Despite the high rates of breast cancer in the child-rearing mother, there is extremely limited research on the effects of the illness on the children, marriage, and parent-child relationship. The current study tested an explanatory model of family functioning with breast cancer based on data obtained from standardized questionnaires from 80 diagnosed mothers and partners with young school-age children. Path analysis results for data obtained from both the mothers and the partners revealed a similar pattern. More frequently experienced illness demands were associated with higher levels of parental depressed mood which negatively affected the marriage. When the marriage was less well adjusted, it negatively affected the family's coping behavior. Household functioning was positively affected by heightened coping activity and by higher levels of marital adjustment. Children functioned better when the non-ill parent more frequently interacted with them and their families coped more frequently with their problems.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Amato, P. R., and Ochiltree, G. (1986). Family resources and the development of child competence.J. Marriage Family 48: 47–56.
American Cancer Society (1993).Cancer Facts & Figures-1993, American Cancer Society, Atlanta, GA.
Asher, H. B. (1983).Causal Modeling, 2nd ed., Sage, Beverly Hills.
Baider, L., and DeNour, A. K. (1984). Couples' reactions and adjustment to mastectomy.Int. J. Psychiat. Med. 14(3): 265–276.
Belsky, J., Lerner, R. M., and Spanier, G. B. (1984).The Child in the Family, Addison-Wesley, Reading, MA.
Blalock, H. M., Jr. (ed.) (1985).Causal Models in the Social Sciences, 2nd ed., Aldine, New York.
Bloom, J. R. (1982). Social support systems and cancer: A conceptual view. In Cohen, J.,et al. (eds.),Psychosocial Aspects of Cancer, Raven Press, New York.
Broderick, C., and Smith, J. (1979). The general systems approach. In Burr, W. R., Hill, R., Nye, F. I., and Reiss, I. L. (eds.),Contemporary Theories about the Family, Vol. 2, Free Press, New York, pp. 112–129.
Brody, G. H., Stoneman, Z., and Burke, M. S. (1987). Family system and individual child correlates of sibling behavior.Am. J. Orthopsychiat. 57: 561–569.
Brown, D. J., Craick, C. C., Davies, S. E.,et al. (1978). Physical, emotional and social adjustments to home dialysis.Med. J. Austral. 1: 245–247.
Buckley, F. (1967).Sociology and Modern Systems Theory, Prentice-Hall, Englewood Cliffs, NJ.
Burke, R. J., and Weir, T. (1982). Husband-wife helping relationships as moderators of experienced stress: The “mental hygiene” function in marriage. In McCubbin, H. I., Cauble, A. E., and Patterson, J. M. (eds.),Family Stress, Coping and Social Support, Charles C Thomas, Springfield, IL.
Burnett, P. (1987). Assessing marital adjustment and satisfaction: A review.Measur. Eval. Counsel. Dev. 113–121.
Chekryn, J. (1984). Cancer recurrence: Personal meaning, communication, and marital adjustment.Cancer Nurs. 7: 491–498.
Cohen, S., and Wills, T. A. (1985). Stress, social support, and the buffering hypothesis.Psychol. Bull. 98: 310–357.
Ellison, E. H. (1983). Parental support and school-aged children.West. J. Nurs. Res. 5: 145–193.
Ellison, E. H. (1985). A multidimensional, dual-perspective index of parental support.West. J. Nurs. Res. 7: 401–424.
Emery, R. E., and O'Leary, K. D. (1982). Children's perceptions of marital discord and behavior problems of boys and girls.J. Abnorm. Child Psychol. 10: 11–24.
Finkelstein, F. O., Finkelstein, S. H., and Steele, T. E. (1976). Assessment of marital relationships of hemodialysis patients.Am. J. Med. Sci. 271(1): 21–28.
Funch, D. P., and Mettlin, C. (1982). The role of support in relation to recovery from breast surgery.Soc. Sci. Med. 16: 91–98.
Gilligan, C. (1982a). Adult development and women's development: Arrangements for a marriage. In Giele, J. (ed.),Women in the Middle Years: Current Knowledge and Directions for Research and Policy, Wiley, New York.
Gilligan, C. (1982b). In a different voice.Psychological Theory and Women's Development, Harvard University, Cambridge, MA.
Gotay, C. C. (1984). The experience of cancer during early and advanced stages: The views of patients and their mates.Soc. Sci. Med. 18: 605–613.
