Eye on Religion: Cultural Signs and Caring for Chinese Patients

Development of the Chinese version of Meaning in Life Scale for cancer patients and psychometric evaluation

AIMS AND OBJECTIVES

To develop a Meaning in Life Scale for cancer patients in Chinese version and to test the validity and reliability.

BACKGROUND

Meaning in life is a protective factor of psychological well-being and is negatively related to depression and demoralisation among cancer patients. The existing scales measuring meaning in life are mostly designed in English and there is no scale designed for Chinese cancer patients based on Chinese cultural background.

DESIGN

Process of instrument development and psychometric evaluation were used.

METHODS

Items were generated from literature review and a focus group interview. Delphi technique was used to test the content validity. Item analysis and exploratory factor analysis were performed with data from 251 cancer patients. The internal consistency of the scale was tested by Cronbach's alpha.

RESULTS

A 25-item Meaning in Life Scale in Chinese version with five domains was developed. The five factors explained 62·686% of the variance. The Cronbach's alpha for the total scale was 0·897.

CONCLUSIONS

The Meaning in Life Scale in Chinese version has acceptable internal consistency reliability and good content validity and acceptable construct validity. The content of the scale reflected the attitudes of cancer patients towards meaning in life based on Chinese cultural background.

RELEVANCE TO CLINICAL PRACTICE

The Chinese version of Meaning in Life Scale for Cancer Patients appears to be a new scale to assess meaning in life among Chinese cancer patients exactly and the concept of meaning in life presented in this scale provides new ideas of meaning intervention in routine clinical practice.

Exploring Meaning in the Life of Chinese Breast Cancer Survivors

BACKGROUND

Breast cancer is the most common cancer among women worldwide, and spiritual fulfillment such as experiencing meaning in life plays an important role in coping with the disease.

OBJECTIVE

The objectives of this study were to explore and understand Chinese breast cancer survivors' perspective on meaning in life.

METHODS

This study used Grounded Theory; 23 participants were recruited using convenience sampling, purposive sampling, and theoretical sampling. Semistructured interviews were conducted, and the data were analyzed using open coding, axial coding, and selective coding.

RESULTS

A core category emerged as "satisfaction with my life" to explain Chinese breast cancer survivors' perspective of meaning in life, and 4 subcategories described the core category including (1) living a healthy and peaceful life, (2) having a good relationship with others, (3) achieving purpose in life, and (4) fulfilling responsibility.

CONCLUSION

Chinese breast cancer survivors value physical health as well as spiritual fulfillment. The experience of adapting to life with cancer, having a good relationship with others, pursuing life goals, and fulfilling responsibility consists of a satisfying life, which makes life more meaningful.

IMPLICATIONS FOR PRACTICE

Health providers should pay more attention to survivors' experience of meaning in life and help them enhance meaning in life and improve their quality of life through building good relationship with others, achieving purpose in life, and fulfilling responsibility for family and society.

Perceptions of caring in China: patient and nurse questionnaire survey

BACKGROUND

The concept of caring is important to both patients and nurses. If patients and nurses perceive caring behaviours differently, patients may not have their needs met or will be dissatisfied with the nursing.

AIM

This study conducted in mainland China compared the perceptions of nurses and patients concerning nurses' caring behaviours.

METHODS

From November 2011 to June 2012, 680 patients and 540 of their nurses in five hospitals in southern, central and eastern China were invited to complete a descriptive comparative survey with four subcategories, the Caring Behaviors Inventory-24. Respondents scored each of the 24 items on the survey from 1 (low) to 6 (high). Of those invited, 595 patients (87.50%) and 445 (82.41%) nurses completed the survey.

RESULTS

The mean item score on the Caring Behaviors Inventory-24 was 4.32 and 4.96 for patients and nurses, respectively. The subcategory with the highest mean score for both groups was knowledge and skills (4.73, 5.25), and the lowest for both groups was positive connectedness (3.98, 4.51). Nurses' scores were significantly higher than those of patients for all four subcategories (P < 0.001).

CONCLUSIONS

The gap between the two groups indicates that nurses need to improve their understanding and response to patients' actual and perceived needs and expectations. In China, patients require more support from nurses of their psychological needs.

STUDY LIMITATIONS

Participants came from a limited number of hospitals in three cities. A larger sample from different hospitals in mainland China could have increased the power of the study.

Fathers of children with disabilities: encounters with health professionals in a Chinese context

AIMS

The aim of this study was to examine the experiences of fathers of developmentally disabled children during interactions with health professionals in Taiwan.

