Chinese Cultural Beliefs about Breast Cancer and Breast Self-Examination

乳癌和乳房自我檢查的中國文化信念

顧雅利(Ya-Lie Ku)

《安寧療護雜誌》 9卷4期 (2004/11) Pp. 313-335

https://doi.org/10.6537/TJHPC.2004.9(4).1

摘要

臺灣的疾病型態已經由急性轉變為慢性，且有很高的癌症發生率，包括乳癌。癌症也為臺灣的主要死亡原因，而乳癌死亡率也超越子宮頸癌。中國婦女乳癌和乳房自我檢查的研究大多為量性，且以健康信念模式為基礎。未發現有企圖確認健康信念模式中之中國文化變項的基礎研究。因此本民族科學研究目的乃在探索健康信念模式中，中國婦女乳癌和乳房自我檢查的文化信念。Meleis(1996)的文化專業原則使用於成為研究過程的指引。此研究使用最大變異原則來徵收個案，並個別訪談中國婦女。依照發現主題的重覆性來決定最後的樣本數。內容分析牽涉到分析並對照訪談的資料和反應，以萃取出另類主題並修正之。由37個婦女中抽出6位個案測試分析者間的信度達90%。研究發現確認出健康信念模式中有許多中國婦女乳癌和乳房自我檢查的中國文化信念。例如，報應、輪迴，命運、風水（易感性）；脂肪瘤，聽天由命，求神問卜，因禍得福（嚴重性）；仁（利益性）；鐵齒，沒消息為好消息，閉塞，無自我（障礙性）；忌諱（行動刺激）。這些既定的文化信念深深地埋於一些中國婦女內心，且與中國哲學，宗教思想，家庭價值，文化禁忌相互交織成實施乳房自我檢查的主要障礙。此文化研究對健康照護專家的未來建議將為1.告知健康照護專家中國文化信念2.發展尊重中國婦女文化信念，但能提供正確資訊之病患衛教教材3.設計包括中西式的預防指引策略。

關鍵字

文化信念 ； 健康信念模式 ； 乳癌 ； 乳房自我檢查

並列摘要

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.

並列關鍵字

cultural beliefs ； health belief model ； breast cancer ； breast self examination