This paper reports a study exploring how traditional Chinese life philosophy, including fatalism, influences understanding of the concepts of health and illness, and the impact of these concepts on cancer screening behaviour.
The language of risk is central to contemporary Western understanding of health and illness. Women aged over 50 years are considered at risk of developing breast cancer and are highly recommended to undergo regular mammographic screening. However, screening rates among Chinese women are consistently lower than for most other groups.
In-depth interviews, in Cantonese, were conducted with a convenience sample of 20 Chinese-Australian women, and the data analysed thematically, using case summaries, coding and matrix tables. The data were collected in 2001.
The findings revealed that when dealing with cancer prevention, Chinese-Australian women are heavily influenced by cultural traditions related to the life-cycle and disease prevention. Informants believed that contracting disease, including cancer, is inevitable and that there is no way to prevent it. Fatalism appears to be a significant barrier to their participation in cancer screening services.
Our findings suggest that the effects of breast cancer screening and other health promotion programmes, which are general and do not take account of cultural variations may be compromised when it comes to cultural minorities. In the case of older Chinese-Australian women, breast cancer screening promotion programmes may overcome acceptance of fatalistic philosophy if they emphasize increased risk following immigration.
"In addition, self-care practices emphasized in TCM counter essentialist claims about reluctance to seek healthcare. In particular, the focus on diet as a natural way to prevent diseases or delay the onset of diseases related to aging are not essentially contradictory to Western preventive medicine (Kwok & Sullivan, 2006; Wang et al., 2009). "
"Current evidence implies that Chinese women are reluctant to participate in breast cancer screening practices     . Non-participation is associated with deficient education on benefits of screening, perception that lifetime risk is low      , so why tempt fate by screening when you feel healthy? There is also a lack of time, financial constraints  . "
[Show abstract][Hide abstract] ABSTRACT: In Eastern Asia, as the incidence of breast cancer continues to increase yet compliance with breast cancer
screening in older Chinese women who are at risk of early stage breast cancer is poor. This meta-ethnography explored breast cancer awareness, attitudes and breast screening behaviour in older Chinese women. Nine qualitative studies were appraised using CASP tools. Many Chinese women believed that illness is preordained, therefore mammography was a futile exercise. Older Chinese women held erroneous views of breast cancer, and believed that if they developed this form of cancer they would hide the disease from their family due to perceptions of bad luck and derision for both the cancer patient and their family. There is a great need for targeted breast health educational programmes for Chinese migrant women that educate women to participate in mammography and promote acculturation and health education. Future public health programmes need to target older Chinese women.
"These fundamental differences in models of illness highlight the importance of attending to cultural influences when attempting to change behaviours linked to disease prevention. Kwok and Sullivan (2006b) also pointed out the importance for addressing and integrating culturally specific health beliefs in health promotion interventions that are oriented towards the Chinese migrants. Other consistent outcomes have been reported; Wang et al. (2007) found that after viewing a culturally-tailored video, including physician-recommendations, Chinese women's screening intentions significantly increased and they were less likely to subscribe to an Eastern view of health. "
[Show abstract][Hide abstract] ABSTRACT: Background:
The study investigated the influence of culturally-based health beliefs on engagement in healthy lifestyle behaviour. Specifically, the study compared levels of engagement between Western and Chinese youth in Australia and assessed the extent to which culture-specific attributions about the causes of illness, and health beliefs, predict engagement in healthy lifestyle behaviour.
Materials and methods:
Ninety-four Western and 95 Chinese (N=189; Mean Age=20.8 years, SD=3 years) young adults completed an online questionnaire. Predictor variables were cultural health beliefs measured by the Chinese Cultural Views on Health and Illness scale (CCVH, Liang et al., 2008), and illness attributions beliefs measured by the Cause of Illness Questionnaire (CIQ, Armstrong and Swartzman, 1999). Outcomes variables were levels of engagement in healthy lifestyle behaviour.
Results indicated that Chinese participants have a significantly lower exercising rate and healthy dietary habits compared to the Western sample. Moreover, Chinese participants were found to believe more strongly than Westerners that cancer was associated with factors measured by the Traditional-Chinese-Model (TCM). Finally, the observed relationship between cultural health beliefs and physical inactivity was mediated by attributions of illness, in particular to the supernatural subscale, with the Sobel Test showing a significant mediation (z=-2.63, p=0.004).
Mainstream approaches to encourage healthy lifestyles are unlikely to be effective when educating Chinese youth. Instead, health promotion programs should attempt to address the illness attribution beliefs and educate Chinese youth about the role of diet and exercise in prevention of diseases such as cancer.
Asian Pacific journal of cancer prevention: APJCP 05/2013; 14(5):3293-3298. DOI:10.7314/APJCP.2013.14.5.3293 · 2.51 Impact Factor
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