BACKGROUND

The role of Chinese fathers in raising a disabled child has been neglected because most studies on the impact of parenting a child with disabilities in this culture have primarily focused on mothers.

DESIGN

A hermeneutic phenomenological approach was undertaken to recover and interpret fathers' experiences.

METHOD

Sixteen fathers living with their disabled child (0-18 years old) were purposively recruited from a teaching hospital in central Taiwan. Data were collected using in-depth interviews and journal notes. All participants were interviewed twice. Interviews lasted from 50-100 minutes, and all were recorded.

RESULTS

Three shared meanings were attributed to fathers' interactions with health professionals: (1) experiencing no supportive communication, (2) missing the critical time for disability management and (3) being excluded from medical decision making.

CONCLUSIONS

Fathers in Taiwan commonly rely on health professionals to solve their child's health problems owing to their perceived power to cure and their professional authority in Chinese society. However, fathers felt powerless and hopeless when they received unclear information and incorrect diagnoses, which delayed appropriate treatment. Expressions of dissatisfaction and possessing a sense of futility were common experiences related to exclusion in a paternalistic healthcare system.

RELEVANCE TO CLINICAL PRACTICE

Taiwanese clinicians' attitudes and parental-professional relationships challenge an exploration of ethics and standards of medical care shaped by Chinese culture. Ways of promoting parental inclusion in decision making and care, in particular father's inclusion, need to be explored. Recognition of the Chinese mother and father and their differing parental healthcare experiences are important to understand to ensure improvement in encounters with health professionals and the maximisation of positive health outcomes.

"A struggle between vanity and life": the experience of receiving breast reconstruction in women of Taiwan

BACKGROUND

Understanding the role of sociocultural factors on women's experiences of breast reconstruction is needed to provide better care and avoid erroneous assumptions of these women's needs.

OBJECTIVE

The purpose of this study was to understand the lived experiences of Taiwanese women with breast cancer who receive breast reconstruction following mastectomy in Taiwan.

METHODS

A qualitative research design, guided by the philosophy of hermeneutic phenomenology, was selected to guide the study. In-depth interviews were conducted 1 to 2 times with each participant and explored the women's experiences related to making decisions about, undergoing, and recovering from breast reconstruction.

RESULTS

Seven women who received either autologous breast reconstruction or saline implants were recruited in southern Taiwan. Five themes were identified, including "dream of a wonderful future," "unexpected reality," "struggling to accept," "balancing vanity with life priorities," and "coming to terms: no regret."

CONCLUSION

Taiwanese women felt ambivalent about their new breasts, which failed to meet their expectations. This ambivalence, combined with a culture that values selflessness and the placement of family first, resulted in many women feeling guilty, vain, and superficial for requesting breast reconstruction.

IMPLICATIONS FOR PRACTICE

Clinical implications include the importance of regular and authentic patient-health care provider communication throughout the process of breast reconstruction, including recovery, and better acknowledgement of Taiwanese women's body image concerns associated with breast reconstruction.

'Making the best of it': Chinese women's experiences of adjusting to breast cancer diagnosis and treatment

AIM

This paper is a report of a study to describe Chinese women's experiences of adjusting to breast cancer diagnosis and treatment.

BACKGROUND

Breast cancer is the most common cancer in women, and its diagnosis and treatment are pivotal life-changing events that prompt women to make immediate adjustments. Adjustment to breast cancer has been studied as a way of coping with a stressful event and adapting to chronic illness. Adequate adjustment through coping and adaptation leads to successful completion of treatment and improved quality of life.

METHOD

A descriptive phenomenological method was used, and 22 Chinese women were interviewed at a large cancer centre in Beijing, China, in 2004-2005.

FINDINGS

Facing breast cancer, Chinese women tried to 'make the best of it'. The essences of Chinese women's experiences were: facing the reality of cancer diagnosis, taking an active part in the cancer treatment, sustaining an optimistic spirit, sustaining physically, lessening the impact of cancer on others, and reflecting and moving on. Chinese women had similar perceptions of breast cancer to women in western countries as a fearful, stressful, life-threatening and life-changing event, and some of their intentions and actions were also similar to western women's coping strategies. However, their experiences of adjusting to breast cancer also reflected Chinese historical, social and cultural influences.

CONCLUSIONS

Our findings have implications for healthcare professionals also in countries with Chinese migrants, and could be used as a basis for information and emotional and social support interventions as these can be effective in promoting adjustment to breast cancer.