Developing and Validating a Measure of Chinese Cultural Views of Health and Cancer

Abstract

To develop and validate quantitative scales that measure Chinese cultural views about health and cancer, cultural views were assessed by a 30-item scale through telephone interviews with 438 Chinese-American women aged 50 and older. Cultural subscales were identified using principal component analysis and validated by their associations with age at immigration and breast, cervical, and colorectal cancer (CRC) screening patterns. The overall scale had good reliability (Cronbach's alpha = .79). Factor analysis yielded seven cultural subscales-fatalism, hot-cold balance, use of herbs, self-care, medical examination, lifestyle, and Western medicine (alpha = .39 to .82). The majority of the cultural subscales were significantly associated with age at immigration (p < .001). Fatalism, Self-Care, and Medical Examination subscales consistently predicted nonadherence to breast, cervical, and CRC screening recommendations, even after considering other factors. Chinese cultural views consist of at least seven domains and may influence older women's breast, cervical, and CRC screening.

Hepatitis B Screening Practice among Older Chinese in the Greater Washington, DC, Area

“…17 This two-item scale (“As long as I can take care of myself and keep myself healthy, I don't need to see a doctor” and “I don't visit doctors if I'm not feeling sick”) has been validated in various Chinese populations (Cronbach α 0.83) and was predictive of Chinese Americans’ cancer screening behaviors. 20,24 Participants responded to each item with a range of options from 1(strongly disagree) to 5 (strongly agree).…”

“…Traditional Chinese believe that self-care (taking care of one's health through regular exercise and healthy diet to prevent illness) is a more desirable preventive strategy than regularly visiting physicians. 17,18 Self-care beliefs have been found to predict Chinese and Asian American women's low breast and cervical cancer screening rates. 19,20 Such a culturally based belief may be a key determinant of older Chinese Americans’ HBV screening behavior in addition to knowledge and access factors.…”

Results of a Randomized Controlled Trial Testing the Efficacy of a Culturally Targeted and a Generic Video on Mammography Screening among Chinese-American Immigrants

“…Eastern cultural views of healthcare were assessed by two subscales: fatalism and self-care were adapted from the Chinese Cultural Views of Healthcare scale and reliable at .82 and .73, respectively (44). The 9-item fatalism (e.g., I cannot control my destiny) and 4-item self-care (e.g., I don’t visit doctors if I’m not feeling sick) scales were found to predict Chinese-Americans’ cancer screening behaviors in previous studies (25, 45).…”

Support needs of Chinese immigrant cancer patients

“…Linguistic, cultural, and financial barriers, and limited knowledge about cancer and its treatment, and how to navigate complex health care systems, contribute to make this population especially vulnerable to poor cancer outcomes 14,25–27 . Asians are at lower risk for some cancers, but have higher rates of other cancers, including liver, gastric, nasopharyngeal, and cervical cancers 21 , and are the only major population group in the U.S. that has a higher annual number of deaths from cancer than from heart disease 27 . Five-year breast cancer survival among immigrant Chinese (0.74, 95% CI=0.72–0.77) is worse than among US-born (0.79, 95% CI=0.76–0.81), with an adjusted hazards ratio of 1.22 (95% CI=1.06–1.40) 20 .…”