Methods: To be eligible for the study, participants were: (a) currently receiving treatment or being closely monitored during the post-treatment phase; (b) mothers of at least one child age 12 or younger; (c) diagnosed at least 2 months but not longer than 3 years prior to the study. Grounded theory was used to analyze interviews and examine the following questions: How do mothers describe their relationship with daughters during their cancer experience? What relational competencies facilitate mothers and daughters' efforts to retain their bond while coping with cancer? What relational ruptures become barriers to their relationship? How do the mothers attempt to repair relational ruptures? The analysis comprised of (a) open coding that resulted in 220 codes from single words, sentences or paragraphs, (b) axiom coding which categorized codes in subcategories based on the theoretical assumptions of RCT, and (c) selective coding in which a core category was identified and systematically related to other sub-categories. Authors reviewed each other's codes and sought to find disconfirming evidence relative to the emerged findings. Reflections, notes, and summaries of the data were kept to account for transparency and clarity about the analytical procedure.
Results: Majority of women (90%) reported a closer relationship with their daughters during the cancer experience. Fear, anger, and guilt in relation to their daughters were some of the ruptures which threatened the mother-daughter bond. These ruptures were repaired through a consistent reliance in relational competencies or one's capacities to move or affect a change in the relationship and the well-being of members of a relationship. Participants reported an increase in three relational competencies, a) anticipatory empathy (sensitivity about the impact they made in each other), b) mutual empowerment (mutual capacity to empower one another) and c) authenticity (full presence in relationship without the fear of the abandonment). The positive impact of the relationship growth transcended the boundaries of a dyadic relationship. Mothers and daughters experienced an increase in spiritual awareness, motivation for self-development, and an inspiration to help others.
Implications: The study furthers our understanding of how the stressful experience of cancer can be transformed into growth-enhancing experience for mothers and daughters. The findings inform social work practitioners and researchers that relational competencies are critical to helping mothers and daughters retain their bond while adjusting to cancer, and that a close mother-daughter relationship is critical to mothers' effective coping with cancer. Psychosocial interventions that utilize strengths-based and relational approaches are recommended for cancer-diagnosed mothers and their daughters.
