Influence of traditional Chinese beliefs on cancer screening behavior among Chinese American women

ArticleinJournal of Advanced Nursing 54(6):691-9 · July 2006with27 Reads
DOI: 10.1111/j.1365-2648.2006.03872.x · Source: PubMed
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.
    • "Breast cancer, or any form of cancer for that matter, is seen as an inescapable death sentence and that early detection by means of screening will make no difference to that outcome. Moreover, like Chinese immigrant women [15, 21], most women from Africa refuse to think about cancer when they are asymptomatic . In addition it has been suggested in the study conducted by Ndukwe and colleagues [22], that cancer carries a stigma and therefore is a taboo subject or is only discussed in strict confidence [23]. "
    [Show abstract] [Hide abstract] ABSTRACT: Background The Breast Cancer Screening Beliefs Questionnaire (BCSBQ) has been designed as a culturally appropriate instrument for assessing women’s beliefs, knowledge and attitudes to breast cancer and breast cancer screening practices. While it has proved to be a reliable instrument when applied to women of Chinese, Arabic and Korean origin living in Australia, its psychometric properties among women from African backgrounds have not been tested. The aim of this study is to examine the psychometric properties of the BCSBQ among African Australian women. Methods The BCSBQ was administered to 284 African Australian women who were recruited from a number of African community organizations and churches. Factor analysis was conducted to study the factor structure. Construct validity was examined using Cuzick’s non-parametric test while Cronbach alpha was used to assess internal consistency reliability. Results Exploratory factor analysis results demonstrated that the African-Australian BCSBQ can be conceptualized as a 4-factor model. The third factor, viz. “barriers to mammography”, was split into two separate factors namely, “psychological” and “practical” barriers. The results indicated that the African-Australian BCSBQ had both satisfactory validity and internal consistency. The Cronbach’s alpha of the three subscales ranged between 0.84-0.92. The frequency of breast cancer screening practices (breast awareness, clinical breast-examination and mammography) were significantly associated with attitudes towards general health check-ups and perceived barriers to mammographic screening. Conclusions Our study provided evidence to support the psychometric properties of the African Australian women. The study moreover demonstrated that the use of the instrument can help health professionals to understand the beliefs, knowledge and attitudes to breast cancer among African Australian women and also the factors that impact on their breast cancer screening practices.
    Full-text · Article · Dec 2015
    • "Fatalism is a submissive attitude toward cancer anchored by a belief in the inevitability of death. Research shows that traditional Chinese belief systems are conducive to the emergence of fatalistic attitudes about cancer (Cheng et al., 2013; Kwok & Sullivan, 2006). Such attitudes, if left unchecked, may reduce motivations for proactive cancer prevention behaviors (Niederdeppe & Levy, 2007; Powe & Finnie, 2003). "
    [Show abstract] [Hide abstract] ABSTRACT: Cancer is now the leading cause of death in China. Effective communication about cancer risk and prevention is an important component of cancer control. Yet, research in this area is very limited in China. This study used probability sample survey data from 2 Chinese cities (Beijing and Hefei, Anhui Province) to investigate potential predictors of self-initiated cancer information seeking. Analysis showed that cancer information seekers in China were likely to be married, relatively educated, earning modest incomes, living in rural areas, smoking occasionally, having a family cancer history, relatively trusting of the media for health information, somewhat knowledgeable about cancer, having nonfatalistic attitudes about cancer, and seeing a personal need for more cancer information. The pattern of results, particularly the lack of influence of personal health and risk perception factors, highlights the possibility that seeking for others might be more prevalent than seeking for self in China. Overall, findings suggest that emphasizing family need and mobilizing family support might be a productive approach to cancer communication interventions in China.
    Full-text · Article · Apr 2015
    • "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). Chinese traditional culture was not only overrepresented in explaining Chinese immigrant women's health behaviours, but was also misrepresented. "
    [Show abstract] [Hide abstract] ABSTRACT: Considering the growing size and diversity of Chinese immigrant populations in English-speaking Western countries, as well as the socioeconomic vulnerability of immigrant women, this integrative review aims to provide a critical analysis of research on the health experiences of the recent wave of Chinese immigrant women. Fifty-six peer-reviewed research articles, written in English and published between 2000 and 2014, formed the sample for this review. Four themes emerged through postcolonial feminist analysis: (1) dichotomy between Chinese “culture” and Western medicine, (2) essentialization of health beliefs and practices, (3) critique of Western healthcare services delivery from Chinese immigrant women's perspectives, and (4) erasure of institutional responsibilities. The conclusion points out some limitations of this review and discusses the implications these themes suggest for strengthening healthcare systems in English-speaking Western countries where Chinese immigrant women's health experiences are shaped.
    Article · Mar 2015
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