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Table 4 Strains and stressors of families when a mother has cancer including illustrative quotes

From: When a mother has cancer: strains and resources of affected families from the mother’s and father’s perspective - a qualitative study

Themes Quotesa
General impact of the disease
 Immediate consequences of diagnosis and treatment “I am sensitive to everything I have to take. My body has completely rebelled. I threw up and felt so miserable. I fully collapsed.” (Single mother of two children)
 Practical and social changes “Well, at the moment it’s like you just can’t go on as before. Of course you do everything a bit slower or you just leave things undone. You tell yourself that it’s just not possible right now.” (Mother of two sons)
 Strong emotions “You get depressed. At least I did. I was never like this. I was always a fun-loving person. But eventually it catches up with you and you ask yourself why.” (Mother of two children)
Strains and stressors regarding the parental role
 Changes of the self-concept as a parent (e.g. other family roles, attachment) “My child is still there and makes demands. I am quickly irritated. I still have the same expectations even though I keep trying to lower them. It’s frustrating not being able to manage [everything] as before.” (Mother of one daughter)
“Certainly, one way or another, there has been a shift […], when I don’t have to work […], when you say ‘let’s go to the zoo or ride our bikes by ourselves’. So my wife can relax for half a day or at least for a couple of hours. Certainly, this has shifted […].” (Father of one daughter)
 Feelings of guilt “I am so sorry that they have a sick mother. But I do the best I can.” (Single mother of two children)
 Fears and concerns about the children (e.g. emotional consequences for children) “The worst thing for me was to see my child every day and to think that I will not be able to watch her grow up. Psychologically, this was the worst – the constant fear that I won’t be able to watch her grow up because she was so young.” (Mother of one daughter)
“But as far as I can see, for now it’s working quite well. While I am not worried at the moment I certainly do pay attention. Especially to him since he is a little older. I’d say that it is normal that he thinks and sometimes asks a question about it. I just want to make sure that he does not become too preoccupied.” (Father of two children)
 Communication about the disease “Especially stressful was to figure out what to say. It still bothers me a bit. What do we say, how do we say it, or should we say anything at all. He came to the hospital, so he knew that I was sick and had surgery. We decided against telling him the whole truth. Since I was unable to lift him, we told him that I had a bad arm. ‘Mom can’t lift you up because she has bad arm. And to make sure she gets well we are here and do exercises and other things.’ I think this is okay. He accepted it. As I said, I really did not want to tell my 4-year-old exactly what is wrong with me.” (Mother of one son)
“Seeing my wife suffer hurt me. It also became increasingly more difficult to explain to the children ‘mom is not doing well and has to sleep.’ So it was good that therapy ended after 6 treatments.” (Father of two children)
 Increase of responsibilities and pressure (e.g. balancing multiple needs, work, time for kids) Then I spent a lot of time at home and tried to deal with him as usual. Even when I was not doing well I tried to hide it and not allow him to see my pain. (Single mother of one son)
“When one parent drops out, you become solely responsible. You have to change the diapers, tuck them in at night, cook, etc. I think that this fact caused the intensity [of responsibilities] to increase.” (Father of two children)
 Additional burden of single mothers “To me it is important, to consider the constellation of the family. It is a huge difference to be in a partnership or not. And if being single parent, one needs to consider the relationship between the ex-partners. In my case it is horrible and an additional stressor.” (Single mother of one son)
“He (ex-partner, father of the children) thinks he should take away my children. And that I am the reason for him (the son) having difficulties at school.” (Single mother of two children)
Impact on the children (Mothers’ and fathers’ perspective)
 Confrontation with disease and consequences “The oldest also had a hard time dealing with the illness. You could tell that she was thinking about it a lot. She will turn 7 in September. At times she would become very quiet.” (Single mother of two children)
 Behavioral changes “My son’s difficulties became apparent at school. Now it is obvious that he has issues.” (Single mother of two children)
 Fears and concerns/strong emotions “Although it has faded a bit, this autumn he had quite fears of abandonment. He was clinging, he was afraid to loose me.” (Mother of two children)
 Seeing the vulnerability of the parents “I think he becomes irritable at times because he sees me as being weak. I was supposed to be his rock […] he has seen me cry and being desperate. He has not before. Then I wonder how he can take it. This could be a burden for him.” (Mother of one son)
 Loss of normal life and activities “I also believe, even though he won’t admit it, […] that he misses my mothering, my taking care of him – definitely.” (Mother of two sons)
  1. aoriginal transcripts in German, quotes have been translated