Grandstaff, N. W. (1976). The impact of breast cancer on the family.Frontiers Radiat. Ther. Oncol. 11: 146–156.
Haberman, M. R., Woods, N. F., and Packard, N. J. (1990). Demands of chronic illness: Reliability and validity assessment of a demands-of-illness inventory.Holist. Nurs. Pract. 5(1): 25–35.
Herting, J. R. (1985). Multiple indicator models using LISREL. In Blalock, H. M., Jr., (ed.),Causal Models in the Social Sciences, Aldine, New York, pp. 263–319.
Hill, R. (1972). Modern systems theory and the family: A confrontation.Soc. Sci. Inform. 10: 7–26.
Hilton, B. A. (1989). The relationship of uncertainty, control, commitment, and threat of recurrence to coping strategies used by women diagnosed with breast cancer.J. Behav. Med. 12(1): 39–54.
Hirsch, B. J., Moos, R. H., and Reischl, T. M. (1985). Psychosocial adjustment of adolescent children of a depressed, arthritic, or normal parent.J. Abnorm. Psychol. 94: 154–164.
Holcomb, J. L., and MacDonald, R. W. (1973). Social functioning of artificial kidney patients.Soc. Sci. Med. 1: 109–119.
Lazarus, R. S., and Folkman, S. (1984).Stress, Appraisal, and Coping, Springer, New York.
Lewis, F. M. (1986). The impact of cancer on the family: A critical analysis of the research literature.Patient Educ. Counsel. 8: 269–289.
Lewis, F. M. (1990). Strengthening family supports: Cancer and the family.Cancer 65: 158–165.
Lewis, F. M., Woods, N. F., Hough, E. E., and Bensley, L. S. (1989). The family's functioning with chronic illness in the mother: The spouse's perspective.Soc. Sci. Med. 29(11): 1261–1269.
Lichtman, R. R., Taylor, S. E., and Wood, J. V. (1987). Social support and marital adjustment after breast cancer.J. Psychosoc. Oncol. 5: 47–74.
Loveys, B. J., and Klaich, K. (1991). Breast cancer: Demands of illness.Oncol. Nurs. Forum 18(1): 75–80.
Maccoby, E. E., and Martin, J. A. (1983). Socialization in the context of the family: Parent-child interaction. In Mussen, P. H. (ed.),Handbook of Child Psychology, Vol. IV. Socialization, Personality, and Social Development, Wiley, New York, pp. 1–101.
Maguire, G. P., Lee, E. G., Bevington, D. L.,et al. (1978). Psychiatric problems in the first year after mastectomy.Br. Med. J. 1: 963–965.
McCubbin, H. I., Larsen, A. S., and Olson, D. H. (1982). F-COPES (Family Coping Strategies). In Olson, D., McCubbin, H. I., Barnes, H., Larsen, A., Muxen, M., and Wilson, M. (eds.),Family Inventories, University of Minnesota, St. Paul.
Melito, R. (1985). Adaptation in family systems: A developmental perspective.Family Proc. 24: 89–100.
Molumphy, S. D., and Sporakowski, M. J. (1984). The family stress of hemodialysis.Family Relat. 33: 33–39.
Monge, P. R. (1982). Systems theory and research in the study of organizational communication: The correspondence problem.Hum. Commun. Res. 8: 245–261.
Namboordiri, N. K., Carter, L. F., and Blalock, H. M. (1975). Recursive models and one-way causation.Applied Multivariate Analysis and Experimental Designs, McGraw-Hill, New York, pp. 439–491.
Norbeck, J., Lindsey, A., and Carrieri, V. (1981). The development of an instrument to measure social support.Nurs. Res. 30: 264–269.
Norbeck, J., Lindsey, A., and Carrieri, V. (1983). Further development of the Norbeck social support questionnaire: Normative data and validity testing.Nurs. Res. 32: 4–9.
Northouse, L. (1988). Social support in patients' and husbands' adjustment to breast cancer.Nurs. Res. 37: 91–95.
Northouse, L., and Swain, M. A. (1987). Adjustment of patients and husbands to the initial impact of breast cancer.Nurs. Res. 36(4): 221–225.
Oberst, M. T., and James, R. H. (1985). Going home: Patient and spouse adjustment following cancer surgery.Topics Clin. Nurs. 46–57.
