Being with and for mother: From perceived difficulties to rebalancing the mothering role in women with breast cancer


1 Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran

2 Department of Paediatric Nursing, Tabriz University of Medical Sciences, Tabriz, Iran

3 Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran

4 Department of Medical Surgical Nursing, School of Nursing and Midwifery, Haematology and Oncology Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran

5 Department of Anaesthesia/Pain, Palliative Care Unit, Multidisciplinary Oncology Centre, College of Medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria


Background: Breast cancer is the most common cancer and the 5th leading cause of death in Iranian women. Many of these women are at the age of fertility and have dependent children. Objectives: This study aimed to explore the experiences of mothers with breast cancer of the support they receive for playing and rebalancing their mothering role. Methods: This qualitative content analysis study was conducted from 2018 to 2019. Participants were 22 mothers with breast cancer purposively recruited from Shahid Ghazi Tabatabaee Hospital in Tabriz, Iran. Data were collected through semi-structured interviews and analyzed through a conventional content analysis method. Results: Participants’ experiences were categorized into three main categories, namely, perceived difficulties, being with and for mother, and rebalancing family functions. The four subcategories of the first category were the physical limitations in performing the mothering role, the psychological burden of the disease, role strain in playing the mothering role, and children’s social difficulties. The second category included five subcategories, namely, assistance with the mothering role, emotional attachment to the mother, provision of family expenses and medical costs, normalization of appearance following cancer-induced changes, and social support resources. Finally, the third category included two subcategories, namely, the stability of the mother’s roles and promoting a health-oriented perspective in the family. Conclusion: Mothers with breast cancer face difficulties in performing their role as mothers. Identifying and providing supportive interventions for them by the health-care providers not only can be effective in achieving role stability for the mother but also in rebalancing family functions.


