Cultural attitudes to cancer management in traditional South‐East Asian patients

Abstract

Cultural differences might influence patients' attitudes to decision-making for cancer management. In a Western medical system promoting shared decision-making and patient autonomy, the effects of traditional South-East Asian cultural and religious attitudes might provoke confusion for both the patient and health-care provider. Especially in oncology, these beliefs might influence patients' perceptions of diagnosis, symptoms, interventions and approaches to death. For the clinician, the potential conflicts in patient disclosure and discussion of diagnosis are evident, as well as patient avoidance of certain interventions. This review article explores the background and interpretation of cultural aspects experienced by Australasian-trained oncologists working in Singapore. Explanations of traditional health beliefs of South-East Asian patients are outlined, and provide a perspective for oncologists managing similar patients within Australasia's multicultural community.

Ethnic Experience of Cancer: A Qualitative Study of Chinese–Australians in Brisbane, Queensland

“…A sick person is thus expected to seek help from immediate and extended family before turning to professionals and the government. This family-centered model of health care service is significantly different from the patient autonomy model that prevails in the western societies (Ong, Michael & Jiade, 2002).…”

“…Cross-cultural studies of cancer experiences have revealed that there are major differences in the understanding of the disease and in ways of coming to terms with it (Ashing Giwa et al, 2003;Domino, Fragoso & Moreno, 1991;Domino & Regmi 1993;Kagawa-Singer, 1993;Kagawa-Singer, 1996;Kagawa-Singer, Wellisch & Durvasula, 1997;Mathews, Lannin & Mitchell, 1994;Ong, Michael & Jiade, 2002;Papadopoulos & Lees, 2002;Thorne & Murray, 2000). Specifically, there are cultural differences in belief of risk and participation in cancer screening services (Garcia & Lee, 1988;Navon, 1999;Vernon et al, 1992), decision making on life and death issues (Hosking et al, 2000;Kagawa-Singer & Blackhall, 2001;Kaufert, 1999;Klessig, 1995), practices of disclosure and communication (Blackhall et al, 1995;Butow, Tattersall & Goldstein, 1997;Gautam & Nijhawan, 1987;Goncalves & Castro, 2001;Gordon & Paci, 1997;Kagawa-Singer & Blackhall, 2001;Mitchell, 1998;Mullin, Cooper & Eremenco, 1998;Mystakidou et al, …”

Studying Cost as a Factor in the Choice between Quality and Quantity of Life amongst Patients with Cancer and their Caregivers at a Cancer Centre in Singapore

“…Although it may be argued that family members are not obliged to do so, they often do in the face of regnant sociocultural beliefs that emphasize familial obligations to care for ill family members [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18].…”

“…First, the continued dominance of family centric decision-making in end of life care, where decisions may favour the family's interests rather than the patient's. Second, local conceptions of Confucian inspired filial piety which requires that the family provide for the financial, physical, social, spiritual and emotional needs of the patient in recognition for their previous contributions to the family or as a result of their place within the family unit [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. Third, mounting care costs do create potential for conflicts of interests in meeting the duty to care for the patient and the primacy placed on protecting the interests of the family.…”

Tairyokuas a belief system of health and illness: a study of cancer patients in Japan

“…Qi is also thought to 'manifest itself through the polar forces of yin and yang, which must be brought into balance for the enjoyment of health' (Martin 1989, 127, cited in Chui, Donoghue, andChenoweth 2005, 499). The concept of yin and yang is 'a system that exists within each human body, and its balance ensures good health and immunity against disease' (Ong et al 2002). A study on responses of Chinese-Australian patients to advanced cancer conducted by Chui, Donoghue, and Chenoweth (2005) demonstrated that when patients encountered acute crises (e.g., the news of a diagnosis of cancer), they felt that their qi was out of control, and they were not in a state of harmony or balance between yin and yang.…”