• G C Armsden and F M Lewis.
• Casey Family Program, School of Social Work, University of Washington, Seattle.
• Oncol Nurs Forum. 1994 Jan 1; 21 (1): 39-45.

Purpose/ObjectivesTo describe children's psychosocial adjustment to their mother's breast cancer and to compare their level of adjustment with normative data and with the level of adjustment of children of women with fibrocystic breast disease or diabetes. Hypotheses tested were (a) children of women with breast cancer would be most negatively affected and (b) families of mothers with fibrocystic breast disease would require less family adaptation than families of women with breast cancer or diabetes.DesignOne component of a larger longitudinal survey.SettingUniversity-based physician clinic in a metropolitan area in the Northwestern United States.SampleMothers, predominantly Caucasian, with medically controlled diabetes mellitus (n = 18), nonmetastatic breast cancer (n = 13), or biopsy-proven fibrocystic breast disease (n = 17) and their children (N = 48), who ranged in age from 6 to 12.MethodsFive in-home interviews conducted at four-month intervals.Main Outcome MeasuresBehavioral adjustment using the Louisville Behavior Checklist (maternal report) and the Zeitlin Coping Inventory (nurse-observer report) and self-esteem using the Personal Attribute Inventory for Children (children's self-report).FindingsChildren of women with breast cancer scored better than average on behavioral adjustment (mothers' ratings) and were judged by nurse observers to be better behaviorally adjusted than children in the noncancer illness groups. Children of women with breast cancer and of women with diabetes tended to score significantly lower on self-esteem than the comparative sample.ConclusionsMeasures of childhood adjustment to chronic medical illness in mothers need to distinguish between behavioral adjustment and self-esteem. Discrepancies between child ratings and mother and nurse-observer ratings suggest that differences exist.Implications For Nursing PracticeFindings are preliminary in nature, and other explanations for findings must be ruled out. However, if a child's self-appraisal is affected negatively by the mother's illness, it would be appropriate to identify ways to increase emotional and physical exchange with the child and to interpret inaccessibility in ways that protect the child's positive self-appraisal.

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