1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA,
Jemal A. Global cancer statistics 2018: GLOBOCAN estimates
of incidence and mortality worldwide for 36 cancers in 185
countries. CA Cancer J Clin 2018;68:394-424.
2. American Cancer Society. Breast Cancer Facts & Figures 20172018. Atlanta: American Cancer Society, Inc.; 2017.
3. Reese JB, Porter LS, Casale KE, Bantug ET, Bober SL,
Schwartz SC, et al. Adapting a couple-based intimacy
enhancement intervention to breast cancer: A developmental
study. Health Psychol 2016;35:1085-96.
4. Kuswanto CN, Stafford L, Sharp J, Schofield P. Psychological
distress, role, and identity changes in mothers following a diagnosis
of cancer: A systematic review. Psychooncology 2018;27:2700-8.
5. Rashi C, Wittman T, Tsimicalis A, Loiselle CG. Balancing illness
and parental demands: Coping with cancer while raising minor
children. Oncol Nurs Forum 2015;42:337-44.
6. Kim S, Ko YH, Jun EY. The impact of breast cancer on motherchild relationships in Korea. Psychooncology 2012;21:640-6.
7. Tavares R, Brandão T, Matos PM. Mothers with breast cancer:
A mixed‐method systematic review on the impact on the parent‐
child relationship. Psychooncology 2018;27:367-75.
8. Whitehead L, Jacob E, Towell A, Abu‐qamar Me, Cole‐Heath A.
The role of the family in supporting the self‐management of
chronic conditions: A qualitative systematic review. J Clin Nurs
9. Peñarrieta MI, Flores-Barrios F, Gutiérrez-Gómez T,
Piñones-Martínez S, Resendiz-Gonzalez E, Quintero-Valle LM.
Self-management and family support in chronic diseases. J Nurs
Educ Pract 2015;5:73-80.10. Schulman-Green D, Brody A, Gilbertson-White S, Whittemore R,
McCorkle R. Supporting self-management in palliative care
throughout the cancer care trajectory. Curr Opin Support Palliat
Care 2018;12:299-307.
11. Bultmann JC, Beierlein V, Romer G, Möller B, Koch U,
Bergelt C. Parental cancer: Health‐related quality of life and
current psychosocial support needs of cancer survivors and their
children. Int J Cancer 2014;135:2668-77.
12. Mousvi Diva R, Moghadam N, Amani O. Evaluating family
functioning and spiritual health in women with breast cancer, cancertreated and healthy women. Iran J Psychiatry Nurs 2017;5:49-56.
13. Joulaee A, Joolaee S, Kadivar M, Hajibabaee F. Living with
breast cancer: Iranian women’s lived experiences. Int Nurs Rev
14. Ghahari S, Fallah R, Behnam L, Rad MM, Farrokhi N,
Ghayoomi R. Preoccupations and worries in women with breast
cancer: A qualitative study. J Pharm Res Int 2018;24:1-7.
15. Lawrence LM, Stone MR, Rainham DG, Keats MR.
Environments Associated with Moderate-to-Vigorous Physical
Activity and Sedentary Behavior of Colorectal Cancer Survivors.
Int J Behav Med 2017;24:120-6.
16. Vaziri S, Lotfi Kashani F, Akbari ME, Ghorbani Ashin Y.
Comparing the motherhood and spouse role in women with breast
cancer and healthy women. Iran Q J Breast Dis 2014;7:76-83.
17. Fisher C, O’Connor M. “Motherhood” in the context of living
with breast cancer. Cancer Nurs 2012;35:157-63.
18. Baltisberger JA. “Bent but Not Broken”: A mixed methods study
of mothering during chemotherapy for breast cancer. University
of Kentucky; 2015. Available from:
cgi/viewcontent.cgi?article=1024&context=rehabsci_etds. [Last
accessed on 2019 Jul 20].
19. Graneheim UH, Lundman B. Qualitative content analysis in
nursing research: Concepts, procedures and measures to achieve
trustworthiness. Nurse Educ Today 2004;24:105-12.
20. Lincoln YS, Guba EG. Naturalistic Inquiry. Illustrated, Reprint
Edition. USA: Sage Publications, Inc.; 1985.
21. de Castro EK, Dornel AK, de Sousa MA. The experience of
motherhood during cancer treatment. Int J Behav Med 2018;23:1-16.
22. Morris JN, Martini A, Preen D. The well-being of children
impacted by a parent with cancer: an integrative review. Support
Care Cancer 2016;24:3235-51.
23. Ghofrani M, Nikfarid L, Nourian M, Nasiri M, Saiadynia M.
Levels of unmet needs among adolescents and young
adults (AYAs) impacted by parental cancer. Support Care Cancer
24. Phillips F, Lewis FM. The adolescent’s experience when a
parent has advanced cancer: A qualitative inquiry. Palliat Med
25. Campbell-Enns H, Woodgate R. The psychosocial experiences
of women with breast cancer across the lifespan: Asystematic
review protocol. JBI Database System Rev Implement Rep
26. Mackenzie CR. Breast cancer survivors’ experiences of partner
support and physical activity participation. Psychooncology
27. Knutsson S, Enskär K, Andersson-Gäre B, Golsäter M.
Children as relatives to a sick parent: Healthcare professionals’
approaches. Nord J Nurs Res 2017;37:61-9.
28. Sieh DS, Visser-Meily JM, Oort FJ, Meijer AM. Risk factors
for problem behavior in adolescents of parents with a chronic
medical condition. Eur Child Adolesc Psychiatry 2012;21:459-71.
29. Hydary L, Mokhtari Hesari P. Common breast cancer family care
giving problems. Iran Q J Breast Dis 2015;8:7-14.
30. Agha Hosini SS, Abdollahzadeh F, Asvadi Kermani E,
Rahmani A. Relationship between awareness of cancer diagnosis
and hope in patients with cancer. Iran J Med Ethics Hist Med
31. Zeighami Mohammadi S, Mohammad Khan S, Zohreh Vanaki K.
Reconstruction of feminine identity: The strategies of women
with breast cancer to cope with body image altered. Int J
Womens Health 2018;10:689-97.
32. Semple CJ, McCance T. Parents’ experience of cancer who have
young children: a literature review. Cancer Nurs 2010;33:110-8.
33. Koosha M, Raoofi A, Bahrami A, Sajadian A,
Tafazzoli-Harandi H, Haghighat S. Mothers and sisters are
the most effective sources of support in coping with disease
in patients with breast cancer. Mult Cancer Invest 2017;1: