“Adaptive communicative behavior of mothers and their adult daughters after a breast cancer diagnosis.” (2006-2008):
While completing doctoral training and dissertation research at Penn State University, Fisher produced the first communication-focused study to examine breast cancer as a transitional point in the mother-daughter relationship in an effort to understand how their interactions affected their ability to adjust and cope with the disease. This study was funded at the federal, local, and private levels and included support from the National Institute on Aging (NIA) Predoctoral Training Grant (T32 AG00048), Joseph M. Juran Center Doctoral Award, and dissertation grants from the Penn State College of Liberal Arts. Her findings are the basis of this research program and the foundation of the subsequent studies.
In this initial study, Fisher talked with nearly a 100 mothers and daughters and had more than 300 women complete surveys to capture how breast cancer is not just a woman’s experience, but a mother-daughter experience. She explored their stories to depict how important family communication is to cancer care illustrating how mother- daughter communication can enhance a women’s ability to adjust to the illness. Fisher’s study was part of a larger, social research agenda—and critical need in healthcare—to provide families with a “psychosocial map” on how to cope with this unfortunately prominent disease. The mixed-method study consisted of two phases to collect both longitudinal and cross-sectional data and understand women’s divergent experiences across the life span.
This first phase of the study was an effort to place family communication as central to cancer patients’ survival, particularly mother-daughter communication after a breast cancer diagnosis, and advocate for attention to family communication in cancer care. In the first phase, she used survey methodology to become the first health communication scholar to argue for a theoretical framework (created by developmental, life-span psychologist, Laura Carstensen, and known as socioemotional selectivity theory) that places family communication as central to wellness when adjusting to a life-threatening health diagnosis like breast cancer. Families are oftentimes not incorporated into cancer patients’ care plans nor given psychosocial support to help them communicatively navigate and manage the many stressors associated with this disease.
In the second phase of the study, Fisher sought to capture what this family communication looks like and how it can both positively and negatively impact diagnosed women’s adjustment to the disease. In this phase, she examined mother-daughter communication when coping with breast cancer by exploring three important areas of their communicative experiences: 1) their emotional support communication that is both helpful (e.g., listening) and not always helpful (e.g., positive talk); 2) how open they were with one another and why; and 3) how they avoided sharing the disease or kept experiences private from one another and their motivations for doing so. Mothers and daughters were interviewed individually about their experiences and those women still in treatment kept longitudinal daily diaries in which they journaled about their interactions and reported on quality of life. These women were later interviewed again about their journal entries. Fisher also focused on women diagnosed across the life span in order to appreciate that their coping experiences, needs, and preferences vary depending upon their age at diagnosis or their developmental period in life (e.g., women diagnosed in young adulthood, midlife, or later life all participated).
This first study is currently being published in various venues, and Fisher has been invited to present the findings at research conferences, psycho-oncology meetings, universities, and medical institutions. The findings will also be published comprehensively as a future book, Coping together, side-by-side: Enriching mother-daughter communication during the breast cancer journey, with Hampton Press’ health communication book series edited by renowned health scholar, Gary Kreps, Ph.D.