Changes in responsibility in women's families after the diagnosis of cancer

It is undisputed that the diagnosis of cancer catalyzes a time of family disruption and that it is important for the family to cope constructively during this time. Little is known, however, about what families actually experience, about what aspects of family life change as members learn to live with cancer. Despite this gap in knowledge families themselves and the health care system are expected to respond constructively. The result is expensive overlaps or gaps in service and sporadic, uncoordinated care.

Using quantitative and qualitative measures Project Family Focus addressed this knowledge gap. Two areas of family behavior were investigated during this first year of living with cancer, (a) changes in responsibility distribution and (b) changes in use of support systems.

In 27 of the Canadian families studied, the patient was female and was treated for breast cancer. Results specific to changes in responsibility distribution in these families reveal that adult females carry a disproportionate percentage of household responsibility prior to their diagnosis of cancer. Although other family members assume more responsibility during the treatment and recovery period, the household labor distribution continues to be skewed toward adult females. This finding is especially true in partnered families. Within a year, prediagnosis responsibility distributions return with adult females again carrying out most of the household activities.

Implications for women and for health care workers involved with breast cancer clients are presented.