Chinese cultural beliefs about breast cancer and breast self-examination

Abstract

The pattern of disease in Taiwan has changed from acute to chronic with a higher incidence of cancer, including breast cancer. Cancer is also the leading cause of death in Taiwan; the mortality of breast cancer has increased and more than cervical cancer. The majority of research on Chinese women's breast cancer and breast self examination (BSE) are quantitative surveys based on the framework of the American Health Belief Model (HBM). Foundational research has not been attempted to identify the Chinese dimensions of cultural variation for the HBM. Therefore, the purpose of this ethnoscience study was to explore Chinese women's cultural beliefs about breast cancer and BSE for the HBM. Meleis's criteria of culturally competent principles (1996) were used in this qualitative study as guides to develop the research process. The study was used individual interviews of Chinese women admitted to the study using maximum varied criteria for inclusion. Final sample size determination depended on thematic redundancy. Content analysis of data involved analysis of interviewing data and contrasting responses to elucidate alternatives and verify themes. Inter-rater reliability finally was approached at 90% from the data of six cases among total 37 women. Findings identified several Chinese cultural beliefs about breast cancer and BSE in HBM. For instance, Bao, Lun Hui, Ming Yun, Feng Shui (susceptibility); Lin Jin, Ting Tian You Ming, Qiu Shen Wen Pu, Yin Huo De Fu (severity); Ren (benefits); Tie Chi, No news is good news, Bi Se, Selfless (barriers); Ji Hui (cues to action) were found in HBM. These predetermined cultural beliefs are deeply embedded in some Chinese women's minds and interweaved with Chinese philosophy, religious thoughts, family values, and cultural taboo that are the major barriers in the motivation to practice BSE. Future recommendations to the health care professionals from this cultural study will be1) to inform health care professionals of Chinese cultural beliefs 2) to develop patient education materials that both respect Chinese women's cultural beliefs and provide correct information 3) to design the prevention protocols for Chinese women that include Western and Chinese styles of strategies.