Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Cultural and Linguistic Isolation: The Breast Cancer Experience of Chinese-Australian Women - A Qualitative Study

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Cultural and Linguistic Isolation: The Breast Cancer Experience of Chinese-Australian Women - A Qualitative Study

Article excerpt

INTRODUCTION

Breast cancer and its treatment is invariably a stressful experience with the potential to impact on many dimensions of a woman's life (Al-Ghazal, Fallowfi eld, & Blamey, 2000; Fobair et al., 2006; Utley, 1999). The diagnosis of breast cancer confronts women with a number of physical and psychological issues, including fear of death, changes in body image, concern for one's family, fear of recurrence, and discomfort caused by the side-effects of treatments (Boehmke & Dickerson, 2005; Holmberg, Scott, Alexy, & Fife, 2001; Luker, Beaver, Leinster, & Owens, 1996). This can cause signifi cant emotional distress, and the surgical removal of a breast can profoundly affect a woman's sexuality and body image (Anagnostopoulos & Myrgianni, 2009; Helms, O'Hea, & Corso, 2008; Holmberg et al., 2001). Many studies have examined the experience and psychosocial needs of Western women and women from other cultural groups (Lindop & Cannon, 2001; Manuel et al., 2007; Minstrell, Winzenberg, Rankin, Hughes, & Walker, 2008; Thewes, Butow, Girgis, & Pendlebury, 2004). Despite Australia being a multicultural society, to date there had been not a single study of the breast cancer experience among Chinese-Australian women (Kwok, Fethney & White, 2010).

Studies reveal that a breast cancer diagnosis may be more detrimental to the well-being of women from minority cultures compared to their counterparts in the host country (Aziz & Rowland, 2002; Henderson, Gore, Davis, & Condon, 2003; Janz et al., 2008). This disparity may be due to the lower socioeconomic status and limited English profi ciency of migrant communities and their limited understanding of the Western medical system. this is probably also true for Chinese-Australian women has been demonstrated by studies which have identifi ed language issues (Kwok, Cant, & Sullivan, 2005) and cultural beliefs about cancer (Kwok & Sullivan, 2006) as the key barriers to attending screening services.

A number of studies outside Australia have investigated the breast cancer experience in immigrant Chinese women. These descriptive studies, based on the use of questionnaires, have explored the effect of breast cancer on quality of life and the factors contributing to decision-making about treatments (Cui et al., 2004; Fielding & Lam, 2004; Yeo et al., 2004). Chinese-American women were reported to have signifi cantly lower levels of help and social-support seeking behaviour and to have differing concepts of self-image (Wellisch et al., 1999). Asian-American women's cancer experiences and treatment decisions were profoundly infl uenced by cultural beliefs relating to the central role of the family, the role of women and the concepts of self-image and self-sacrifi ce (Ashing, Padilla, Tejero, & Kagawa-Singer, 2003). In particular, the women's primary concern was to survive for the sake of their children, rather than maintain an image of femininity and beauty for their husbands. Similarly, a study (Lam & Fielding, 2003) of Hong Kong-Chinese women found that none of the participants had concerns about the impact of breast loss on their sexual relationships or sexuality. To date, no study has explored Chinese-Australian women's experiences.

According to the 2008 census, ethnic Chinese form the largest group of immigrants from a non-English speaking country living in Australia. The Chinese-born population increased 12-fold between 1981 and 2008, and currently comprises 6% of the overseas-born population (Australian Bureau of Statistics, 2008). The state of New South Wales has the largest Chinese immigrant population (New South Wales Government Department of Planning, 2010). Although women of Chinese ancestry have a lower incidence rate of breast cancer than Australian-born women (Australian Institute of Health and Welfare, 2009), they are at higher risk of being diagnosed with breast cancer compared to their counterparts in China (Grulich, McCredie, & Coates, 1995). …

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