Common approaches to further exploring the anxiety experienced by adolescent daughters of cancer patients have commonly included qualitative measures. Spira and Kenemore (2004) small vignettes of actual interviews are presented as to give further insight to the anxious tendencies regarding changes in familial roles and the relationship with their mother. This approach has several cons, including the in-depth exposition of intimate fears regarding such changes and loses. It can also provide a clearer picture of the reoccurring fears regarding their own position with the disease for further analysis, (Spira & Kenemore, 2004). This can then provide structure for psychological constructs regarding treatment and grief counseling for such individuals.
However, there are also a few negative ramifications which are present within qualitative measures to study the true depth of the affect breast cancer has on patient's adolescent daughters. Qualitative studies can sometimes jeopardize the usability of the variables involved within the study. Due to the fact that the units of analysis consisting of the adolescent teens' lived experiences, the usable data can easily be compromised. One major negative aspect is the idea that such research provides very little usable comparison groups for future research (Cappelli et al., 2005). This is also a limitation for the study currently discussed here. The sample sizes consist of only 8-14 women, which does prove difficult to span over all demographics of adolescent females. Other limitations include the limitation of the breadth of the study, for most qualitative designs previously employed have been restricted to small sample groups (Cappelli et al., 2005). Another limitation includes the specified age range of the participants which then limits the quality of the responses. Some previous research has used comparison groups of a narrow age range, and even only adolescents in their teenage state. One study limited the age range to participants between twelve and eighteen years of age (Spira & Kenemore, 2004). Such limitations are common in such new studies, and so can be properly addressed within the context of this study to provide more in-depth results.
Alternatives to such qualitative measures have also been taken by researchers to further explore the affect of cancer within the family -- especially adolescent daughters. These studies tend to dominate much of the research conducted previously to this exploration. A common design of this type of method is studying the reaction of the daughter to her mother's breast cancer (Eiser & Eiser, 2000). One particular study was conducted by Cappelli et al. (2005) and used a quantitative design. In this design, comparison groups consisted 55 pairs of mothers and their daughters who had experienced bouts of breast cancer in contrast to the same number of pairs who had not, (Cappelli et. al, 2005). When analyzed through MANOVA methodologies, the study revealed that there was little difference between the two groups (Cappelli et. al, 2005). Yet, this same study did provide evidence that heredity was a major concern for many adolescent daughters who did see first-hand affects of the battle with cancer. Cappelli et. al's 2005 study does provide the need for further information in order to better construct a comprehensive style of dealing with such affects. Yet, the data collected in this style of research fails to provide the in-depth picture of the psychological process of an adolescent girl who has had to deal with her mother's breast cancer. In fact, most quantitative studies fail to allow the female's perspective to be told truly in their own words.
And so, with these methodology designs in mind, this study aims to return to a qualitative approach in order to best explore the issue further. A qualitative design proves to be the best in order to truly examine the realities of the everyday world of a teenage female who is dealing with her mother's breast cancer. It allows the intimate to come through the study and help further develop the treatment and care of individuals dealing with such grief and anxiety. This study will aim to help further connect real life occurrences and affects on the everyday cancer has on adolescent females. With this information, psychologists and other caretakers can benefit from more thorough theoretical basis for their clinical practices. Through further incorporating familial members into the treatment of cancer, psychologists can better fight the after affects of the horrible disease. Previous research has posited the important significance daughters take within the larger familial unit. In fact, they can take a large portion of the care-taking activities for several of the other family roles (Eiser & Eiser, 2000). Better understanding the psychological state of the adolescent daughter can then better help the familial unit to cope with the grief of the disease, along with the care of patients with breast cancer. The study also addresses some of the limitations seen in previous qualitative research. A main point is the growth of the potential sample age range. As stated before, some previously conducted studies have had limited age ranges (Spira & Kenemore, 2004). However, this study has extended the age range to adults who had experienced the traumatic event of their mother having breast cancer while in their teens. The age range of this study starts at eighteen and ends at fifty-five years of age. This then gathers important data regarding the role and distress of the adolescent female as she progresses out of her adolescence and further into adulthood.
Using the previous research of the role and importance of the daughter for treatment of breast cancer patients, the basic research problem of this study aims to explore the experience of the daughter within the context of the mother having breast cancer. Out of the extensive research cancer has on family members, relatively little has been conducted fully to the study of breast cancer patients and their adolescent daughters, (Spira & Kenemore, 2004). However, there is a body of research will helps provide the construct of this study. Earlier research has shown the need to further discern both the daughter's psychological stress caused as a result of breast cancer, along with her role in her mother's treatment, (Eiser and Eiser, 2000 & Romar et al., 2002). And so this study aims to gather a better understanding of the role of the daughter and how that role is affected by the anxieties seen in many of whom who have mothers with breast cancer.
In summary, a literature review was conducted to examine existing research about how daughters' experience their mothers' breast cancer. Since some daughters' experiences may be similar to those of other family members, this discussion will also include an exploration of spousal, sibling, and parental reactions to breast cancer. The last section will include a description of relevant research about daughters of mothers with breast cancer. Most of this research included studies about the following topics: 1) daughters' psychological distress, 2) daughters' uncertainty, 3) daughters' dealing with intrusive thoughts, 4) daughters' overestimation of risks to breast cancer, 5) daughters' beliefs that things will work out for themselves in the future, 6) and the nature of the mother-daughter relationship.
The literature review demonstrated that this proposed study will be significant to the field of psychology because of the existing gap of knowledge in this area, as well as the importance of knowing the experiences of daughters whose mothers have breast cancer, from the daughters' perspective. This study will use an integrative review that presents a "state of knowledge" relevant to a subject and draws inferences and conclusions based on studies and other literature that are reviewed (Moustakas, 1994, p. 12). Through understanding the everyday experiences of the adolescent daughter, further expansions of treatment both for the breast cancer patient along with the family as a whole will prove to have positive affects on the current discourse in progress regarding the topic.
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