothers currently in treatment for stage II or III breast cancer responded with intense sadness, worries, and fears about their mothers’ prognosis. All six African American teenagers having mothers with stage 0, I and II breast cancer, minimized current worries or fears and stated no current concerns about their mothers’ breast cancer. All of the adolescent males seemed less expressive when asked about their feelings and ways of coping and relied more on distraction, keeping busy and athletics. The African American females tended to keep to their normal routines as much as possible, tried not to think about it, and were less expressive. The Caucasian females talked more about the importance of sharing their feelings with others, writing, and other mediums of expression. African American males and female tended to go to church more often and to pray daily to cope. All adolescents talked about seeing their mothers vulnerable during the cancer treatments. All were more affectionate and helped out by cooking, cleaning, shopping, washing clothes and protecting their mothers by making sure they were eating well and sleeping. The oldest adolescents in their families reported taking on the most responsibility at home during their mothers’ treatment. Parents often relied on the eldest to care for younger siblings and to take on additional household responsibilities. Adolescents coped with faith, humor, talking with others, distraction, thinking positively and keeping busy in athletics or other activities. Regarding support, all adolescents said having a teen group close to diagnosis (within four months) would have been an asset. They wanted to be fully informed sooner rather than later regarding the treatment, expectations, etc..It would be better to have a mixed group of boys and girls close to diagnosis and similar ages, don’t talk down to them, boys may not feel comfortable exposing their feelings with females present, female and male therapist at a younger age would have been preferred. Listen to the teenagers more; and have families come together as a group. Regarding “Research on how to help their children is absent.”(American Cancer Society, 2003).P 248. I contacted the American Cancer Society and they sent me the paper via email (www.cancer.org/docroot/STT/stt_0_2003. This paper has 52 pages. Yet the reference page was never provided. I did not see such reference as noted by the researcher. Does the Researcher therefore mean that she did not see the mentioned research in this paper? Pages 41 and 43 of the reference does offer resources and publications offering practical and emotional support for families. There are also books during the time of this research available for support. Note below. Coping with breast cancer, and helping your children do the same, is an ongoing process. If you want to read more about supporting children, some books you might find helpful are: McCue, K. (1994). How to Help Children though a Parent’s Serious Illness. St. Martin’s Griffin: New York. Harpham,W. (2004). When a Parent has Cancer:A Guide to Caring for your Children. HarperCollins: New York. There were assumptions which I think restricts the researcher in thought. All avenues should be open and disproved by evidence. For example “Although African American women have a 13% lower incidence of newly diagnosed breast cancer, as compared with Caucasian women, they have a higher death rate.” This is likely due……If the answers were posed as questions stemming from grounded research it would have deserved merit. Opinions are not valid for research. There are too many factors to consider. Chapter five of our text indicates that if a group has fewer than 6 people it can be hard at times to generate a diversity of ideas (focus groups in this study were four, two and four). Each focus group was well below the minimum recommendation for each focus group. Even the adolescents had to inform the researchers of what they already should have known as indicated earlier in bold.