To define the target group appropriately is essential to include all the candidates of the group and to identify the unique attributes of this group. In this paper, as in many other researches in this field, the target group is defined as women who are under age 50 at diagnosis of breast cancer and survived without recurrence or the development of other forms of cancer (Bloom et al. , 2004). This definition has two main implications of the target group’s biological status and life stage (Dunn & Steginga, 2000):
First of all, the women are of child bearing age, which means they have reproductive capacity and they believe that the selves are on the life stage of having children. They may have young children or no child currently. Secondly, the women have not yet reached menopause, which means they can still be sexual active. Due to their relative youth, the target group tends to have more aggressive treatment. And thus, they are especially vulnerable to physical and psychosocial late effects of the treatment (Bloom et al. , 2004). Moreover, the target group is a significant part of all cases of breast cancer.
Hence, to analyze and facilitate the adjustment of this specific group is very salient. Stressors and Concerns According to the previous researches, the target group has three major stressors. First and foremost, because of their vulnerability, the concern and fear of recurrence and other health problems (Dunn & Steginga, 2000) is a chronic stressor that may stay for the whole life of the target group members. Obviously, this stressor has negative valence.
And it is a common issue among all fatal disease survivors. Because it is not unique for the target group, there were not many researches on this topic. 2 ADJUSTMENT OF YOUNG WOMEN SURVIVED BREAST CANCER.
And secondly, the fertility issue is also a major concern of the target group. On the one side, with many women delaying the birth of their first child, a proportion of young women will be childless when they receive the breast cancer diagnosis (Corney & Swinglehurst, 2012). On the other side, biological parenthood is an important goal for most cancer survivors because their experience of cancer may add to their appreciation of parenthood (Moffat et al. , 2012) and the future (Dunn & Steginga, 2000).
Thus, when fertility will possibly be impaired after treatment and they may have to wait for a number of years before pregnancy is advised (Corney & Swinglehurst, 2012), fertility becomes a stressor with strong negative valence. Fertility is an acute stressor because most of the survivors will recover sooner or later. However, most women stated that they didn’t have sufficient information about fertility preservation and that lack of information made them feel depressed and anxious.
Thus, although not all the breast cancer survivors are candidates for fertility preservation practices, it would be essential to inform all the survivors the available options at an early point to facilitate their decision making (Moffat et al., 2012).
Fertility can be defined as a personal non-event, because it shows a life goal of the persons, having children, that’s not fulfilled. And not being able to fulfill that goal caused significant stress to the persons. Finally, sexual problems and body image is the last main concern and stressor of the target group. Sexual problems and body image were experienced by a substantial proportion of women (Fobair et al. , 2006). This stressor is chronic and it has obvious negative valence.
Even with reconstruction, after mastectomy, the women’s body images won’t be the same as they were. And after chemotherapy and surgical treatment, the women’s sexual functioning can be affected significantly (Avis, Crawford, & Manuel, 2004). Addressing these problems is essential to improve the quality of life of the target group (Fobair et al. , 2006). 2 3 ADJUSTMENT OF YOUNG WOMEN SURVIVED BREAST CANCER There are also some less important concerns that have been brought up in previous studies. For example, women reported difficulties of communicating with their physicians and depression related with the communication problem (Corney & Swinglehurst, 2012).
Also, the expectations and stereotypes of women with breast cancer that were set up by publicity and media portrayals were also reported as stressors of the target group, since the images of women with breast cancer are often set as elder women, which makes the younger group feel as outliers (Dunn & Steginga, 2000). Impact on Family Members Breast cancer as a negative life event, affects not only the survivors’ own lives, but also the lives of their family members. Moreover, breast cancer also changes the interaction and relationship between the young women and their spouses and children.
As stated by Fletcher, Lewis and Haberman (2010), there are five categories of spouses’ cancer-related demands. They are concerns about spouses’ own functioning, wife’s well-being and response to treatment, couples’ sexual activities, the family’s and children’s well-being, and the spouses’ role in supporting their wives. The spouses are the wife’s preferred confidant and social support (Fletcher et al. , 2010). However, with too much burden on shoulders, the spouses may hold negative long-range implications for their own health as well as their effectiveness in being a major source of support for their wife (Fletcher et al., 2010).
Breast cancer will also change the mother-children relationship. As Kim, Ko and Jun (2012) suggested in their research based in Korea, from the mother’s perspective, there are five topics of mother-children relationship changes: First, the delicate balance of being able to focus on self; Second, the continuing challenge of taking care of children, which was closely linked to supports, health condition, and cultural notions of parenting and lingering stigma;
Third, the importance of informing children in a timely manner, which means 3 4 ADJUSTMENT OF YOUNG WOMEN SURVIVED BREAST CANCER balancing between telling the truth and protecting the children; Fourth, an overall shift in attitudes towards raising children as independent beings, which caused by switching tracks, as these women could no longer fully perform the socio-cultural role of protective mother due to the challenges of cancer;
Fifth, relinquishing and re-envisioning the future for their children and themselves. It is obvious that culture played a role in this study, since the participants are not ethnically diverse enough. However, by comparing with other studies, Kim et al. stated that the results could potentially be applied to a larger population.