Adolescent daughters' response and adjustment to maternal breast cancer

描述(申请人提供)：这项研究的目的是确定母亲患有乳腺癌的青春期女儿使用的不同应对策略，以及这与她们表现出的压力反应之间的关系。还将检查青少年的年龄以及他们与母亲的关系与他们的应对方式的关系。这组青春期的女儿报告说，与正常样本和儿子相比，压力反应的比率增加了25%，特别是焦虑和抑郁。此外，他们还报告了情绪困扰和担忧，以及对参与健康促进活动的恐惧。在最初被诊断为抑郁症的青春期女儿中，有40%会经历第二次抑郁，其中70%会在成年后复发，就像那些母亲患有乳腺癌的女儿一样。青少年用来应对压力的策略可能是压力对当前和未来适应影响的重要中介。例如，那些使用问题解决策略的人比那些使用回避策略的人有更好的心理健康结果。然而，当青春期的女儿面临母亲的乳腺癌时，人们对不同的应对策略以及这些策略如何调节这种影响知之甚少。美国的许多癌症中心每年为20多万新诊断为乳腺癌的女性提供心理社会支持服务。然而，没有针对其处于青春期的女儿应对其母亲乳腺癌的压力的支持性护理服务。在发展这些服务之前，我们需要更多地了解哪些应对策略可以调解母亲乳腺癌的压力，并被纳入任何干预措施。随着这些女儿患乳腺癌的风险增加，对健康筛查产生恐惧，并可能面临终身抑郁，这些都是重要的公共卫生问题，因此必须更多地了解可能调解这一事件压力的应对策略和因素。这项横断面的相关研究将针对90名患有乳腺癌的青少年女儿和她们的母亲，他们是通过纽约大学医学癌症中心和贝尔维尤医院癌症诊所招募的。数据收集将包括面谈时间表和针对青春期女儿的工具，她们使用的不同应对策略，以及她们在确诊后第一年内对孕产妇疾病的适应或痛苦程度。最终，从这项研究中获得的知识将导致制定针对应对措施的干预措施，并促进这一弱势群体的适应。这项关于青春期女儿应对和适应母亲乳腺癌的横断面相关研究解决了三个主要的公共健康问题：在青春期发展抑郁症，这可能导致终生心理健康问题；避免参加有助于更早发现乳腺癌的健康促进筛查，如乳房自我检查；以及基于缺乏信息和对乳腺癌风险的恐惧而降低健康素养。更好地了解哪些应对策略可以调解母亲乳腺癌的压力影响，可以导致针对这一弱势群体的这些关切制定促进健康的干预措施。

DESCRIPTION (provided by applicant): The aims of this study are to determine the differential coping strategies used by adolescent daughters whose mothers have breast cancer, and how this relates to the stress responses they exhibit. Adolescent age, and their relationship with their mothers will also be examined in relation to their coping. This group of adolescent daughters has reported a 25% increased rate of stress responses, specifically anxiety and depression, than a normative sample and than sons. They additionally report emotional distress and worries, and fear engaging in health promoting activities. Forty percent of adolescent daughters who are initially diagnosed with depression, like those whose mothers have breast cancer, will experience a second bout of depression, and 70% of those will have a relapse in adulthood. The strategies that adolescents use to cope with stress are potentially important mediators of the impact of stress on current and future adjustment. For example those that use problem-solving strategies can have a better mental health outcomes than those that use avoidance strategies. Yet little is known about the differential coping strategies used when adolescent daughters are faced with their mothers' breast cancer, and how these mediate that impact. Many cancer centers in the United States provide psychosocial support services for the over 200,000 women newly diagnosed with breast cancer each year. There are no supportive care services however that targets the coping of their adolescent daughters with the stress of their mother's breast cancer. Before developing these services we need to understand more about which coping strategies can mediate the stress of mothers' breast cancer and be included in any interventions. With the increased risk that these daughters face of acquiring breast cancer, developing fear about health screening, and potentially facing life-long depression, all important public health concerns, it is imperative to understand more about the coping strategies and factors that can mediate the stressfulness of this event. This cross-sectional, correlational study will target 90 adolescent daughters and their mothers with breast cancer recruited through the New York University Medical Cancer Center and Bellevue Hospital cancer clinics. Data collection will include an interview schedule and instruments that target adolescent daughters, the different coping strategies they use, and their level of adjustment or distress with the maternal disease within the first year following diagnosis. Ultimately, the knowledge gained from this study will lead to the development of interventions that target coping and promote adjustment in this vulnerable group. This cross-sectional, correlational study of adolescent daughters' coping and adjustment to their mothers' breast cancer addresses three major pubic health concerns: developing depression in adolescence which can lead to lifelong mental health problems; avoidance of engaging in health promoting screening like breast-self exams, that can facilitate earlier identification of breast cancer; and decreased health literacy based on a lack of information and fear regarding their breast cancer risks. A better understanding of which coping strategies can mediate the stressful impact of their mothers' breast cancer can lead to the development of health promoting interventions that target these concerns in this vulnerable population.