Research That Matters (January 17 - 20, 2008)

Background: This qualitative study examined cultural beliefs and quality of life (QOL) among Chinese immigrants in San Francisco who had been diagnosed with cancer within the past two years. The specific aims of the study were to explore participants' experiences and beliefs regarding breast cancer and life expectancy and to examine how these beliefs related to patients' QOL.

Methods: In-depth semi-structured interviews were conducted with 15 Chinese breast cancer survivors. Participants, who were recruited from the Chinese Hospital in San Francisco included Chinese women who were diagnosed with breast cancer within two years and living in the United States for less than 10 years. Bilingual researchers with high levels of Chinese literacy conducted the interviews in Cantonese or Mandarin. Interviews lasted from sixty to ninety minutes and were transcribed professionally in the participants' spoken language. Led by the PI, interview data were analyzed in a series of steps that resulted in key themes about participants' cultural beliefs and QOL. Themes and illustrative participant quotes were first translated into English and back translated to Chinese to ensure accuracy of data including subtle meanings. Although efficiency and accuracy may be achieved by using qualitative data analysis software such as Nudist, the transcripts have to be translated into English first for that purpose. However, cultural meanings of certain phases would have been lost or compromised if translation was conducted at the early stage of data analysis.

Results: Study participants revealed the importance of the family in providing both financial and emotional support that enhanced their quality of life. For some of these women extended family members such as adult siblings, grandparents and cousins were especially important. Although the importance of family is not unique to Chinese culture, our study participants seemed to assume the importance of family in all cultures. Not surprisingly, participants also noted challenges associated with managing their family responsibilities while receiving treatment. Specifically, participants voiced difficulties caring for themselves during treatment when they were trained to view family as their priority. With regard to medical information, participants preferred getting news directly from their physician but wanted family members to be included in discussions of treatment options.

Conclusion: Findings from this study underscore the importance of the family in shaping quality of life for Chinese breast cancer survivors. Therefore, it is crucial for social workers to partner with family members when working with Chinese patients diagnosed with breast cancer. If family members are not perceived as a stressor by the patient, then they can be considered as supports readily available for the patient.