Olson, D. H., McCubbin, H. I., Barnes, H.,et al. (1983).Families, What Makes Them Work, Sage, Beverly Hills, CA.
Peters, L. C., and Esses, L. M. (1985). Family environment as perceived by children with a chronically ill parent.J. Chron. Dis. 38: 301–308.
Peters-Golden, H. (1982). Breast cancer: Varied perceptions of social support in the illness experience.Soc. Sci. Med. 16: 483–491.
Porter, B., and O'Leary, K. D. (1980). Types of marital discord and child behavior problems.J. Abnor. Child Psychol. 8: 287–295.
Radley, A., and Green, R. (1986). Bearing illness: Study of couples where the husband awaits coronary graft surgery.Soc. Sci. Med. 23: 577–585.
Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population.Appl. Psychol. Meas. 1: 385–401.
Reid, W. J. and Crisafulli, A. (1990). Marital discord and child behavior problems: A meta-analysis.J. Abnorm. Child Psychol. 18: 105–117.
Schwenk, T. L., and Hughes, C. C. (1983). The family as patient in family medicine. Rhetoric or reality?Soc. Sci. Med. 17: 1–16.
Sexton, D. L., and Munro, B. H. (1985). Impact of a husband's chronic illness (COPD) on the spouse's life.Res. Nurs. Health 8: 83–90.
Sharpley, C. F., and Cross, D. G. (1982). A psychometric evaluation of the Spanier Dyadic Adjustment Scale.J. Marriage Family 46: 739–741.
Spanier, G. B. (1976). Measuring dyadic adjustment: New scales for assessing the quality of marriage and similar dyads.J. Marriage Family 38: 15–28.
Stetz, K., Lewis, F. M., and Primomo, J. (1986). Family coping strategies and chronic illness in the mother.Family Relat. 35: 515–522.
Stetz, K., Lewis, F. M., and Houck, G. (1988). Family goals as indicants during chronic illness. Presented at the National Council on Family Relations.
Stewart, M. J. (1989). Social support: Diverse theoretical perspectives.Soc. Sci. Med. 28: 1275–1282.
Thoits, P. A. (1982). Conceptual, methodological, and theoretical problems in studying social support as a buffer against life stress.J. Health Soc. Behav. 23: 145–159.
Webster-Stratton, C., and Hammond, M. (1988). Maternal depression and its relationship to life stress, perceptions of child behavior problems, parenting behaviors, and child conduct problems.J. Abnorm. Child Psychol. 16(3): 299–315.
Weissman, W. M. (1981). Women, the major victims of depression.Med. Times 109: 245–365.
Weissman, W. M., and Myers, J. K. (1980). Psychiatric disorders in a U.S. community: The application of research diagnostic criteria to a resurveyed community sample.Arch. Psychiat. Scand. 62: 99–111.
Weissman, W. M., Myers, J. K., and Thompson, W. D. (1981). Depression and its treatment in a U.S. urban community, 1975–1976.Arch. Gen. Psychiat. 38: 417–421.
Wellisch, D. K., Fawzy, F. I., Landsverk, J., Pasnau, R. O., and Wolcott, D. L. (1983). Evaluation of psychosocial problems of the home-bound cancer patient: The relationship of disease and the sociodemographic variables of patients to family problems.J. Psychosoc. Oncol. 1: 1–5.
Widmer, R. B., Cadoret, R. J., and North, C. S. (1980). Depression in family practice: Some effects on spouses and children.J. Family Pract. 10: 45–51.
Wortman, C. B. (1984). Social support and the cancer patient: Conceptual and methodological issues.Cancer 2339–2359.
Zahlis, E. H., and Shands, M. E. (1991). Breast cancer: Demands of the illness on the patient's partner.J. Psychosoc. Oncol. 9(1): 75–93.
Zuckerman, B. S., and Beardslee, W. R. (1987). Maternal depression: A concern for pediatricians.Pediatrics 79: 110–117.
This research was supported by a grant from the Center for Nursing Research, National Institutes of Health (R01-NR-01000), and an American Cancer Society Oncology Nursing Professorship awarded to the senior author.
About this article
Cite this article
Lewis, F.M., Hammond, M.A. & Woods, N.F. The family's functioning with newly diagnosed breast cancer in the mother: The development of an explanatory model. J Behav Med 16, 351–370 (1993). https://doi.org/10.1007/BF00844777
- family functioning
- breast cancer
- model development